青少年安氏Ⅱ类错矫治前后错程度及美观效果变化的临床研究
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摘要
目的:探讨正畸治疗青少年安氏Ⅱ类错畸形治疗前后错程度及美观效果变化。方法:选取笔者医院口腔科2014年1月-2016年1月收治的50例安氏Ⅱ类错畸形的青少年患者作为观察组,并选取30例门诊诊断为安氏Ⅱ类错畸形但未接受治疗的患者作为对照组。观察组患者均接受正畸治疗,并于治疗前、治疗后6个月、12个月、18个月进行指数评分量表(IOTN-AC)和美观期待值评价;对照组患者在治疗前(初次)和随访18个月时(末次)进行了这些美观效果评估。对观察组患者治疗前后的前牙覆盖、磨牙咬合关系、中线关系、前牙覆等牙颌畸形指标及软组织情况进行评价,比较患者治疗前后相关指标的差异。结果:观察组患者在治疗前、治疗后6个月、12个月、18个月四个时间点的IOTN-AC分值逐渐降低,美观期待值逐渐升高,每个评估时间点的IOTN-AC、美观期待值与前次的值比较均有显著性差异(P<0.05)。观察组与对照组患者在初次(治疗前)评估时的美观效果无显著性差异(P>0.05);而观察组在末次(治疗后18个月)的IOTN-AC分值明显低于对照组,其美观期待值明显高于对照组(P<0.05);对照组患者初次与末次的IOTN-AC与美观期待值比较无显著性差异(P>0.05)。观察组患者治疗后的前牙覆盖、磨牙咬合关系、中线关系、前牙覆等畸形程度评分均明显低于治疗前(P<0.001)。观察组患者治疗后的软组织面角、全面凸角、下唇基角、上下唇角、下唇倾角、Eangle角、Z角UL、Z角LL均明显低于治疗前,而面型角、面凸角、鼻唇角、唇基角、颏唇沟角、鼻唇角、上唇倾角、H角(软)、H角等指标均明显高于治疗前(P<0.05)。结论:正畸治疗青少年安氏Ⅱ类错畸形临床疗效显著,能有效提高患者牙列美观程度,显著降低患者错畸形严重程度,值得在临床推广应用。
Objective To investigate the aesthetic effects of orthodontic treatment for Class Ⅱ malocclusion in adolescents and the severity of malocclusion before and after treatment. Methods Fifty adolescents with Class II malocclusion who underwent orthopedics from January 2014 to January 2016 in our hospital were recruited into this study as observation group, and thirty patients diagnosed as Class II malocclusion without ambulation were taken as control group. All patients in observation group were treated with orthodontic therapy. The scores of IOTN-AC and the values of aesthetic expectation were evaluated in the patients in observation group at four time points such as before treatment, 6 months, 12 months and 18 months after treatment, and the same indexes of aesthetic effects were evaluated in the patients in control group before treatment(the first valuation time) and at 18 months of follow-up(the last valuation time). The tooth and jaw deformity indicators including anterior coverage, molar occlusion, midline relationship and dental overbite denture and soft tissue conditions were assessed in the patients of observation group, and the differences of these indicators were compared before and after treatment. Results The scores of IOTN-AC gradually decreased and the values of aesthetic expectation gradually increased in the four time points in the patients of observation group. Moreover, the scores or values of each time point were significant different from those of the previous one(P<0.05). There was no significant difference in the aesthetic effects between the observation group and the control group at the first valuation time(before the treatment)(P>0.05). However, the score of IOTN-AC of the observation group was significantly lower than that of the control group the last valuation time(18 months after treatment/of follow-up), and the aesthetic expectation value of the observation group was significantly higher than that of the control group(P<0.05). In the control group, There was no significant difference in the aesthetic effects between the first and last valuation time points(P >0.05). In the observation group, the scores of the tooth and jaw deformity indicators including anterior coverage, molar occlusal, midline relationship and dental overbite denture after treatment were significantly higher than those before treatment(P <0.001). The soft tissue surface angle, total lobe angle, lower lip angle, upper and lower lip angle, lower lip inclination, Eangle angle, Z angle UL and LL after treatment were significantly lower than those before treatment, and nasolabial angle, labial angle, chin labial furrow angle, nasolabial angle, labial angle, H angle(soft) and H angle were all significantly higher than those before treatment(P<0.05). Conclusion Orthodontic treatment of adolescent occlusal deformity had a significant clinical effect,which could effectively improve the aesthetic degree of dentition of patients and significantly reduce the severity of malocclusion deformity.It is worthy of in the clinical application.
Objective To investigate the aesthetic effects of orthodontic treatment for Class Ⅱ malocclusion in adolescents and the severity of malocclusion before and after treatment. Methods Fifty adolescents with Class II malocclusion who underwent orthopedics from January 2014 to January 2016 in our hospital were recruited into this study as observation group, and thirty patients diagnosed as Class II malocclusion without ambulation were taken as control group. All patients in observation group were treated with orthodontic therapy. The scores of IOTN-AC and the values of aesthetic expectation were evaluated in the patients in observation group at four time points such as before treatment, 6 months, 12 months and 18 months after treatment, and the same indexes of aesthetic effects were evaluated in the patients in control group before treatment(the first valuation time) and at 18 months of follow-up(the last valuation time). The tooth and jaw deformity indicators including anterior coverage, molar occlusion, midline relationship and dental overbite denture and soft tissue conditions were assessed in the patients of observation group, and the differences of these indicators were compared before and after treatment. Results The scores of IOTN-AC gradually decreased and the values of aesthetic expectation gradually increased in the four time points in the patients of observation group. Moreover, the scores or values of each time point were significant different from those of the previous one(P<0.05). There was no significant difference in the aesthetic effects between the observation group and the control group at the first valuation time(before the treatment)(P>0.05). However, the score of IOTN-AC of the observation group was significantly lower than that of the control group the last valuation time(18 months after treatment/of follow-up), and the aesthetic expectation value of the observation group was significantly higher than that of the control group(P<0.05). In the control group, There was no significant difference in the aesthetic effects between the first and last valuation time points(P >0.05). In the observation group, the scores of the tooth and jaw deformity indicators including anterior coverage, molar occlusal, midline relationship and dental overbite denture after treatment were significantly higher than those before treatment(P <0.001). The soft tissue surface angle, total lobe angle, lower lip angle, upper and lower lip angle, lower lip inclination, Eangle angle, Z angle UL and LL after treatment were significantly lower than those before treatment, and nasolabial angle, labial angle, chin labial furrow angle, nasolabial angle, labial angle, H angle(soft) and H angle were all significantly higher than those before treatment(P<0.05). Conclusion Orthodontic treatment of adolescent occlusal deformity had a significant clinical effect,which could effectively improve the aesthetic degree of dentition of patients and significantly reduce the severity of malocclusion deformity.It is worthy of in the clinical application.
引文
[1]杨鸣良.牙颌面畸形正畸正颌联合治疗:从正颌外科角度看待术前正畸[J].中国实用口腔科杂志,2017,10(5):257-260.
[2]Akram A,Mcknight MM,Bellardie H,et al.Craniofacial malformations and the orthodontist[J].Br Dental J,2015,218(3):129.
[3]Kj?r I.Sella turcica morphology and the pituitary gland--a new contribution to craniofacial diagnostics based on histology and neuroradiology[J].Eur J Orthod,2015,37(1):28-36.
[4]Paley JS,Cisneros GJ,Nicolay OF,et al.Effects of fixed labial orthodontic appliances on speech sound production[J].Angle Orthod,2015,86(3):462.
[5]张艺,严宁.T4K矫治器治疗儿童安氏Ⅱ类错牙合应用基础研究.中国实用口腔科杂志,2017,10(6):365-368.
[6]Nakano Y,Yamaguchi M,Shimizu M,et al.Interleukin-17 is involved in orthodontically induced inflammatory root resorption in dental pulp cells[J].Am J Orthod Dentofacial Orthop,2015,148(2):302-309.
[7]郑博文,赵阳,陈艳娜,等.正畸-正颌联合治疗的骨性Ⅲ类错牙合畸形与颈椎骨骼异常的相关性研究[J].口腔医学,2017,37(2):136-138.
[8]Noar JH,Sharma S,Roberts-Harry D,et al.A discerning approach to simple aesthetic orthodontics[J].Br Dent J,2015,218(3):157-166.
[9]Dalstra M,Cattaneo PM,Laursen MG,et al.Multi-level synchrotron radiation-based microtomography of the dental alveolus and its consequences for orthodontics[J].J Biomech,2015,48(5):801-806.
[10]Pontes LF,Cecim RL,Machado SM,et al.Tooth angulation and dental arch perimeter-the effect of orthodontic bracket prescription[J].Eur J Orthod,2015,37(4):e0137717.
[11]郭斌,南海涛,孙雷,等.正畸联合修复疗法治疗牙列缺损伴牙颌畸形疗效美观效果及对牙齿功能的影响[J].河北医学,2016,22(10):1598-1600.
[12]Wang H,PJ LV,Wang Y,et al.Quantitative evaluation of fabricating complete denture by computer numerical control in manufacturing dentition and baseplate separately plus adhesive molding[J].Beijing Daxue Xuebao Yixueban,2016,48(5):884.
[13]徐文珍.正畸与修复联合治疗牙缺损伴牙颌畸形的临床疗效[J].现代医药卫生,2016,32(16):2556-2557.
[14]Lione R,Ghislanzoni LTH,Defraia E,et al.Bonded versus banded rapid palatal expander followed by facial mask therapy:analysis on digital dental casts[J].E Eur J Orthod,2016,38(2):657.
[15]殷飞云,刘忠汉.探讨自锁托槽矫治器在牙颌畸形患者正畸中的应用价值[J].中国保健营养,2016,26(33):46-47.
[16]Bondevik O,Espeland L,Stenvik A.Dental arch changes from 22 to43 years of age:are they different in individuals with high versus low mandibular plane angle[J].Eur J Orthod,2015,37(4):367.
[17]Lione R,Franchi L,Huanca Ghislanzoni LT,et al.Palatal surface and volume in mouth-breathing subjects evaluated with threedimensional analysis of digital dental casts-a controlled study[J].Eur J Orthod,2015,37(1):101-104.
[18]Wang X,Gong X,Yu Z,et al.Follow-up study of dental and skeletal changes in patients with obstructive sleep apnea and hypopnea syndrome with long-term treatment with the Silensor appliance[J].Am J Orthod Dentofacial Orthop,2015,147(5):559-565.
[19]杨柳青,曲晓东,黎钢,等.广西柳州地区儿童错牙颌畸形正畸需求与心理健康状况调查[J].中国临床研究,2017,30(6):851-854.
[20]Ali A.Book review:Handbook of orthodontics,second edition[J].Br Dental J,2016,220(4):162.
[2]Akram A,Mcknight MM,Bellardie H,et al.Craniofacial malformations and the orthodontist[J].Br Dental J,2015,218(3):129.
[3]Kj?r I.Sella turcica morphology and the pituitary gland--a new contribution to craniofacial diagnostics based on histology and neuroradiology[J].Eur J Orthod,2015,37(1):28-36.
[4]Paley JS,Cisneros GJ,Nicolay OF,et al.Effects of fixed labial orthodontic appliances on speech sound production[J].Angle Orthod,2015,86(3):462.
[5]张艺,严宁.T4K矫治器治疗儿童安氏Ⅱ类错牙合应用基础研究.中国实用口腔科杂志,2017,10(6):365-368.
[6]Nakano Y,Yamaguchi M,Shimizu M,et al.Interleukin-17 is involved in orthodontically induced inflammatory root resorption in dental pulp cells[J].Am J Orthod Dentofacial Orthop,2015,148(2):302-309.
[7]郑博文,赵阳,陈艳娜,等.正畸-正颌联合治疗的骨性Ⅲ类错牙合畸形与颈椎骨骼异常的相关性研究[J].口腔医学,2017,37(2):136-138.
[8]Noar JH,Sharma S,Roberts-Harry D,et al.A discerning approach to simple aesthetic orthodontics[J].Br Dent J,2015,218(3):157-166.
[9]Dalstra M,Cattaneo PM,Laursen MG,et al.Multi-level synchrotron radiation-based microtomography of the dental alveolus and its consequences for orthodontics[J].J Biomech,2015,48(5):801-806.
[10]Pontes LF,Cecim RL,Machado SM,et al.Tooth angulation and dental arch perimeter-the effect of orthodontic bracket prescription[J].Eur J Orthod,2015,37(4):e0137717.
[11]郭斌,南海涛,孙雷,等.正畸联合修复疗法治疗牙列缺损伴牙颌畸形疗效美观效果及对牙齿功能的影响[J].河北医学,2016,22(10):1598-1600.
[12]Wang H,PJ LV,Wang Y,et al.Quantitative evaluation of fabricating complete denture by computer numerical control in manufacturing dentition and baseplate separately plus adhesive molding[J].Beijing Daxue Xuebao Yixueban,2016,48(5):884.
[13]徐文珍.正畸与修复联合治疗牙缺损伴牙颌畸形的临床疗效[J].现代医药卫生,2016,32(16):2556-2557.
[14]Lione R,Ghislanzoni LTH,Defraia E,et al.Bonded versus banded rapid palatal expander followed by facial mask therapy:analysis on digital dental casts[J].E Eur J Orthod,2016,38(2):657.
[15]殷飞云,刘忠汉.探讨自锁托槽矫治器在牙颌畸形患者正畸中的应用价值[J].中国保健营养,2016,26(33):46-47.
[16]Bondevik O,Espeland L,Stenvik A.Dental arch changes from 22 to43 years of age:are they different in individuals with high versus low mandibular plane angle[J].Eur J Orthod,2015,37(4):367.
[17]Lione R,Franchi L,Huanca Ghislanzoni LT,et al.Palatal surface and volume in mouth-breathing subjects evaluated with threedimensional analysis of digital dental casts-a controlled study[J].Eur J Orthod,2015,37(1):101-104.
[18]Wang X,Gong X,Yu Z,et al.Follow-up study of dental and skeletal changes in patients with obstructive sleep apnea and hypopnea syndrome with long-term treatment with the Silensor appliance[J].Am J Orthod Dentofacial Orthop,2015,147(5):559-565.
[19]杨柳青,曲晓东,黎钢,等.广西柳州地区儿童错牙颌畸形正畸需求与心理健康状况调查[J].中国临床研究,2017,30(6):851-854.
[20]Ali A.Book review:Handbook of orthodontics,second edition[J].Br Dental J,2016,220(4):162.