掩饰性正畸矫治对骨性Ⅲ类错牙合患者软、硬组织的影响
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摘要
目的:探究掩饰性正畸矫治对骨性Ⅲ类错牙合患者软、硬组织的影响。方法:对骨性Ⅲ类错牙合共61例患者行掩饰性正畸矫治。比较治疗前后患者牙弓长度、牙弓宽度、软组织投影值及硬组织投影值等指标。结果:牙弓长度比较,治疗后患者上颌的中段长度增加、下颌的前段长度减少,且均具有统计学意义(P<0.05);其余指标则无统计学差异(P>0.05)。牙弓宽度比较,治疗后患者下颌的前段宽度减少,且具有统计学意义(P<0.05);其余指标则无统计学差异(P>0.05)。治疗后患者软组织投影Z-plane、NLA、UL-E线均增加、LL-E线减少,差异具有统计学意义(P<0.05)。治疗前后患者硬组织投影ANB、A0-B0负值减少,NP-FH、UI-SN、UI-NA增加,UI-LI减少,差异均具有统计学意义(P<0.05);其余指标则无统计学改变(P>0.05)。结论:掩饰性正畸矫治骨性Ⅲ类错牙合效果显著,能有效扩展牙弓,调整上下牙弓相对位置,改善错牙合和覆盖,提高患者面部协调美观程度,值得临床推广使用。
Objective To explore the effects on soft and hard tissues in patients with class Ⅲ malocclusion by disguised orthodontic treatment. Methods 61 patients with class Ⅲ skeletal malocclusion were treated with disguised orthodontic treatment. The dental arch length, arch width, soft tissue projection and hard tissue projection were compared before and after treatment. Results After treatment, the maxillary middle length increased and the mandibular anterior length decreased(P<0.05), but there was no significant difference in other indexes(P>0.05). After treatment, the width of anterior segment of mandible decreased significantly(P<0.05), but there was no significant difference in other indexes(P>0.05). After treatment,the projection of Z-plane, NLA, UL-E line increased and the LL-E line decreased(P<0.05). After treatment, the negative value of projection ANB, AO-BO in hard tissue decreased, NP-FH, UI-SN, UI-NA increased and UI-LI decreased, with significant difference(P<0.05), but the other indexes had no statistical change(P>0.05). Conclusion The effect of disguised orthodontic treatment on class Ⅲ malocclusion is remarkable. It can effectively expand the arch, adjust the relative position of the upper and lower arch, improve the overbite and cover, and improve the aesthetic degree of facial coordination of the patients, which is worthy of clinical application.
Objective To explore the effects on soft and hard tissues in patients with class Ⅲ malocclusion by disguised orthodontic treatment. Methods 61 patients with class Ⅲ skeletal malocclusion were treated with disguised orthodontic treatment. The dental arch length, arch width, soft tissue projection and hard tissue projection were compared before and after treatment. Results After treatment, the maxillary middle length increased and the mandibular anterior length decreased(P<0.05), but there was no significant difference in other indexes(P>0.05). After treatment, the width of anterior segment of mandible decreased significantly(P<0.05), but there was no significant difference in other indexes(P>0.05). After treatment,the projection of Z-plane, NLA, UL-E line increased and the LL-E line decreased(P<0.05). After treatment, the negative value of projection ANB, AO-BO in hard tissue decreased, NP-FH, UI-SN, UI-NA increased and UI-LI decreased, with significant difference(P<0.05), but the other indexes had no statistical change(P>0.05). Conclusion The effect of disguised orthodontic treatment on class Ⅲ malocclusion is remarkable. It can effectively expand the arch, adjust the relative position of the upper and lower arch, improve the overbite and cover, and improve the aesthetic degree of facial coordination of the patients, which is worthy of clinical application.
引文
[1]孙香,杨阿丽.掩饰性正畸治疗对骨性Ⅲ类错牙合畸形的疗效[J].中国临床研究,2018,31(7):897-900.
[2]杨柳青,曲晓东,黎钢,等.广西柳州地区儿童错牙合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.
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[4]谭宇,赖文莉.上颌和下颌后牙牙合垫辅助矫治成人前牙反牙合的临床评价[J].海南医学,2017,28(14):2379-2381.
[5]张双,蔡天恒,米丛波.CBCT评价成人骨性Ⅲ类错牙合畸形下切牙牙槽骨形态的研究[J].现代口腔医学杂志,2017,31(5):269-272.
[6]刘永媛,张晓蓉.颜面部不对称畸形诊治的研究进展[J].医学综述,2018,24(8):1565-1569.
[7]Nie P,Tao L,Zhu YF,et al.Evaluation of the effects of two different modes of orthognathic surgery on upper airway morphology in patients with skeletal ClassⅢmalocclusion[J].Shanghai Kou Qiang Yi Xue,2018,27(3):280-284..
[8]翁嘉华,王大为.上颌切牙托槽倒置粘接治疗骨性Ⅲ类错牙合的临床研究[J].口腔疾病防治,2016,24(11):665-670.
[9]王飞宇,薛俊杰,王璟,等.牙周膜减阻牵张移动上下颌尖牙的三维有限元分析[J].中华口腔医学研究杂志(电子版),2014,8(3):186-190.
[10]刘东晖,路潜.固定矫治患者口腔卫生状况及口腔保健方式研究现状[J].护士进修杂志,2017,32(17):1569-1571.
[11]林思豆,吴补领,孙风阳,等.三类骨性错牙合下颌牙弓和基骨弓的测量及相关性分析[J].中国临床解剖学杂志,2016,34(2):171-175.
[12]张宇帆.拔除下颌第二磨牙治疗轻中度骨性Ⅲ类错牙合畸形的临床效果分析[J].同济大学学报(医学版),2017,38(1):48-51,56.
[13]范少轻,周彦恒.种植体支抗整体远中移动下颌牙列治疗骨性Ⅲ类错牙合的疗效评价[J].北京大学学报(医学版),2017,49(3):531-539.
[14]沈丹阳,胡丽华,左思慧,等.轻度骨性偏颌患者的牙牙合及颌骨特征研究[J].上海口腔医学,2018,27(4):376-381.
[15]Radalj Mili?i?Z,Kranj?evi?Bubica A,Nikolov Bori?D,et al.Linear predictors of facial rotation pattern in croatian subjects with skeletal ClassⅢmalocclusion[J].Acta Stomatol Croat,2018,52(3):227-237.
[16]谭励华,周嫣,方志欣,等.骨性Ⅲ类错牙合非拔牙矫治后牙弓与基骨弓变化的分析研究[J].中国美容医学,2017,26(11):91-94.
[17]荆璇,武秀萍.垂直骨面型对正畸诊断治疗的影响[J].中国药物与临床,2016,16(6):833-835.
[18]马静,江久汇.骨性Ⅱ类和Ⅲ类高角错牙合患者下切牙区的牙槽骨形态分析[J].北京大学学报(医学版),2018,50(1):98-103.
[19]刘艾芃,沈慧娟,彭娟敏,等.成人轻度骨性Ⅲ类错牙合不同拔牙模式矫治的侧貌分析[J].临床口腔医学杂志,2016,32(3):153-157.
[20]金超超,邵玶.Ⅲ类错牙合垂直骨面型与牙弓宽度关系的研究[J].口腔医学,2018,38(1):52-54.
[2]杨柳青,曲晓东,黎钢,等.广西柳州地区儿童错牙合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.
[3]Seifi M,Matini NS,Motabar AR,et al.Dentoskeletal stability in conventional orthognathic surgery,presurgical orthodontic treatment and surgery-first approach in Class-Ⅲpatients[J].World J Plast Surg,2018,7(3):283-293.
[4]谭宇,赖文莉.上颌和下颌后牙牙合垫辅助矫治成人前牙反牙合的临床评价[J].海南医学,2017,28(14):2379-2381.
[5]张双,蔡天恒,米丛波.CBCT评价成人骨性Ⅲ类错牙合畸形下切牙牙槽骨形态的研究[J].现代口腔医学杂志,2017,31(5):269-272.
[6]刘永媛,张晓蓉.颜面部不对称畸形诊治的研究进展[J].医学综述,2018,24(8):1565-1569.
[7]Nie P,Tao L,Zhu YF,et al.Evaluation of the effects of two different modes of orthognathic surgery on upper airway morphology in patients with skeletal ClassⅢmalocclusion[J].Shanghai Kou Qiang Yi Xue,2018,27(3):280-284..
[8]翁嘉华,王大为.上颌切牙托槽倒置粘接治疗骨性Ⅲ类错牙合的临床研究[J].口腔疾病防治,2016,24(11):665-670.
[9]王飞宇,薛俊杰,王璟,等.牙周膜减阻牵张移动上下颌尖牙的三维有限元分析[J].中华口腔医学研究杂志(电子版),2014,8(3):186-190.
[10]刘东晖,路潜.固定矫治患者口腔卫生状况及口腔保健方式研究现状[J].护士进修杂志,2017,32(17):1569-1571.
[11]林思豆,吴补领,孙风阳,等.三类骨性错牙合下颌牙弓和基骨弓的测量及相关性分析[J].中国临床解剖学杂志,2016,34(2):171-175.
[12]张宇帆.拔除下颌第二磨牙治疗轻中度骨性Ⅲ类错牙合畸形的临床效果分析[J].同济大学学报(医学版),2017,38(1):48-51,56.
[13]范少轻,周彦恒.种植体支抗整体远中移动下颌牙列治疗骨性Ⅲ类错牙合的疗效评价[J].北京大学学报(医学版),2017,49(3):531-539.
[14]沈丹阳,胡丽华,左思慧,等.轻度骨性偏颌患者的牙牙合及颌骨特征研究[J].上海口腔医学,2018,27(4):376-381.
[15]Radalj Mili?i?Z,Kranj?evi?Bubica A,Nikolov Bori?D,et al.Linear predictors of facial rotation pattern in croatian subjects with skeletal ClassⅢmalocclusion[J].Acta Stomatol Croat,2018,52(3):227-237.
[16]谭励华,周嫣,方志欣,等.骨性Ⅲ类错牙合非拔牙矫治后牙弓与基骨弓变化的分析研究[J].中国美容医学,2017,26(11):91-94.
[17]荆璇,武秀萍.垂直骨面型对正畸诊断治疗的影响[J].中国药物与临床,2016,16(6):833-835.
[18]马静,江久汇.骨性Ⅱ类和Ⅲ类高角错牙合患者下切牙区的牙槽骨形态分析[J].北京大学学报(医学版),2018,50(1):98-103.
[19]刘艾芃,沈慧娟,彭娟敏,等.成人轻度骨性Ⅲ类错牙合不同拔牙模式矫治的侧貌分析[J].临床口腔医学杂志,2016,32(3):153-157.
[20]金超超,邵玶.Ⅲ类错牙合垂直骨面型与牙弓宽度关系的研究[J].口腔医学,2018,38(1):52-54.