Lin Jiu-xiang, Gu Yan
Department of Orthodontics, Peking University School of Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2004 Mar;39(2):91-6.
To analyze effects of non-surgical treatment on subjects of 12-20 years old with severe skeletal Class III deformity and to directly evaluate dental and facial profile changes.
Eighteen patients with severe skeletal Class III malocclusion (male 5, female 13), diagnosed as indication for orthognathic surgery, were included in the study. The average age was 14.6 +/- 2.5 years old., with age range from 12 years old to 20 years old. 12 cases were treated with Tip-Edge straight-wire technique and 6 cases with Begg light wire technique. The average treatment time was 2.5 +/- 0.8 years. The selection criteria included: (1) mesial or superior mesial Class III molar relationship, with maxillary first molar occlude the buccal groove of the mandibular second molars (2) no mandibular shift (3) ANB < -1.5 degrees (4) high angle cases with average value of SN-MP 34.9 degrees +/- 5.9 degrees, 4 cases present with openbite (5) concave facial profile (6) originally classified as surgery cases. Lateral cephalometric films taken at the beginning and the end of the treatment were analyzed with traditional cephalometric analysis. The arithmetic mean (Mean) and standard deviation (SD) were calculated for each variable. Paired t-test was performed to evaluate the significant treatment change.
Normal overjet and overbite were established with proclination of upper incisors and retroclination of lower incisors. Inclination of upper incisors was increased 5.9 degrees when measured with the angle of upper incisor to SN plane (P < 0.01). Inclination of lower incisors was decreased 6.6 degrees when measured with the angle of lower incisor to mandibular plane (P < 0.001). Negative value of the distance difference of upper lip and lower lip to Sn-Pg' at the beginning of treatment changed to positive value with significant difference (P < 0.001).
Successful treatment effects could be obtained with non-surgical therapy in severe skeletal Class III malocclusion in permanent dentition. Remarkable soft-tissue change was noted after the treatment and concave facial profile changed to straight profile.
分析非手术治疗对12至20岁严重骨性Ⅲ类错畸形患者的效果，并直接评估牙颌面外形的变化。
纳入18例严重骨性Ⅲ类错畸形患者（男5例，女13例），均被诊断为正颌手术适应证。平均年龄为14.6±2.5岁，年龄范围为12岁至20岁。12例采用Tip-Edge直丝弓技术治疗，6例采用Begg细丝弓技术治疗。平均治疗时间为2.5±0.8年。入选标准包括：（1）近中或近中高位Ⅲ类磨牙关系，上颌第一磨牙咬合于下颌第二磨牙颊沟；（2）无下颌移位；（3）ANB＜-1.5°；（4）高角病例，SN-MP平均值为34.9°±5.9°，4例存在开；（5）面部外形凹陷；（6）原被分类为手术病例。治疗开始和结束时拍摄的头颅侧位片采用传统头影测量分析法进行分析。计算每个变量的算术平均值（Mean）和标准差（SD）。采用配对t检验评估治疗前后的显著变化。
通过上颌切牙唇倾和下颌切牙舌倾建立了正常的覆盖和覆。用上颌切牙与SN平面夹角测量时，上颌切牙倾斜度增加了5.9°（P＜0.01）。用下颌切牙与下颌平面夹角测量时，下颌切牙倾斜度减小了6.6°（P＜0.001）。治疗开始时上唇和下唇至Sn-Pg'距离差的负值变为正值，差异有统计学意义（P＜0.001）。
恒牙列严重骨性Ⅲ类错畸形采用非手术治疗可获得成功的治疗效果。治疗后软组织有明显变化，面部凹陷外形变为直面型。
