Xu Tian-Min, Liu Yan, Yang Min-Zhi, Huang Wei
Department of Orthodontics, School of Stomatology, Peking University, Beijing, China.
Am J Orthod Dentofacial Orthop. 2006 May;129(5):672-7. doi: 10.1016/j.ajodo.2005.12.007.
The purpose of this study was to compare orthodontic treatment outcomes in Chinese patients with borderline problems treated with and without extractions.
Records of 39 borderline patients treated at the Faculty Clinic of the Peking University Orthodontic Department were evaluated retrospectively by 5 associate professors. Sixteen patients had been treated without extractions, and 23 had 4 first or second premolars extracted. Each judge evaluated the posttreatment records independently for tooth alignment, overbite, overjet, midline symmetry, lateral occlusion, and facial profile, and rated them on a scale from 1 to 5.
The only statistically significant difference between the extraction and nonextraction groups was for facial profile, with the judges preferring the extraction profiles. Fifteen soft-tissue cephalometric variables were measured to determine the source of the difference, and 6 showed statistically significant differences. When profile changes from pretreatment to posttreatment were examined, significant differences in treatment-associated changes between extraction and nonextraction groups were all related to the lower lip and chin.
In this sample of Chinese borderline orthodontic patients, Chinese clinicians had a statistically significant preference for the facial profiles of the extraction patients, but no statistically significant preferences for tooth alignment, overbite, overjet, midline symmetry, or posterior occlusion. Extraction treatment increases the inclination of the chin and reduces protrusion of the lower lip compared with nonextraction treatment, and this might explain the difference.
本研究旨在比较在中国患有临界病例的患者中,拔牙与不拔牙正畸治疗的效果。
北京大学正畸科临床门诊治疗的39例临界病例记录由5位副教授进行回顾性评估。16例患者未拔牙治疗,23例患者拔除了4颗第一或第二前磨牙。每位评估者独立评估治疗后的记录,内容包括牙齿排列、覆合、覆盖、中线对称性、侧方咬合及面部轮廓,并按1至5分进行评分。
拔牙组与非拔牙组之间唯一具有统计学显著差异的是面部轮廓,评估者更倾向于拔牙组的面部轮廓。测量了15项软组织头影测量变量以确定差异来源,其中6项显示出统计学显著差异。当检查治疗前到治疗后的面部轮廓变化时,拔牙组和非拔牙组在与治疗相关的变化上的显著差异均与下唇和下巴有关。
在这个中国临界正畸患者样本中,中国临床医生在统计学上显著倾向于拔牙患者的面部轮廓,但在牙齿排列、覆合、覆盖、中线对称性或后牙咬合方面没有统计学上的显著偏好。与不拔牙治疗相比,拔牙治疗增加了下巴的倾斜度并减少了下唇的前突,这可能解释了这种差异。