Karlsson Ingela, Bondemark Lars
National Health Service, Skane County Council, Orthodontics Clinic, Malmoe, Sweden.
Angle Orthod. 2006 Nov;76(6):923-9. doi: 10.2319/110805-390.
To evaluate the maxillary molar distalization and anchorage loss in two groups, one before (MD 1 group) and one after (MD 2 group) eruption of second maxillary molars.
After a sample size calculation, 20 patients were recruited for each group from patients who fulfilled the following criteria: no orthodontic treatment before distal molar movement, Class II molar relationship defined by at least end-to-end molar relationship, space deficiency in the maxilla, and use of an intra-arch NiTi coil appliance with a Nance appliance to provide anchorage. Patients in the MD 1 group were without any erupted second molars during the distalization period, whereas in the MD 2 group both the first and second molars were in occlusion at start of treatment. The main outcome measures to be assessed were: treatment time, ie, time in months to achieve a normal molar relation, distal movement of maxillary first molars, and anterior movement of maxillary incisors (anchorage loss). The mean age in the MD 1 group was 11.4 years; in the MD 2 group, 14.6 years.
The amount of distal movement of the first molars was significantly greater (P < .01) and the anchorage loss was significantly lower (P < .01) in the group with no second molars erupted. The molar distalization time was also significantly shorter (P < .001) in this group, and thus the movement rate was two times higher.
It is more effective to distalize the first maxillary molars before the second molars have erupted.
评估上颌第二磨牙萌出前(MD 1组)和萌出后(MD 2组)两组上颌磨牙远中移动及支抗丧失情况。
经样本量计算后,从符合以下标准的患者中每组招募20例患者:在磨牙远中移动前未接受正畸治疗、至少为磨牙近远中尖相对的II类磨牙关系、上颌骨间隙不足、使用带Nance弓矫治器的牙弓内镍钛螺旋弹簧矫治器提供支抗。MD 1组患者在远中移动期间无第二磨牙萌出,而MD 2组患者在治疗开始时第一磨牙和第二磨牙均已萌出。待评估的主要观察指标为:治疗时间,即达到正常磨牙关系的月数、上颌第一磨牙的远中移动量以及上颌切牙的前移量(支抗丧失)。MD 1组的平均年龄为11.4岁;MD 2组为14.6岁。
在未萌出第二磨牙的组中,第一磨牙的远中移动量显著更大(P < .01),支抗丧失显著更低(P < .01)。该组的磨牙远中移动时间也显著更短(P < .001),因此移动速率高出两倍。
在第二磨牙萌出前远中移动上颌第一磨牙更有效。