Martins Renato Parsekian, da Rosa Martins Joel Claudio, Martins Lidia Parsekian, Buschang Peter H
FAEPO/UNESP and FAMOSP/GESTOS, Araraquara, São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 2008 Dec;134(6):732-41. doi: 10.1016/j.ajodo.2007.07.022.
The purpose of this study was to differentiate the dentoalveolar and skeletal effects to better understand orthodontic treatment. We evaluated the treatment changes associated with the bionator and the removable headgear splint (RHS).
The sample comprised 51 consecutively treated Class II patients from 1 office who had all been successfully treated with either a bionator (n=17) or an RHS appliance (n=17). Class II patients waiting to start treatment later served as controls (n=17). A modified version of the Johnston pitchfork analysis was used to quantify the dentoalveolar and skeletal contributions to the anteroposterior correction at the levels of the molars and the incisors.
Both appliances significantly improved anteroposterior molar relationships (2.15 mm for the bionator, 2.27 mm for the RHS), primarily by dentoalveolar modifications (1.49 and 2.36 mm for the bionator and the RHS, respectively), with greater maxillary molar distalization in the RHS group. Overjet relationships also improved significantly compared with the controls (3.11 and 2.12 mm for the bionator and the RHS, respectively), due primarily to retroclination of the maxillary incisors (2.2 and 2.38 mm for the bionator and the RHS, respectively). The differences between overall corrections and dentoalveolar modifications for both molar and overjet relationships were explained by skeletal responses, with the bionator group showing significantly greater anterior mandibular displacement than the RHS group.
The bionator and the RHS effectively corrected the molar relationships and overjets of Class II patients primarily by dentoalveolar changes.
本研究的目的是区分牙槽骨和骨骼的影响，以更好地理解正畸治疗。我们评估了与生物调节器和可摘式头帽夹板（RHS）相关的治疗变化。
样本包括来自同一诊所的51例连续接受治疗的II类患者，他们均成功接受了生物调节器（n = 17）或RHS矫治器（n = 17）治疗。等待稍后开始治疗的II类患者作为对照（n = 17）。使用改良版的约翰斯顿叉状分析来量化在磨牙和切牙水平上牙槽骨和骨骼对前后向矫正的贡献。
两种矫治器均显著改善了磨牙的前后关系（生物调节器为2.15 mm，RHS为2.27 mm），主要是通过牙槽骨的改变（生物调节器和RHS分别为1.49和2.36 mm），RHS组上颌磨牙远移更大。与对照组相比，覆盖关系也显著改善（生物调节器和RHS分别为3.11和2.12 mm），主要是由于上颌切牙舌倾（生物调节器和RHS分别为2.2和2.38 mm）。磨牙和覆盖关系的总体矫正与牙槽骨改变之间的差异由骨骼反应解释，生物调节器组显示下颌前部移位明显大于RHS组。
生物调节器和RHS主要通过牙槽骨变化有效矫正了II类患者的磨牙关系和覆盖。
