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边缘性III类错颌畸形的治疗:正畸掩饰治疗(拔牙)与正颌外科手术

Treatment in Borderline Class III Malocclusion: Orthodontic Camouflage (Extraction) Versus Orthognathic Surgery.

作者信息

Rabie A-Bakr M, Wong Ricky W K, Min G U

机构信息

Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, HKSAR, China.

出版信息

Open Dent J. 2008;2:38-48. doi: 10.2174/1874210600802010038. Epub 2008 Mar 8.

Abstract

AIMS

To investigate the differences in morphological characteristics of borderline class III patients who had undergone camouflage orthodontic treatment or orthognathic surgery, and to compare the treatment effects between these two modalities.

MATERIALS AND METHODS

Cephalograms of 25 patients (13 orthodontic, 12 surgical) with class III malocclusion were analyzed. All had a pretreatment ANB angle greater than -5 masculine.

RESULTS

Using discriminant analysis, only Holdaway angle was selected to differentiate patients in the pretreatment stage. Seventy-two per cent patients were correctly classified. In the orthodontic group, reverse overjet was corrected by retraction of the lower incisors and downward and backward rotation of the mandible. The surgical group was corrected by setback of the lower anterior dentoalveolus and uprighting of the lower incisors. No difference was found in posttreatment soft tissue measurements between the two groups.

CONCLUSIONS

Twelve degree for the Holdaway angle can be a guideline in determining the treatment modalities for borderline class III patients, but the preferences of operators and patients are also important. (2) Both therapeutic options should highlight changes in the lower dentoalveolus and lower incisors. (3) Both treatment modalities can achieve satisfactory improvements to the people.

摘要

目的

研究接受掩饰性正畸治疗或正颌手术的临界III类患者的形态学特征差异,并比较这两种治疗方式的治疗效果。

材料与方法

分析25例III类错牙合患者(13例正畸治疗,12例手术治疗)的头影测量片。所有患者治疗前ANB角均大于-5°(男性标准)。

结果

采用判别分析,仅Holdaway角被选用于区分治疗前阶段的患者。72%的患者被正确分类。正畸组通过下切牙内收及下颌向下向后旋转矫正反牙合。手术组通过下前牙牙槽骨后退及下切牙直立矫正。两组治疗后软组织测量结果无差异。

结论

(1)Holdaway角12°可作为确定临界III类患者治疗方式的参考指标,但术者和患者的偏好也很重要。(2)两种治疗方案均应突出下牙槽骨和下切牙的变化。(3)两种治疗方式均可使患者获得满意改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3199/2581536/95ab1971d4d2/TODENTJ-2-38_F1.jpg

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