[三种拔牙方法治疗高角双颌前突的临床研究]

[Treating high angle bimaxillary protrusion with three kinds of extraction method: a clinical study].

作者信息

Dai Jia-Yin, Zhang Miao-Miao, Sun Miao, Ni Hui

机构信息

Dept. of Orthodontics, College of Stomatology, Harbin Medical University, Harbin 150001, China.

出版信息

Hua Xi Kou Qiang Yi Xue Za Zhi. 2009 Jun;27(3):268-71, 275.

PMID:19637474

Abstract

OBJECTIVE

To compare the effect of three kinds of extraction model on high angle bimaxillary protrusion patients.

METHODS

A total of 30 patients with Class I malocclusion and bimaxillary protrusion, aged 14-25 years old, were selected and divided into three groups. Four first premolars were extracted in the first group. The two maxillary first premolars and two mandibular first molars were extracted in the second group. The two maxillary first premolars and two mandibular first molars were extracted in the third group, and two additional micro-implants used as orthodontic anchorage in maxilla. Three groups were all treated with MBT appliance. Cephalometric analysis were carried out before and after treatment, and the results were analyzed with statistics.

RESULTS

About the hard tissues, compared with the first group, there were statistically significant differences of N-Me, SGo/NMe, ANS-Me, FH/MP, SN/MP, and ODI in the second and the third group after treatment (P<0.01). 2) About the soft tissues, the teeth and the alveolar bone, compared with the first group, there were statistically significant differences of Pg-Pos, Li-SnPos, Si-LiPos, LL-E, L1-NB, L1/NB, U1/L1, L7-MP in the second and the third group after treatment (P<0.01). 3) All patients received consummate orthodontic treatment and obtained fine occlusion. Facial profiles were improved significantly after orthodontic treatment.

CONCLUSION

After orthodontic treatment with mandibular first molars extraction, FH/MP, SN/MP, N-Me, ANS-Me, L1-NB and L1/NB decreased respectively, and soft tissue profiles were improved significantly. 2) Additional micro-implant used as orthodontic anchorage in maxilla significantly contributed to the maxillary incisor retraction and subsequent soft tissue change. 3) The first molars extraction and additional micro-implant used as orthodontic anchorage are efficient in improving the facial profiles for high angle bimaxillary protrusion patients.

摘要

目的

比较三种拔牙模式对高角双颌前突患者的治疗效果。

方法

选取30例年龄在14 - 25岁的安氏Ⅰ类双颌前突患者，分为三组。第一组拔除四颗第一前磨牙；第二组拔除两颗上颌第一前磨牙和两颗下颌第一磨牙；第三组拔除两颗上颌第一前磨牙和两颗下颌第一磨牙，并在上颌额外使用两颗微型种植体作为正畸支抗。三组均采用MBT矫治器治疗。治疗前后进行头影测量分析，并对结果进行统计学分析。

结果

1）硬组织方面，治疗后第二组和第三组与第一组相比，N-Me、SGo/NMe、ANS-Me、FH/MP、SN/MP和ODI有统计学显著差异（P<0.01）。2）软组织、牙齿及牙槽骨方面，治疗后第二组和第三组与第一组相比，Pg-Pos、Li-SnPos、Si-LiPos、LL-E、L1-NB、L1/NB、U1/L1、L7-MP有统计学显著差异（P<0.01）。3）所有患者均接受了完善的正畸治疗并获得了良好的咬合。正畸治疗后面部轮廓有显著改善。

结论

（1）拔除下颌第一磨牙正畸治疗后，FH/MP、SN/MP、N-Me、ANS-Me、L1-NB及L1/NB分别减小，软组织侧貌显著改善。（2）上颌额外使用微型种植体作为正畸支抗，对上颌切牙后移及后续软组织改变有显著作用。（3）拔除第一磨牙并在上颌额外使用微型种植体作为正畸支抗，对改善高角双颌前突患者的面部轮廓有效。