Baccetti Tiziano, Franchi Lorenzo, Kim Ludia H
Department of Orthodontics, University of Florence, Florence, Italy.
Am J Orthod Dentofacial Orthop. 2009 Oct;136(4):501-9. doi: 10.1016/j.ajodo.2007.08.029.
The aim of this cephalometric study was to evaluate the role of timing in relation to skeletal maturity on the outcomes of nonextraction comprehensive Class II therapy.
Three samples of patients with Class II Division 1 malocclusion were treated with headgear combined with fixed appliances and Class II elastics. Lateral cephalograms were taken of all subjects before therapy (T1) and at an average interval of 6 months after therapy (T2). The first sample (23 subjects) was treated before the pubertal growth spurt, the second sample (24 subjects) received therapy during the pubertal growth spurt, and the third sample (13 subjects) was treated at a postpubertal stage of development. The average T1 to T2 interval was approximately 30 months for all patients, with an average treatment duration of 24 months. Longitudinal observations of a group of 17 subjects with untreated Class II malocclusions were compared with the treated groups at the 3 skeletal maturation intervals with nonparametric statistics.
Class II treatment before or during the pubertal growth spurt induced significant favorable skeletal changes (restricted maxillary advancement in prepubertal patients and enhanced mandibular growth in pubertal patients). Patients treated after the pubertal growth spurt had only significant dentoalveolar changes.
The greatest amount of dentoskeletal correction of Class II malocclusion with 1-phase nonextraction treatment occurred in patients treated during the pubertal growth spurt.
本头影测量研究的目的是评估在骨骼成熟度方面的治疗时机对非拔牙综合II类错颌畸形治疗效果的作用。
选取三组安氏II类1分类错颌畸形患者,采用口外弓联合固定矫治器及II类牵引橡皮圈进行治疗。在治疗前(T1)及治疗后平均每6个月(T2)对所有受试者拍摄头颅侧位片。第一组样本(23名受试者)在青春期生长高峰前接受治疗,第二组样本(24名受试者)在青春期生长高峰期间接受治疗,第三组样本(13名受试者)在青春期后发育阶段接受治疗。所有患者从T1到T2的平均间隔约为30个月,平均治疗时间为24个月。采用非参数统计方法,将一组17名未经治疗的安氏II类错颌畸形患者的纵向观察结果与在三个骨骼成熟阶段接受治疗的组进行比较。
在青春期生长高峰前或期间进行II类错颌畸形治疗可引起显著的有利骨骼变化(青春期前患者上颌前突受限,青春期患者下颌生长增强)。在青春期生长高峰后接受治疗的患者仅有显著的牙牙槽变化。
采用一期非拔牙治疗方法对II类错颌畸形进行的最大量牙-骨矫正发生在青春期生长高峰期间接受治疗的患者中。