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上颌骨微型种植体支抗的多曲方丝弓和改良型 III 类橡皮链矫治骨性 III 类错[牙合]的掩饰治疗。

Camouflage treatment of skeletal Class III malocclusion with multiloop edgewise arch wire and modified Class III elastics by maxillary mini-implant anchorage.

机构信息

State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China.

出版信息

Angle Orthod. 2013 Jul;83(4):630-40. doi: 10.2319/091312-730.1. Epub 2013 Jan 11.

Abstract

OBJECTIVE

To evaluate the effect of the multiloop edgewise arch wire (MEAW) technique with maxillary mini-implants in the camouflage treatment of skeletal Class III malocclusion.

MATERIALS AND METHODS

Twenty patients were treated with the MEAW technique and modified Class III elastics from the maxillary mini-implants. Twenty-four patients were treated with MEAW and long Class III elastics from the upper second molars as control. Lateral cephalometric radiographs were obtained and analyzed before and after treatment, and 1 year after retention.

RESULTS

Satisfactory occlusion was established in both groups. Through principal component analysis, it could be concluded the anterior-posterior dental position, skeletal sagittal and vertical position, and upper molar vertical position changed within groups and between groups; vertical lower teeth position and Wits distance changed in the experimental group and between groups. In the experimental group, the lower incisors tipped lingually 2.7 mm and extruded 2.4 mm. The lingual inclination of the lower incisors increased 3.5°. The mandibular first molars tipped distally 9.1° and intruded 0.4 mm. Their cusps moved 3.4 mm distally. In the control group, the upper incisors proclined 3°, and the upper first molar extruded 2 mm. SN-MP increased 1.6° and S-Go/N-ME decreased 1.

CONCLUSIONS

The MEAW technique combined with modified Class III elastics by maxillary mini-implants can effectively tip the mandibular molars distally without any extrusion and tip the lower incisors lingually with extrusion to camouflage skeletal Class III malocclusions. Clockwise rotation of the mandible and further proclination of upper incisors can be avoided. The MEAW technique and modified Class III elastics provided an appropriate treatment strategy especially for patients with high angle and open bite tendency.

摘要

目的

评估上颌微型种植体支抗的多曲方丝弓(MEAW)技术在骨性 III 类错颌畸形掩饰治疗中的效果。

材料与方法

20 例患者采用 MEAW 技术和改良的上颌微型种植体支抗类 III 橡皮圈进行治疗。24 例患者采用 MEAW 和上颌第二磨牙的长类 III 橡皮圈作为对照。治疗前后和保持 1 年后均获得侧位头颅侧位片并进行分析。

结果

两组均建立了满意的咬合关系。通过主成分分析,可以得出结论,即前牙-后牙位置、矢状骨和垂直骨位置以及上颌磨牙垂直位置在组内和组间都发生了变化;实验组和组间的下切牙垂直位置和 Wits 距离发生了变化。在实验组中,下切牙舌倾 2.7mm,外展 2.4mm。下切牙舌倾增加 3.5°。下颌第一磨牙远中倾斜 9.1°,内收 0.4mm。其牙尖远移 3.4mm。在对照组中,上颌切牙前倾 3°,上颌第一磨牙外展 2mm。SN-MP 增加 1.6°,S-Go/N-ME 减少 1°。

结论

上颌微型种植体支抗的 MEAW 技术结合改良的类 III 橡皮圈可以有效地远中倾斜下颌磨牙而不发生任何外展,同时内收并舌倾下切牙以掩饰骨性 III 类错颌畸形。可以避免下颌的顺时针旋转和上颌切牙进一步的前倾。MEAW 技术和改良的类 III 橡皮圈为高角和有开牙合倾向的患者提供了一种合适的治疗策略。

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