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成人安氏Ⅱ类错牙合患者应用口内牙支抗式双侧下颌骨牵引成骨的长期疗效。

Long-term results of bilateral mandibular distraction osteogenesis using an intraoral tooth-borne device in adult Class II patients.

机构信息

Orthodontics and Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Int J Oral Maxillofac Surg. 2013 Nov;42(11):1446-53. doi: 10.1016/j.ijom.2013.05.004. Epub 2013 Jun 18.

Abstract

The aim of this prospective clinical study was to evaluate the short-term and long-term skeletal and dental changes after mandibular osteodistraction with tooth-borne appliances in adult orthodontic patients. The sample consisted of 10 non-growing Caucasian patients with a Class II skeletal relationship due to mandibular deficiency, together with Class II dental malocclusion. All patients underwent mandibular distraction osteogenesis (MDO) using the ROD1 tooth-borne device. Lateral cephalograms were evaluated at four time intervals: pretreatment (T1), after mandibular distraction (T2), after orthodontic fixed appliance therapy (T3), and at long-term observation 8-year post-distraction (T4). Statistical analyses compared the skeletal and dental changes in intervals T1-T2, T2-T3, T3-T4, T1-T4, and T2-T4. MDO with the ROD1 tooth-borne device produced significant long-term (T1-T4) increases in the SNB angle (2.3°), total mandibular length (5.9mm), and corpus length (4.5mm). Potential adverse sequelae included significant increases in mandibular plane angle (4.3°), lower anterior dental height (2.8mm), and lower posterior dental height (2.5mm). Significant increases in lower incisor proclination occurred during distraction (7.5°). Distraction osteogenesis with tooth-borne appliances offers a minimally invasive surgical method with stable results for correcting mandibular deficiency in non-growing patients.

摘要

本前瞻性临床研究旨在评估成人正畸患者中使用牙支抗的下颌骨牵张成骨术后短期和长期的骨骼和牙齿变化。样本由 10 名非生长型白种成人患者组成,这些患者由于下颌骨发育不全而存在 II 类骨骼关系,同时存在 II 类牙列不齐。所有患者均使用 ROD1 牙支抗装置行下颌骨牵张成骨术(MDO)。在四个时间间隔评估侧位头颅侧位片:治疗前(T1)、下颌骨牵张后(T2)、正畸固定矫治器治疗后(T3)和牵张后 8 年的长期观察(T4)。统计分析比较了 T1-T2、T2-T3、T3-T4、T1-T4 和 T2-T4 间隔的骨骼和牙齿变化。使用 ROD1 牙支抗装置的 MDO 可使 SNB 角(2.3°)、下颌骨总长度(5.9mm)和体部长度(4.5mm)在长期(T1-T4)上显著增加。潜在的不良后果包括下颌平面角(4.3°)、下前牙高度(2.8mm)和下后牙高度(2.5mm)显著增加。在牵张过程中发生了下切牙明显的前倾(7.5°)。使用牙支抗的牵张成骨术为非生长型患者矫正下颌骨发育不全提供了一种微创的手术方法,结果稳定。

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