Wang Bo, Shen Guofang, Fang Bing, Yu Hongbo, Wu Yong, Sun Liangyan
Resident, Center of Craniofacial Orthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
J Oral Maxillofac Surg. 2014 Mar;72(3):596-602. doi: 10.1016/j.joms.2013.08.021.
To quantitatively evaluate lower incisor decompensation and the surrounding periodontal region after augmented corticotomy-assisted surgical orthodontics in patients with Class III malocclusion.
This prospective study enrolled patients with severe Class III malocclusion who underwent augmented corticotomy in the lower anterior region before orthodontic surgery. Cone-beam computed tomograms and lateral cephalograms were obtained before treatment (T0), after presurgical orthodontic treatment (T1), and at removal of the orthodontic surgical appliances (T2). Repeated measures analysis of variance was used to compare variables at each time point: root length (RL), anterior vertical alveolar bone level at the labial side (AVBL), posterior vertical alveolar bone level at the lingual side (PVBL), labial alveolar bone thickness at the apex (LA), lingual alveolar bone thickness at the apex (LP), and angle of the incisor to the mandibular plane (L1-MP).
In the 8 subjects studied, RL was maintained from T0 to T2 (P > .05), whereas AVBL and PVBL increased from T0 to T1 (P < .05) and then decreased from T1 to T2 (P < .05). LA and L1-MP increased from T0 to T1 (P < .001) but remained steady from T1 to T2 (P > .05). LP decreased from T0 to T1 (P < .05) but increased from T1 to T2 (P < .05) with no further change.
Augmented corticotomy-assisted surgical orthodontics can achieve adequate tooth decompensation with minimal periodontal side-effects in the lower anterior region in patients with Class III malocclusion.
定量评估Ⅲ类错牙合患者在增强型皮质骨切开辅助外科正畸治疗后下切牙的去代偿情况及周围牙周区域。
本前瞻性研究纳入了重度Ⅲ类错牙合患者，这些患者在正畸手术前在下颌前部区域接受了增强型皮质骨切开术。在治疗前（T0）、术前正畸治疗后（T1）以及去除正畸外科矫治器时（T2）获取锥形束计算机断层扫描（CBCT）和头颅侧位片。采用重复测量方差分析比较各时间点的变量：牙根长度（RL）、唇侧前垂直牙槽骨水平（AVBL）、舌侧后垂直牙槽骨水平（PVBL）、根尖处唇侧牙槽骨厚度（LA）、根尖处舌侧牙槽骨厚度（LP）以及切牙与下颌平面的夹角（L1-MP）。
在研究的8名受试者中，RL从T0到T2保持稳定（P > 0.05），而AVBL和PVBL从T0到T1增加（P < 0.05），然后从T1到T2下降（P < 0.05）。LA和L1-MP从T0到T1增加（P < 0.001），但从T1到T2保持稳定（P > 0.05）。LP从T0到T1下降（P < 0.05），但从T1到T2增加（P < 0.05），且无进一步变化。
增强型皮质骨切开辅助外科正畸治疗可在Ⅲ类错牙合患者的下颌前部区域实现充分的牙齿去代偿，同时牙周副作用最小。
