Manni Antonio, Mutinelli Sabrina, Pasini Marco, Mazzotta Laura, Cozzani Mauro
Private practice, Lecce, Italy.
Private practice, Trento, Italy.
Am J Orthod Dentofacial Orthop. 2016 Jun;149(6):871-80. doi: 10.1016/j.ajodo.2015.11.029.
The aim of this study was to evaluate the effectiveness of the treatment of skeletal Class II malocclusions with an acrylic splint Herbst appliance anchored to miniscrews with 2 types of ligation.
Sixty patients (mean age, 11.6 years; SD, 1.9) with a bilateral Angle Class II Division 1 malocclusion were retrospectively selected and divided into 3 homogeneous and balanced groups on the basis of the Herbst anchorage used: without anchorage, miniscrews with elastic chains, and miniscrews with metallic ligatures. A cephalometric sagittal occlusion analysis merged with mandibular incisor proclination and skeletal divergence was carried out before and after treatment. To compare the absolute variations within and among the groups, we performed the 1-sample t test for repeated measures and 1-way analysis of variance, respectively.
Overjet was reduced similarly in all groups (P <0.05). The mandibular bone base length increased in the group with elastic chains only (P = 0.001). The change in the distance between Point A and pogonion showed the most reduction in the group with elastic chains (P <0.05). Incisive flaring was more pronounced in the group with no anchorage than in the group with elastic chains (P <0.001) and the group with metallic ligatures (P = 0.003).
Anchorage to miniscrews with elastic chains increases the orthopedic effect of the acrylic splint Herbst appliance. It has been confirmed that skeletal anchorage reduces incisor flaring.
本研究旨在评估用两种结扎方式将丙烯酸夹板式Herbst矫治器固定于微型螺钉上治疗骨性安氏II类错牙合的有效性。
回顾性选取60例双侧安氏II类1分类错牙合患者(平均年龄11.6岁;标准差1.9),根据所使用的Herbst矫治器支抗分为3组,每组病例数均衡:无支抗组、弹性链圈连接微型螺钉组和金属结扎丝连接微型螺钉组。治疗前后进行了头影测量矢状向咬合分析,并结合下颌切牙倾斜度和骨骼差异进行分析。为比较组内和组间的绝对变化,我们分别进行了重复测量的单样本t检验和单因素方差分析。
所有组的覆盖均有相似程度的减小(P<0.05)。仅弹性链圈连接微型螺钉组的下颌骨基底部长度增加(P = 0.001)。A点与颏前点之间距离的变化在弹性链圈连接微型螺钉组减小最为明显(P<0.05)。无支抗组的切牙唇倾比弹性链圈连接微型螺钉组(P<0.001)和金属结扎丝连接微型螺钉组(P = 0.003)更明显。
用弹性链圈连接微型螺钉作为支抗可增强丙烯酸夹板式Herbst矫治器的矫形效果。已证实骨支抗可减少切牙唇倾。