Elnagar Mohammed H, Elshourbagy Eman, Ghobashy Safaa, Khedr Mohamed, Evans Carla A
Assistant lecturer, Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt; visiting scholar, Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Ill.
Professor, Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt.
Am J Orthod Dentofacial Orthop. 2016 Nov;150(5):751-762. doi: 10.1016/j.ajodo.2016.04.025.
The aim of this study was to evaluate and compare the effects of 2 protocols of bone-anchored maxillary protraction with an untreated control group.
Thirty growing Class III subjects with maxillary deficiency in the late mixed or early permanent dentition were included in the study. In group 1 (n = 10), skeletally anchored facemasks were used with miniplates placed at the zygomatic buttress. In group 2 (n = 10), the patients were treated with Class III elastics extending from infrazygomatic miniplates in the maxilla to symphyseal miniplates in the mandible. Group 3 (n = 10) was an untreated control group. Pretreatment and posttreatment cephalometric radiographs were analyzed.
The treatment periods were 8 and 8.9 months in groups 1 and 2, respectively, and the untreated control group was observed for 9.4 months. The maxilla moved forward significantly in groups 1 and 2 compared with the untreated control group (4.87 mm in group 1, 5.81 mm in group 2); overjet and maxillary incisor display were improved without proclination or mesialization of the maxillary teeth relative to the maxillary base. Soft tissue harmony demonstrated the great improvement. However, group 1 showed more opening rotation of the mandible and lingual inclination of the mandibular incisors than did group 2.
The 2 skeletal anchorage protocols for maxillary protraction effectively resolved the severe maxillary deficiently in growing Class III patients. However, vertical changes and retroclination of the mandibular incisors were better controlled by Class III elastics extending from the infrazygomatic miniplates in the maxilla to the symphyseal miniplates in the mandible (group 2).
本研究的目的是评估和比较两种骨锚式上颌前牵引方案与未治疗的对照组的效果。
本研究纳入了30名处于混合牙列晚期或恒牙列早期且上颌骨发育不足的Ⅲ类生长发育期受试者。第1组(n = 10)使用骨骼锚固式面罩,微型钛板置于颧突。第2组(n = 10),患者使用Ⅲ类弹性牵引,从上颌的颧下微型钛板延伸至下颌的颏联合微型钛板。第3组(n = 10)为未治疗的对照组。分析治疗前和治疗后的头颅侧位片。
第1组和第2组的治疗周期分别为8个月和8.9个月,未治疗的对照组观察了9.4个月。与未治疗的对照组相比,第1组和第2组的上颌骨显著向前移动(第1组为4.87mm,第2组为5.81mm);覆盖和上颌切牙的暴露情况得到改善,而上颌牙齿相对于上颌基骨没有前倾或近中移动。软组织协调性有显著改善。然而,第1组比第2组表现出更多的下颌骨开口旋转和下颌切牙舌倾。
两种上颌前牵引的骨骼锚固方案有效解决了生长发育期Ⅲ类患者严重的上颌骨发育不足问题。然而,从上颌的颧下微型钛板延伸至下颌的颏联合微型钛板的Ⅲ类弹性牵引(第2组)能更好地控制下颌切牙的垂直变化和后倾。