Jayachandran Santhosh, Wiltshire William A, Hayasaki Sandra M, Pinheiro Fabio H S L
Resident, Department of Preventive Dental Science, Division of Orthodontics, Faculty of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada.
Professor and head, Department of Preventive Dental Science, Division of Orthodontics, Faculty of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada.
Am J Orthod Dentofacial Orthop. 2016 Dec;150(6):979-988. doi: 10.1016/j.ajodo.2016.05.008.
Our objectives were to compare the skeletal, dentoalveolar, and soft tissue effects of the AdvanSync appliance (Ormco, Glendora, Calif) with intermaxillary elastics in the correction of Class II malocclusions in growing patients.
A retrospective study was conducted using lateral cephalograms of patients taken before and after comprehensive orthodontic treatment; 41 patients consecutively treated with the AdvanSync were compared with 41 similar patients treated with intermaxillary Class II elastics. All patients had significant growth potential during treatment, as assessed by cervical vertebral maturation. A comparison group was generated from historical data bases and matched to the experimental groups for skeletal age, sex, and craniofacial morphology. Treatment changes were evaluated between the time points using a custom cephalometric analysis generating 31 variables as well as regional superimpositions. Data were analyzed using 1-way analysis of variance and Tukey-Kramer tests.
The effects of the AdvanSync and fixed orthodontics included maxillary growth restriction, protrusion, proclination, and intrusion of the mandibular incisors as well as mesialization of the mandibular molars (P <0.01). The effects of Class II elastics and fixed orthodontics were similar to AdvanSync, with the exceptions of less maxillary growth restriction and greater retrusion and retroclination of the maxillary incisors (P <0.01). Significant mandibular growth stimulation, relative to the untreated controls, did not occur with either modality.
AdvanSync and intermaxillary elastics were effective in normalizing Class II malocclusions during comprehensive fixed orthodontics. AdvanSync produced its effects through maxillary skeletal growth restriction and mandibular dentoalveolar changes. Class II elastics worked primarily through dentoalveolar changes in both the maxilla and the mandible.
我们的目的是比较AdvanSync矫治器（奥美科公司，加利福尼亚州格伦多拉）联合颌间弹力牵引与单纯使用颌间弹力牵引在矫治生长发育期II类错牙合畸形时对骨骼、牙槽骨及软组织的影响。
采用回顾性研究方法，利用患者在正畸综合治疗前后拍摄的头颅侧位片；将41例连续使用AdvanSync矫治器治疗的患者与41例使用II类颌间弹力牵引治疗的类似患者进行比较。所有患者在治疗期间均有显著的生长潜力，通过颈椎成熟度进行评估。从历史数据库中生成一个对照组，并与实验组在骨骼年龄、性别和颅面形态方面进行匹配。使用自定义的头影测量分析生成31个变量以及区域重叠图，在不同时间点评估治疗变化。采用单因素方差分析和Tukey-Kramer检验对数据进行分析。
AdvanSync矫治器联合固定正畸治疗的效果包括上颌生长受限、下颌切牙前突、前倾和内收以及下颌磨牙近中移动（P<0.01）。II类弹力牵引联合固定正畸治疗的效果与AdvanSync矫治器联合固定正畸治疗相似，但上颌生长受限程度较轻，上颌切牙后缩和后倾程度更大（P<0.01）。相对于未治疗的对照组，两种治疗方式均未出现显著的下颌生长刺激。
在正畸综合固定矫治过程中，AdvanSync矫治器联合颌间弹力牵引在矫治II类错牙合畸形方面均有效。AdvanSync矫治器通过限制上颌骨骼生长和改变下颌牙槽骨发挥作用。II类弹力牵引主要通过上颌和下颌牙槽骨的改变发挥作用。
