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正畸掩饰治疗与正颌手术治疗Ⅲ类错畸形:头影测量对比分析

Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis.

作者信息

Martinez P, Bellot-Arcís C, Llamas J M, Cibrian R, Gandia J L, Paredes-Gallardo V

机构信息

Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.

Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.

出版信息

Int J Oral Maxillofac Surg. 2017 Apr;46(4):490-495. doi: 10.1016/j.ijom.2016.12.001. Epub 2016 Dec 26.

Abstract

The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella-nasion-A-point (SNA), sella-nasion-B-point (SNB), and A-point-nasion-B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle. There were statistically significant differences in cephalometric variables before and after treatment between the two groups. The percentage of normal pre-treatment measurements in the camouflage orthodontics group was 30.7%, which worsened slightly to 28.4% post-treatment. However in the group receiving surgery, this was 24.5% pre-treatment, improving to 33.5% after surgery. SNA, SNB, Wits appraisal, lower incisor inclination, and inter-incisal angle showed differences between the two groups before and after treatment. Wits appraisal, lower incisor inclination, and inter-incisal angle were indicative of one or other treatment. Upper and lower incisor decompensation in both groups did not reach ideal values, which impeded complete skeletal correction in 52% of surgical cases.

摘要

本研究的目的是比较成年III类错牙合患者治疗前后的不同头影测量变量,以确定哪些变量可指示正畸掩饰治疗或正颌外科手术。对156例成年患者的病例进行了评估:77例接受正畸掩饰治疗,79例接受正畸和正颌外科联合治疗。在治疗前(T1)和治疗后(T2)的头颅侧位片上测量以下头影测量变量:蝶鞍-鼻根点-A点(SNA)、蝶鞍-鼻根点-B点(SNB)以及A点-鼻根点-B点(ANB)角、Wits值、面轴角、下颌平面角、上下切牙倾斜度以及切牙间角。两组治疗前后的头影测量变量存在统计学显著差异。正畸掩饰治疗组治疗前测量值正常的百分比为30.7%,治疗后略有恶化,降至28.4%。然而,接受手术治疗的组治疗前为24.5%,手术后提高到33.5%。SNA、SNB、Wits值、下切牙倾斜度和切牙间角在两组治疗前后存在差异。Wits值、下切牙倾斜度和切牙间角可指示其中一种治疗方式。两组上下切牙的代偿均未达到理想值,这在52%的手术病例中阻碍了骨骼的完全矫正。

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