Department of Orthodontics, Heinrich-Heine-University, Kasernenstr. 1, 40213, Düsseldorf, Germany.
Private Practice, Düsseldorf, Germany.
Prog Orthod. 2018 Oct 22;19(1):42. doi: 10.1186/s40510-018-0239-8.
Protraction of maxilla is usually the preferred and more commonly used treatment approach for skeletal Class III with a retrognathic maxilla. The aim of this study was the comparison of the skeletal and dental effects of two skeletally borne appliances for maxillary protraction: a) Hybrid-Hyrax in combination with facemask (FM), b) Hybrid-Hyrax in combination with Mentoplate (ME).
Thirty four Patients (17 facemask, 17 Mentoplate) were investigated by means of pre- and posttreatment cephalograms. The two groups matched with regard to treatment time, age gender and type of dentoskeletal deformity before treatment.
Both groups showed a significant forward movement of A-point (FM GROUP: SNA + 2.23° ± 1.30°- p 0.000*; ME: 2.23° ± 1.43°- p 0.000*). B-Point showed a larger sagittal change in the FM Group (SNB 1.51° ± 1.1°- p 0.000*) compared to the ME group (SNB: - 0.30° ± 0.9°- p 0.070). The FM group showed a significant increase of the ML-NL + 1.86° ± 1.65° (p 0.000*) and NSL-ML + 1.17° ± 1.48 (p 0.006*). Upper Incisor inclination did not change significantly during treatment in both groups as well as the distance of the first upper Molar in relation to A-point.
Both treatments achieve comparable rates of maxillary protraction, without dentoalveolar side effects. Skeletal anchorage with symphysial plates in the mandible provides greater vertical control and might be the treatment of choice in high angle patients.
上颌骨的伸展通常是治疗上颌后缩的首选和更常用的方法。本研究的目的是比较两种骨骼支抗上颌骨伸展的骨骼和牙齿效果:a)Hybrid-Hyrax 与面弓(FM)联合,b)Hybrid-Hyrax 与颏兜(ME)联合。
34 名患者(17 名使用面弓,17 名使用颏兜)通过治疗前后的头颅侧位片进行研究。两组在治疗时间、年龄、性别和治疗前牙颌面畸形类型方面相匹配。
两组 A 点均有显著的前向移动(FM 组:SNA +2.23°±1.30°-p<0.000*;ME 组:2.23°±1.43°-p<0.000*)。B 点在 FM 组的矢状变化较大(SNB 1.51°±1.1°-p<0.000*),而在 ME 组变化较小(SNB:-0.30°±0.9°-p<0.070)。FM 组的 ML-NL 增加了 1.86°±1.65°(p<0.000*),NSL-ML 增加了 1.17°±1.48°(p<0.006*)。两组在治疗过程中上颌切牙倾斜度均无明显变化,上颌第一磨牙相对于 A 点的距离也无明显变化。
两种治疗方法均能达到相似的上颌骨牵引效果,且无牙颌面副作用。下颌骨颏部的骨性支抗提供了更大的垂直控制,可能是高角患者的首选治疗方法。