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生长型后缩型高角超(牙合)患者的矫形治疗能否获得稳定的效果?

Do orthopedic corrections of growing retrognathic hyperdivergent patients produce stable results?

出版信息

Angle Orthod. 2019 Jul;89(4):552-558. doi: 10.2319/061818-460.1. Epub 2019 Feb 11.

Abstract

OBJECTIVES

To determine if posterior dental intrusion produces stable orthodontic and orthopedic corrections in growing retrognathic hyperdivergent patients.

MATERIALS AND METHODS

The sample included 14 subjects (five males and nine females), who were 13.4 ± 0.7 years pretreatment, treated for 3.5 years, and followed for 3.6 years posttreatment. During the initial orthopedic phase, 150 g NiTi coil springs were attached to two palatal miniscrew implants (MSIs) for maxillary intrusion; two buccal mandibular MSIs were used for posterior vertical control. Full orthodontic therapy was initiated to correct the malocclusions during the orthodontic phase. Patients were recalled a minimum of 1 year posttreatment (mean 3.6 ±1.6 years). Patients were compared to matched untreated controls.

RESULTS

Relative to the untreated controls, during treatment and retention, maxillary and mandibular molars underwent 2.8 mm and 3.7 mm of relative posterior intrusion, respectively. Maxillary incisors were extruded 1.3 mm and the mandibular incisors underwent 2.9 mm of relative intrusion. Overall orthopedic changes included a reduction in the mandibular plane angle (MPA; 3.3°), an increase in SN-Pg (2.4°), an increase in S-N-B (2.1°), and a 4.3 mm relative reduction in anterior facial height. The maxillary incisors, which showed 0.6 mm of intrusion (relative to controls), was the only dental or skeletal measure to show a statistically significant between-group posttreatment difference.

CONCLUSIONS

Except for maxillary incisor position, the substantial dental intrusion and associated orthopedic corrections that were produced during treatment remained stable post-treatment.

摘要

目的

确定后牙内倾是否能为生长型后缩型高角患者提供稳定的正畸和矫形矫正效果。

材料与方法

本研究共纳入 14 名受试者(5 名男性,9 名女性),治疗前年龄为 13.4±0.7 岁,治疗 3.5 年,随访 3.6 年。在初始矫形阶段,150gNiTi 螺旋弹簧被连接到两个腭侧微型种植体支抗(MSI)上以实现上颌骨内倾;两个颊向下颌 MSI 用于后向垂直控制。在矫形阶段,开始进行全牙列正畸治疗以矫正错合畸形。患者在治疗后至少 1 年(平均 3.6±1.6 年)时被召回。将患者与未治疗的匹配对照组进行比较。

结果

与未治疗的对照组相比,在治疗和保持期,上颌磨牙和下颌磨牙分别发生了 2.8mm 和 3.7mm 的相对后倾。上颌切牙被挤出 1.3mm,下颌切牙发生 2.9mm 的相对内倾。整体矫形变化包括下颌平面角(MPA)减小 3.3°,SN-Pg 增加 2.4°,S-N-B 增加 2.1°,以及前后面高相对减少 4.3mm。上颌切牙的内倾量为 0.6mm(与对照组相比),是唯一一项在治疗后显示出组间统计学差异的牙性或骨性测量指标。

结论

除了上颌切牙位置外,治疗过程中产生的大量牙齿内倾和相关的矫形矫正效果在治疗后仍保持稳定。

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