Bombonatti Roberto, Aliaga-Del Castillo Arón, Bombonatti Juliana Fraga Soares, Garib Daniela, Tompson Bryan, Janson Guilherme
Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia, (Bauru/SP, Brazil).
Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos (Bauru/SP, Brazil).
Dental Press J Orthod. 2020 Jul-Aug;25(4):24-32. doi: 10.1590/2177-6709.25.4.024-032.oar.
The aim of this retrospective study was to evaluate the cephalometric and occlusal changes of orthodontically treated Class III malocclusion patients.
The experimental groups comprised 37 Class III patients treated: G1) without (n=19) and G2) with extractions (n=18) . The control group (G3), matched by age and sex with the experimental groups, consisted of 18 subjects with untreated Class III malocclusion. Cephalometric (radiographs) and occlusal (study models) changes were assessed between the beginning (T1) and the end (T2) of treatment. Intergroup comparisons were performed with one-way ANOVA followed by Kruskal-Wallis tests (p< 0.05). Occlusal changes were evaluated by the peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the treatment outcomes were evaluated by the Objective Grading System (OGS) (t-tests).
The experimental groups showed a restrictive effect on mandibular anterior displacement and a discrete improvement in the maxillomandibular relationship. Extraction treatment resulted in a greater retrusive movement of the incisors and significant improvements in the overjet and molar relationship in both groups. The PAR indexes were significantly reduced with treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no significant intergroup difference.
Orthodontic treatment of Class III malocclusion patients with fixed appliances improved the sagittal relationships, with greater incisor retrusion in the extraction group. Both the extraction and non-extraction treatments significantly decreased the initial malocclusion severity, with adequate and similar occlusal outcomes of treatment.
本回顾性研究旨在评估正畸治疗的Ⅲ类错颌畸形患者的头影测量和咬合变化。
实验组包括37例接受治疗的Ⅲ类患者：G1组（19例）未拔牙，G2组（18例）拔牙。对照组（G3组）由18例未经治疗的Ⅲ类错颌畸形患者组成，年龄和性别与实验组匹配。在治疗开始（T1）和结束（T2）时评估头影测量（X线片）和咬合（研究模型）变化。组间比较采用单因素方差分析，随后进行Kruskal-Wallis检验（p<0.05）。咬合变化通过同行评估评分（PAR）指数（方差分析和Kruskal-Wallis检验）进行评估，治疗结果通过客观分级系统（OGS）（t检验）进行评估。
实验组对下颌前移位有抑制作用，上下颌关系有明显改善。拔牙治疗使两组患者的切牙后移更大，覆盖和磨牙关系有显著改善。治疗后PAR指数显著降低，OGS评分G1组为25.6，G2组为28.6，组间无显著差异。
使用固定矫治器对Ⅲ类错颌畸形患者进行正畸治疗可改善矢状关系，拔牙组切牙后移更大。拔牙和非拔牙治疗均显著降低了初始错颌畸形的严重程度，治疗后的咬合结果充分且相似。
