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青少年低角和高角Ⅱ类错牙合畸形经改良 C 型腭托远移后牙颌和骨骼的变化。

Dental and skeletal effects after total arch distalization using modified C-palatal plate on hypo- and hyperdivergent Class II malocclusions in adolescents.

出版信息

Angle Orthod. 2021 Jan 1;91(1):22-29. doi: 10.2319/031720-188.1.

Abstract

OBJECTIVES

To compare the dental and skeletal treatment effects after total arch distalization using modified C-palatal plates (MCPPs) on adolescent patients with hypo- and hyperdivergent Class II malocclusion.

MATERIALS AND METHODS

The study group included 40 patients with Class II malocclusion (18 boys and 22 girls, mean age = 12.2 ± 1.4 years) treated with MCPPs. Fixed orthodontic treatment started with the distalizing process in both groups. Participants were divided into hypo- or hyperdivergent groups based on their pretreatment Frankfort mandibular plane angle (FMA) ≤22° or ≥28°, respectively. Pre- and posttreatment lateral cephalograms were digitized, and 23 variables were measured and compared for both groups using paired and independent t-tests.

RESULTS

The hyper- and hypodivergent groups showed 2.7 mm and 4.3 mm of first molar crown distalizing movement, respectively (P < .001). The hypodivergent group had a slight 2.2° crown distal tipping of first molars compared with 0.3° in the hyperdivergent group. After distalization, the FMA increased 3.1° and 0.3°, in the hypodivergent and hyperdivergent groups, respectively (P < .001). SNA decreased in the hypodivergent group, while other skeletal variables presented no statistically significant differences in the changes between the groups.

CONCLUSIONS

The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.

摘要

目的

比较使用改良 C 形腭板(MCPP)远移全弓后,低角和高角 II 类错(牙合)畸形青少年患者的牙颌和骨骼治疗效果。

材料和方法

研究组包括 40 名 II 类错(牙合)畸形患者(18 名男孩和 22 名女孩,平均年龄=12.2±1.4 岁),使用 MCPP 治疗。两组均在远移过程中开始固定正畸治疗。根据治疗前法兰克福下颌平面角(FMA)≤22°或≥28°,将患者分为低角或高角组。对治疗前后的侧位头颅侧位片进行数字化,使用配对和独立 t 检验对两组的 23 个变量进行测量和比较。

结果

高角组和低角组的第一磨牙冠远移分别为 2.7mm 和 4.3mm(P<.001)。低角组第一磨牙冠远中倾斜角较高角组略小,为 2.2°,而高角组为 0.3°。远移后,低角组 FMA 增加 3.1°,高角组增加 0.3°(P<.001)。低角组 SNA 减小,而其他骨骼变量在组间变化无统计学差异。

结论

低角组上颌第一磨牙远移和倾斜角度大于高角组,FMA 增加较多。因此,临床医生在使用 MCPP 进行 II 类非拔牙治疗时,必须考虑垂直面型。

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