Angle Orthod. 2021 Jul 1;91(4):449-458. doi: 10.2319/090320-768.1.
To evaluate skeletal, dentoalveolar, and soft tissue changes between intraoral light force application and extraoral heavy force application in growing patients with skeletal Class III malocclusion.
Methods: A retrospective study was conducted with pretreatment and posttreatment lateral cephalometric data from 50 subjects with skeletal Class III malocclusion. In the first group (15 boys, 10 girls; 8.67 ± 2.13 years old), each subject wore a biocreative horseshoe appliance (CHS) with two Class III elastics that exerted a force of 200 g. In the second group (13 boys, 12 girls; 8.96 ± 1.82 years old), each subject wore a Petit-type facemask and a lingual arch with hooks fixed to the maxillary arch with a total force of 700 g. Both groups of patients were instructed to wear the appliance approximately 14 hours a day, and 22 linear measurements and 8 angular measurements were evaluated. Changes of measurements from each group were compared by paired t-tests, considering a 5% significance level.
Forward growth of the maxilla, improvement of the maxilla-mandible relationship, and upper incisor flaring were achieved in both groups without any statistically significant difference between them. Lateral cephalometric analysis also showed that U1 exposure, IMPA (Angle between mandibular plane and mandibular incisor axis), FMIA (Angle between FH plan and mandibular incisor axis), and L1-APog (Angle formed by the intersection of tooth axis of lower incisor and A-Pog line, Distance from lower incisor edge to A-Pog line) showed statistically significant differences. Lower incisors were inclined lingually in the CHS group.
During treatment of skeletal Class III malocclusion, the CHS with light Class III intermaxillary elastics therapy exhibits similar orthopedic changes to the maxillary complex and more dental changes to the lower anterior teeth compared with facemask therapy.
评估生长发育期骨性 III 类错(牙合)畸形患者采用口内轻力和口外大力应用时骨骼、牙牙槽和软组织的变化。
本研究为回顾性研究,纳入 50 例骨性 III 类错(牙合)畸形患者的治疗前后侧位头颅侧位片。在第一组(15 名男孩,10 名女孩;8.67 ± 2.13 岁)中,每个患者均佩戴生物活性马蹄形矫治器(CHS),并用 200 g 的 III 类橡皮筋施加力。在第二组(13 名男孩,12 名女孩;8.96 ± 1.82 岁)中,每个患者均佩戴 Petit 型面具和带有钩的舌弓,上颌弓上总力为 700 g。两组患者均被指示每天佩戴矫治器约 14 小时,评估 22 项线性测量值和 8 项角度测量值。使用配对 t 检验比较两组的测量值变化,以 5%的显著性水平为标准。
两组均实现了上颌骨的向前生长、上颌骨-下颌骨关系的改善和上颌切牙的外展,两组之间无统计学差异。侧位头颅侧位片分析还显示,U1 暴露、IMPA(下颌平面与下颌切牙轴的夹角)、FMIA(FH 平面与下颌切牙轴的夹角)和 L1-APog(下切牙轴与 A-Pog 线的交点形成的角度,下切牙边缘到 A-Pog 线的距离)存在统计学差异。CHS 组的下颌切牙向舌侧倾斜。
在治疗骨性 III 类错(牙合)畸形时,CHS 配合轻力 III 类颌间弹性治疗对上颌复合体的矫形变化与面具治疗相似,但对下前牙的牙齿变化更大。