Zhou Z J, Chen Y, Lin Y J, Sun Y T, Wang T G, Mao L X, Liu J Q
Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology & National Clinical Research Center of Stomatology, Shanghai 200011, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2021 Jan 9;56(1):63-69. doi: 10.3760/cma.j.cn112144-20200330-00180.
To investigate the correlation between tooth movement and profile change in patients with class Ⅱ division 1 malocclusion. Pre- and post-treatment lateral cephalograms of 42 patients [10 males and 32 females, (23.8±6.3) years old, mean treatment time: 1.9 years] with class Ⅱ division 1 malocclusion were collected in Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from June 2012 to November 2017. The patients were treated with extraction of four first premolars or two maxillary first premolars. Cephalometric analysis was carried out before and after treatment. Thirty parameters were measured. The changes of soft and hard tissue after orthodontic treatment and their correlations were analyzed using bivariate linear regression. Related factors affecting the upper and lower lip, nasolabial angle (NLA) and mentolabial angle (MLA) were analyzed according to the standardized regression coefficient (). Among all the 30 parameters, 18 parameters were statistically different before and after treatment. After treatment, upper central incisor sagittal distance [(63.87±7.14) mm] and upper lip sagittal distance [(77.73±7.60) mm] were significantly decreased (<0.05). The changes in 14 parameters after treatment showed linear relationship including strong positive correlation between upper lip sagittal retraction and upper central incisor sagittal retraction (=0.649, <0.01). There were moderate positive correlations between upper lip and upper central incisor vertical movement (=0.544, <0.01). While the sagittal change of gnathion and the Y-axis angle showed moderate negative correlations (=0.537, <0.01). The stepwise multiple linear regression showed that the retraction of upper lip process was correlated with the retraction of upper central incisor, the increase of occlusal plane angle and the increase of upper central incisor angle, which was most correlated with the retraction of upper central incisor (=0.79). The downward displacement of upper lip process was correlated with the downward displacement of upper incisor, the decrease of upper central incisor angle, the decrease of the distance between maxillary first molar and palatal plane, and the increase of occlusal plane angle, which was more correlated with the downward displacement of upper incisor and the increase of occlusal plane angle (=0.59). The downward displacement of lower lip process was correlated with the downward displacement of upper incisor and lower incisor, which was more correlated with the upper incisor (=0.36). The relationship among nose, lips and chin was more coordinated. Incisor retraction had significant influence on lip prominence, and the lower lip position was highly related to the movement of upper incisor in sagittal and vertical dimension after orthodontic treatment in patients with class Ⅱ division 1 malocclusion. However, tooth movement had limited impact on the chin position.
探讨安氏Ⅱ类1分类错牙合患者牙齿移动与面部轮廓变化之间的相关性。收集了上海交通大学医学院附属第九人民医院口腔颅颌面外科2012年6月至2017年11月期间42例安氏Ⅱ类1分类错牙合患者[10例男性，32例女性，年龄(23.8±6.3)岁，平均治疗时间：1.9年]治疗前和治疗后的头颅侧位片。这些患者接受了拔除四颗第一前磨牙或两颗上颌第一前磨牙的治疗。治疗前后进行了头影测量分析。测量了30个参数。采用双变量线性回归分析正畸治疗后软硬组织的变化及其相关性。根据标准化回归系数(β)分析影响上、下唇、鼻唇角(NLA)和颏唇沟角(MLA)的相关因素。在所有30个参数中，18个参数在治疗前后有统计学差异。治疗后，上颌中切牙矢状距[(63.87±7.14)mm]和上唇矢状距[(77.73±7.60)mm]显著减小(P<0.05)。治疗后14个参数的变化呈线性关系，包括上唇矢状向退缩与上颌中切牙矢状向退缩之间呈强正相关(β=0.649，P<0.01)。上唇与上颌中切牙垂直向移动之间呈中度正相关(β=0.544，P<0.01)。而颏点矢状向变化与Y轴角呈中度负相关(β=0.537，P<0.01)。逐步多元线性回归显示，上唇突度的退缩与上颌中切牙的退缩、牙合平面角的增加和上颌中切牙角的增加相关，其中与上颌中切牙的退缩相关性最强(β=0.79)。上唇突度的向下移位与上颌中切牙的向下移位、上颌中切牙角的减小、上颌第一磨牙与腭平面距离的减小和牙合平面角的增加相关，其中与上颌中切牙的向下移位和牙合平面角的增加相关性更强(β=0.59)。下唇突度的向下移位与上颌中切牙和下颌中切牙的向下移位相关，其中与上颌中切牙相关性更强(β=0.36)。鼻、唇、颏的关系更加协调。切牙的内收对唇部突度有显著影响，在安氏Ⅱ类1分类错牙合患者正畸治疗后，下唇位置在矢状向和垂直向与上颌中切牙的移动高度相关。然而，牙齿移动对颏部位置的影响有限。
