Angle Orthod. 2024 Mar 1;94(2):159-167. doi: 10.2319/062723-447.1.
To compare posttreatment stability in skeletal Class III patients between those treated by total mandibular arch distalization (TMAD) with buccal mini-implants and those by mandibular setback surgery (MSS).
The samples included 40 Class III adults, 20 treated by TMAD using buccal interradicular mini-implants and 20 treated with MSS. Lateral cephalograms were taken at pretreatment, posttreatment, and at least 1-year follow-up, and 24 variables were compared using statistical analysis.
Mandibular first molars moved distally 1.9 mm with intrusion of 1.1 mm after treatment in the TMAD group. The mandibular incisors moved distally by 2.3 mm. The MSS group exhibited a significant skeletal change of the mandible, whereas the TMAD group did not. During retention, there were no skeletal or dental changes other than 0.6 mm labial movement of the mandibular incisors (P < .05) in the MSS group. There was 1.4° of mesial tipping (P < .01) and 0.4 mm of mesial movement of the mandibular molars and 1.9° of labial tipping (P < .001) and 0.8 mm of mesial movement of the mandibular incisors in the TMAD group. These dental changes were not significantly different between the two groups.
The TMAD group showed a slightly decreased overjet with labial tipping of the mandibular incisors and mesial tipping of the first molars during retention. Posttreatment stability of the mandibular dentition was not significantly different between the groups. It can be useful to plan camouflage treatment by TMAD with mini-implants in mild-to-moderate Class III patients.
比较使用颊侧支抗微型种植体远移下颌全弓的治疗效果与下颌骨后退术(MSS)在治疗骨性 III 类错颌患者中的治疗后稳定性。
纳入 40 名成人骨性 III 类错颌患者,其中 20 名患者接受 TMAD 治疗(使用颊侧支抗微型种植体远移下颌全弓),20 名患者接受 MSS 治疗。在治疗前、治疗后和至少 1 年随访时拍摄侧位头颅侧位片,并使用统计学分析比较 24 个变量。
TMAD 组治疗后下颌第一磨牙远中移动 1.9mm,同时压低 1.1mm。下颌切牙远中移动 2.3mm。MSS 组下颌骨发生明显的骨骼变化,而 TMAD 组没有。在保持期,MSS 组除了下颌切牙唇向移动 0.6mm 外,没有骨骼或牙齿的变化(P<0.05)。TMAD 组下颌磨牙近中倾斜 1.4°(P<0.01),近中移动 0.4mm,下颌切牙唇向倾斜 1.9°(P<0.001),近中移动 0.8mm。两组之间这些牙齿的变化没有显著差异。
TMAD 组在保持期,下颌切牙唇倾和第一磨牙近中倾斜,导致覆盖略有减小。两组下颌牙列的治疗后稳定性无显著差异。对于轻度至中度骨性 III 类错颌患者,使用颊侧支抗微型种植体的 TMAD 进行掩饰性治疗的计划可能是有用的。