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三种不同功能矫治器治疗青少年患者的面部软组织变化:一项随机临床试验。

Facial soft tissue changes in adolescent patients treated with three different functional appliances: a randomized clinical trial.

机构信息

State University of Rio de Janeiro, School of Dentistry, Department of Orthodontics (Rio de Janeiro/RJ, Brazil).

出版信息

Dental Press J Orthod. 2024 Oct 7;29(5):e242440. doi: 10.1590/2177-6709.29.5.e242440.oar. eCollection 2024.

DOI:10.1590/2177-6709.29.5.e242440.oar
PMID:39383371
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11457964/
Abstract

INTRODUCTION

Patients with Class II, division 1 malocclusion generally seek treatment to improve facial esthetics. Therefore, the orthodontist needs to know the changes in the soft profile produced by functional appliances.

OBJECTIVE

This study evaluated the soft tissue profile changes in patients treated during the peak of the pubertal growth spurt.

METHODS

Thirty selected patients were randomized into three treatment groups: Twin Block (TB), Herbst with dental anchorage (HDA), and Herbst with skeletal anchorage (HSA). All patients had computed tomographic images: pretreatment (T1) and after 12 months of active treatment (T2). Twenty-four soft tissue cephalometric measures were analyzed. The normality of all data was assessed by the Shapiro-Wilk test. Intragroup comparisons were analyzed using the t-paired test; the inter-group comparisons were determined through ANOVA and the post-hoc Tukey test.

RESULTS

At T1, no significant differences were observed between groups. At T2, in the intragroup comparison, facial soft tissue changes were statistically significant in the three groups for the lower lip, sulcus inferioris, facial soft tissue convexity in HDA group and TB group, and H angle in HDA group and HSA group, and soft tissue pogonium in TB group. In the inter-group comparison, no statistically significant differences were observed.

CONCLUSION

It can be concluded that there were significant changes in soft tissue measurements that benefited Class II, division 1 patient's facial profile treated with the functional appliances Twin Block, Herbst, and Herbst with skeletal anchorage. Nevertheless, no significant differences were detected among the effects obtained by the three treatment protocols.

摘要

简介

患有安氏 II 类 1 分类错颌畸形的患者通常寻求治疗以改善面型美观。因此,正畸医生需要了解功能性矫治器对面部软组织侧貌的改变。

目的

本研究评估了在青春生长高峰期接受治疗的患者的软组织侧貌变化。

方法

将 30 名患者随机分为三组:双板矫治器(TB)、带牙支抗的Herbst(HDA)和带骨支抗的 Herbst(HSA)。所有患者均行 CT 扫描:治疗前(T1)和治疗 12 个月后(T2)。分析 24 项软组织头影测量指标。采用 Shapiro-Wilk 检验评估所有数据的正态性。采用配对 t 检验进行组内比较;采用方差分析和事后 Tukey 检验进行组间比较。

结果

在 T1 时,三组间无显著差异。在 T2 时,组内比较中,三组患者的下唇、下龈沟、HDA 组和 TB 组的软组织前凸、HDA 组和 HSA 组的 H 角以及 TB 组的软组织颏前点均有统计学意义。组间比较无统计学差异。

结论

可以得出结论,使用 Twin Block、Herbst 和 Herbst 带骨支抗三种功能性矫治器治疗安氏 II 类 1 分类错颌畸形患者的软组织测量值有显著变化,改善了患者的面型。然而,三种治疗方案的效果之间没有发现显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/4ececbe06ce7/2177-6709-dpjo-29-05-e242440-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/f1799b7b8f6e/2177-6709-dpjo-29-05-e242440-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/97f1b541e11c/2177-6709-dpjo-29-05-e242440-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/7172688a2e87/2177-6709-dpjo-29-05-e242440-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/8fed315b8a82/2177-6709-dpjo-29-05-e242440-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/6a3e490a9c0b/2177-6709-dpjo-29-05-e242440-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/4ececbe06ce7/2177-6709-dpjo-29-05-e242440-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/f1799b7b8f6e/2177-6709-dpjo-29-05-e242440-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/97f1b541e11c/2177-6709-dpjo-29-05-e242440-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/7172688a2e87/2177-6709-dpjo-29-05-e242440-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/8fed315b8a82/2177-6709-dpjo-29-05-e242440-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/6a3e490a9c0b/2177-6709-dpjo-29-05-e242440-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641a/11457964/4ececbe06ce7/2177-6709-dpjo-29-05-e242440-gf6.jpg

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本文引用的文献

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Cochrane Database Syst Rev. 2018 Mar 13;3(3):CD003452. doi: 10.1002/14651858.CD003452.pub4.
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Can the use of skeletal anchors in conjunction with fixed functional appliances promote skeletal changes? A systematic review and meta-analysis.使用骨骼锚固装置结合固定功能矫治器能否促进骨骼改变?一项系统评价与Meta分析。
Eur J Orthod. 2016 Oct;38(5):532-45. doi: 10.1093/ejo/cjv081. Epub 2015 Dec 28.
3
A comparison of the efficacy of fixed versus removable functional appliances in children with Class II malocclusion: A systematic review.
固定功能矫治器与活动功能矫治器治疗安氏II类错颌儿童的疗效比较:一项系统评价
Eur J Orthod. 2016 Dec;38(6):621-630. doi: 10.1093/ejo/cjv086. Epub 2015 Nov 30.
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Facial profile esthetic preferences: perception in two Brazilian states.面部轮廓审美偏好:巴西两个州的认知情况
Dental Press J Orthod. 2015 May-Jun;20(3):88-95. doi: 10.1590/2176-9451.20.3.088-095.oar.
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Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis.固定功能矫治器治疗安氏II类错颌畸形患者的疗效:一项系统评价与Meta分析
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