微型螺钉锚定上颌前牵引的牙骨骼效应：评估下颌锚固杆和夜间面罩的作用。

Dentoskeletal effects of miniscrew-anchored maxillary protraction: Evaluating the role of mandibular anchorage bar and night facemask.

作者信息

Manhães Fernando Rayes, Pereira da Silva Tafnes, André Cristiane Barros, Valdrighi Heloísa Cristina, Carmo de Menezes Carolina, Vedovello Silvia A S

机构信息

Araras Dental School, Department of Orthodontic, University Center of Hermınio Ometto Foundation-FHO, Araras, São Paulo, Brazil.

Research and Development Sector, Kika Digital Orthodontics, Sorocaba, São Paulo, Brazil.

出版信息

Am J Orthod Dentofacial Orthop. 2025 Apr;167(4):436-443. doi: 10.1016/j.ajodo.2024.11.004. Epub 2024 Dec 20.

DOI:10.1016/j.ajodo.2024.11.004

PMID:39708002

Abstract

INTRODUCTION

This study evaluated the dentoskeletal effects of miniscrew-anchored maxillary protraction, which included a mandibular anchorage bar and a night facemask in adolescents.

METHODS

A total of 20 growing patients with Class III malocclusion and maxillary deficiency were treated with a hybrid hyrax expander with 2 miniscrews in the maxilla and a mandibular anchor bar supported in 2 miniscrews in the anterior region of the mandible. Class III elastics were used from the maxillary first molars to the mandibular anchorage bar, joining the mandibular miniscrews installed between permanent incisors and canines. The variables that met the presuppositions of a parametric analysis were analyzed using the paired t test, and the remaining variables were analyzed using the nonparametric Wilcoxon paired test.

RESULTS

The final sample included 17 subjects (4 females and 13 males; initial age, 12.3 ± 1.2 years). The results demonstrated a significant increase in Wits appraisal (mm), ANB (°), SNA (°), N perp-A (mm), Co-A (mm), Co-Gn (mm), AFAI (mm), molar relationship (mm), overjet (mm), U6-vertical Pt (mm), L1-NB (mm) and U1-L1 (°) (P <0.05).

CONCLUSIONS

The study showed that miniscrew-anchored maxillary protraction associated with facemasks and mandibular anchorage bars produces positive skeletal effects in adolescents while also favoring the control of dental effects.

摘要

引言

本研究评估了微型螺钉锚定上颌前牵引的牙颌面效应，该方法包括下颌锚固杆和夜间面罩，用于青少年患者。

方法

共有20例生长发育期的III类错颌畸形和上颌骨发育不足患者接受治疗，采用混合式扩弓器，在上颌植入2枚微型螺钉，在下颌前部区域的2枚微型螺钉上支撑下颌锚固杆。使用III类弹力牵引，从 maxillary第一磨牙至下颌锚固杆，连接安装在恒切牙和尖牙之间的下颌微型螺钉。对符合参数分析预设条件的变量采用配对t检验进行分析，其余变量采用非参数Wilcoxon配对检验进行分析。

结果

最终样本包括17名受试者（4名女性和13名男性；初始年龄，12.3±1.2岁）。结果显示，Wits值（mm）、ANB（°）、SNA（°）、N垂线-A（mm）、Co-A（mm）、Co-Gn（mm）、AFAI（mm）、磨牙关系（mm）、覆盖（mm）、U6垂直于Pt（mm）、L1-NB（mm）和U1-L1（°）均有显著增加（P<0.05）。