Fidler B C, Artun J, Joondeph D R, Little R M
Department of Orthodontics, University of Washington, Seattle.
Am J Orthod Dentofacial Orthop. 1995 Mar;107(3):276-85. doi: 10.1016/s0889-5406(95)70143-5.
The purpose of this study was to examine long-term stability of Angle Class II, Division 1 malocclusions with successful occlusal results at the end of active appliance therapy, search for predictors of relapse, and look for characteristics associated with successful treatment. Records taken before and after treatment and a mean of 14.0 years postretention of adolescent patients treated for a significant Angle Class II, Division 1 malocclusion both with and without tooth extraction were evaluated. The sample was limited to successfully treated cases as judged by subjective evaluation of intercuspation and incisor occlusion of posttreatment study models and included 78 patients. Cephalometric characteristics or postretention occlusion was not considered in sample selection. The mode response was no change postretention for molar, premolar, and canine relationships and relapse of 0.5 mm for overjet and overbite. Maximum relapse was 3.5 mm for molar, premolar, and canine relationship, 3 mm for overjet, and 4.5 mm for overbite. Stepwise backward multiple regression analyses revealed no associations between either pretreatment characteristics or skeletal and dental treatment changes and relapse of overjet. However, relapse of overjet was associated with relapse of molar, premolar, and canine relationships, postretention increase in overbite, postretention proclination of maxillary incisors, and postretention retroclination of mandibular incisors. Active treatment changes included redirection or inhibition of maxillary growth and retraction of maxillary incisors. Mandibular incremental growth was favorable both during and after treatment. It was concluded that successful correction of Angle Class II, Division 1 malocclusions through differential growth adaptation and tooth movement appears to be very stable.
本研究的目的是检查在活动矫治器治疗结束时具有成功咬合结果的安氏II类1分类错牙合的长期稳定性，寻找复发的预测因素，并寻找与成功治疗相关的特征。对青少年患者在治疗前后以及保持平均14.0年后的记录进行了评估，这些患者均接受了有或无拔牙的明显安氏II类1分类错牙合治疗。样本仅限于根据治疗后研究模型的尖窝关系和切牙咬合的主观评估判断为成功治疗的病例，包括78名患者。样本选择时未考虑头影测量特征或保持后的咬合情况。磨牙、前磨牙和尖牙关系在保持后无变化，覆盖和覆牙合复发0.5mm为最常见反应。磨牙、前磨牙和尖牙关系的最大复发为3.5mm，覆盖为3mm，覆牙合为4.5mm。逐步向后多元回归分析显示，治疗前特征或骨骼及牙齿治疗变化与覆盖复发之间均无关联。然而，覆盖复发与磨牙、前磨牙和尖牙关系的复发、保持后覆牙合增加、保持后上颌切牙前倾以及保持后下颌切牙后倾有关。积极治疗的变化包括上颌生长的重新导向或抑制以及上颌切牙的后移。下颌的渐进性生长在治疗期间和治疗后均有利。得出的结论是，通过差异生长适应和牙齿移动成功矫治安氏II类1分类错牙合似乎非常稳定。
