快速扩弓结合上颌前方牵引治疗上颌骨发育不足的研究.docVIP

快速扩弓结合上颌前方牵引治疗上颌骨发育不足的研究 　　【摘要】 目的：探讨前方牵引结合快速扩弓治疗骨性前牙反的疗效。方法：选取2006年6月-2012年5月本院正畸科收治的上颌发育不足引起的骨性Ⅲ类错患者18例，其中男8例，女10例；年龄8.5～13.5岁，平均10.3岁。治疗前、中、后分别拍摄头颅侧位X线片，进行头影测量分析，治疗前后各指标比较采用方差分析。结果：所有患者均由Class Ⅲ矫正为Class Ⅰ类，牵引结束上颌骨A点平均移动2.03 mm（P0.001）。SNA平均前移0.92度（P0.01），上切牙向前移动平均2.75 mm（P0.001），上切牙至SN角度平均改变5.01度（P0.01）。Class Ⅲ关系有复发趋势，可能是下颌生长导致。结论：Class Ⅲ错接近于4～5 mm的反覆盖或者更小比较接近成功矫治的范围。研究结果表明，牙齿和骨骼的改变是均等的，但这并不意味着反覆盖大于5 mm就成为禁忌证。上颌骨前移的效果基本稳定，Class Ⅲ的复发趋势主要是由于下颌骨进一步生长的结果。 　　【关键词】 骨性反； 头影测量分析； 前方牵引； 快速扩弓 　　【Abstract】 Objective：To evaluate the curative effect of maxillary protraction combined with rapid maxillary expansion in treatment of skeletal anterior crossbite.Method：18 skeletal anterior crossbite patients caused by maxillary deficiency from department of orthodontics in our hospital from June 2006 to May 2012 were selected，8 cases were male，10 cases were female in the late mixed dentition.The age ranged from 8.5 to 13.5 years.The mean age was 10.3 years.For each patient，a lateral cephalogram was taken before treatment（T1），immediately posttreatment（T2） and after an observation period（T3） averaging 6 months.The indices before and after treatment were compared using analysis of variance.Result：All patients were corrected by Class Ⅲ to Class Ⅰ.It showed that immediately posttreatment， the maxilla moved anteriorly a mean of 2.03 mm（P0.001）and A point increased 0.92 degree（P0.01）.The maxillary teeth moved anteriorly 2.75 mm（P0.001）and changed 5.01 degree（P0.01），while the mandible rotated in a downward and backward direction.Long-term，the anterior position of the maxilla was maintained，but some of the Class Ⅲ correction was lost because of mandibular growth.Conclusion：The Class Ⅲ malocclusion with a negative overjet of 4 to 5 mm or smaller is close to the successful treatment range.The results show that the dental and skeletal changes are equal.This does not necessarily mean that treatment in children with a negative overjet greater than 5 mm is contraindicated.The effect of max