微螺钉种植体支抗在高角深覆牙合患者中应用.docVIP

微螺钉种植体支抗在高角深覆牙合患者中应用[摘要] 目的 研究微螺钉种植体支抗治疗高角深覆的临床效果。方法 选择高角深覆露龈笑患者男5例、女8例，均拔除上下颌第一前磨牙，采用直丝弓矫治技术，与上颌双侧中切牙与侧切间近根尖处、上颌第二前磨牙与第一磨牙膜龈联合线处植入微螺钉，在压低前牙的同时进行前牙内收，时间5～8个月，拍摄治疗前后头颅侧位片和模型，进行头影测量和模型分析。结果 前牙覆、上切牙龈缘到上唇下缘距离、U1-PP明显减小，SN-MP不变。结论 微螺钉种植体能有效压低前牙，控制后牙段高度，避免高角病例的下颌顺时针旋转 [关键词] 微螺钉种植体支抗；高角；深覆 [中图分类号] R783.5 [文献标识码] B [文章编号] 1673-9701（2011）33-134-02 The Application of Microscrew Anchorage in Deep Bite Patients Accompanied with High Angle PAN Yu WANG Yang XU Jing The First Peoples Hospital of Foshan City，Foshan 528000，China [Abstract] Objective To determine the efficiency of microscrew anchorage in deep bite patients accompanied with high angle. Methods Thirteen deep bite subjects with high angle（5 males，8 females）were allocated in the study. All subjects were treated with straight-wire appliance and four premolars were extracted in all subjects. In anterior area，two microscrew anchorages were planted between apexes of upper anterior incisor and upper lateral incisor. In postier area，two microscrew anchorage were planted at mucogingival junction between first molar and second premolar. Anterior teeth were intruded. After 5 to 8 months，cephalometric analysis and study models before and after treatment were compared. Results Anterior overbite，distance between incisor gingival edge and lower edge of the upper lip，U1-PP decreased significantly，and SN-MP showed no significant changes. Conclusion Mini-implant anchorage could intrude anterior incisors when retruding them，and prevent mandible from rotating clockwisely. [Key words] Microscrew anchorage；High angle；Deep bite 前牙深覆、深覆盖是常见的错畸形，对于高角前牙深覆的患者大多伴有上唇发育不良，出现上唇和上前牙关系的不协调，继而出现露龈笑。对于深覆的患者，打开咬合是矫治中的重点和难点。我们常用的摇椅弓和平导等打开咬合方法，在临床上产生的效果更多是升高了后牙段，这在高角病例中是绝对禁忌的[1]。采用多用途弓方法压低上前牙在打开前牙咬合方面可获得明显的效果，但也有学者认为会产生支抗磨牙的旋转[2]；“J”钩理论上可产生绝对的压低效果，但由于依赖于患者的配合度，有时未能产生良好的效果[3]。近年来，微螺钉种植体支抗应用于正畸临床，解决了部分患者的难题。我科在临床中对于13例高角深覆患者采用了直丝弓矫治器联合种植体支抗，成功地在短时间内打开了咬合，并且有效地控制了后牙段的高度，临床效果满意，现报道如下 1 资料与方法 1.1 临床资料 13例患者均来自本科2007～2009年就诊者，其中