骨型Ⅱ类高角型错牙合减数矫治前后头影测量探究.docVIP

骨型Ⅱ类高角型错牙合减数矫治前后头影测量探究[摘要]目的：研究拔牙矫治对骨型Ⅱ类高角病例牙颌方面的影响。方法：选择恒牙期正畸拔除前磨牙患者20例（SN-MP＞40°，ANB＞5°），年龄11～14岁，采用直丝弓矫治器治疗。对矫治前后的头颅侧位X线片进行头影测量，并进行统计学分析。结果：20例患者治疗后前牙覆牙合、覆盖均达到正常，第一磨牙中性关系。SNB、B-RL、U1-SN、U6-RL、L6-RL矫治前后差异有统计学意义（P＜0.05)。结论：骨型Ⅱ类高角型错牙合对正畸治疗的反应主要表现在切牙及磨牙的变化，对垂直向的改变并不明显。 [关键词]拔牙矫治；Ⅱ类错牙合；高角；头影测量 [中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455（2011）03-0457-03 Study of cephalometric analysis on skeletal classⅡmalocclusion with high-angle after tooth- extraction treatment HOU Tie-jun,LIU Xin-qiang (Department of Orthodontics, The Afifiliated Hospital of Medical College,Qingdao University,Qingdao 266003,Shandong,China) Abstract: ObjectiveTo evaluate changes of skeletal class Ⅱ high-angle malocclusion after tooth- extraction treatment.MethodsTwenty skeletal class Ⅱ hight-angle malocclusion patients in permanent dention (SN-MP＞40°，ANB＞5°）,aged 11 to 14 years old,were selected.All patients with extaction premolar were treaed with straight wrie appliance.Cephalometric analysis were carried out before and after treatment,and the results were analyzed with statistics.Results All patients achieved normal overbite and overjet in anterior teeth,and class Ⅰocclusion in molar relationship.Campared with the before tretment ,there were statistically significant difference in SNB、B-RL、U1-SN、U6-RL、L6-RL.ConclusionTo correct the skeletal class Ⅱ high-angle malocclusion by orthodontic extracion treatment,there are obvious results in incisors and molars without changes in the vertical relationship. Key words:extraction treatment;classⅡ malocclusionh;high angle;cephalometric analysis 骨型Ⅱ类高角型错牙合反映了该错牙合类型在矢状向和垂直向上均存在不调，临床上常表现为上颌前突，下颌后缩，下颌升支高度不足，面高比例失调，牙列拥挤等特征。一般认为，此类错牙合多采用拔除第一或第二前磨牙，使下颌磨牙近中移动，促使下颌发生逆时针旋转，改善患者面型。但也有学者指出，拔牙对Ⅱ类错牙合垂直向的改变并不明显。另一方面，虽然部分存在着严重骨骼畸形的患者超出了正畸治疗范围，但对于某些边缘性病例或正处于生长发育期的青少年仍然值得尝试，特别是大部分患者对外科手术心存担忧和畏惧，依然有迫切改善软组织侧貌的愿望。因此，笔者通过头影测量对骨型Ⅱ类高角型错牙合治疗前后进行对比分析，以期为临床工作带来参考。 1资料和方法 1.1研究对象：在我院矫治完成的病例中进行样本选择，纳入标准如下：①恒牙牙合，牙列完整，无多生牙及缺失牙；②上下颌第一磨牙远中关系；③SN-MP＞40°；④ANB＞5°；⑤拔除上