上颌前方牵引器联合固定式(牙合)垫治疗恒牙早期前牙反(牙合)的疗效观察

Maxillary protraction combined with fixed occlusal pad for treatment of anterior crossbite in early permanent dentition

  • 摘要: 目的 探讨固定式(牙合)垫联合上颌前方牵引器治疗恒牙早期前牙反(牙合)的临床疗效。 方法 选择本院口腔正畸科2015年1月- 2017年1月恒牙早期安式Ⅲ类骨性错(牙合)畸形患者12例,男性4例,女性8例,年龄10 ~ 13岁,平均年龄11.5岁,前牙反(牙合),双侧磨牙为近中关系,下颌不能后退至前牙对刃关系,颜面侧貌呈凹面型。均采用上颌前方牵引器联合固定式(牙合)垫进行一期矫形治疗。矫治前后分别拍摄头颅侧位X线片和全口曲面断层片,应用X线头影测量技术进行软、硬组织分析。 结果 12例患者平均疗程5个月,治疗后SNA角增加2.29°,SNB角减少2.08°,ANB角为3.0°,Y轴角增加2.14°,上齿槽座A点明显前移,软组织侧貌由治疗前Ⅲ类凹面型转变为治疗后Ⅰ类直面型。 结论 在恒牙早期采用上颌前方牵引矫治器联合固定式(牙合)垫矫治安氏Ⅲ类错(牙合),可以显著促进上颌骨向前生长发育,控制下颌骨的旋转及生长速度,使患者正侧貌外形均得到较大的改善。

     

    Abstract: Objective To investigate the clinical effect of maxillary protraction combined with fixed occlusal pad on ClassⅢ malocclusion in early permanent dentition. Methods Twelve cases, 4 males and 8 females, aged 11.5 (10 -13) years old, with ClassⅢmalocclusion in early permanent dentition were selected in department of orthodontics, Chinese PLA General Hospital from January 2015 to January 2017. They were treated with maxillary protraction combined with fixed occlusal pad in the first stage orthopedic treatment. Clinical examination, including cephalometrics and panoramic radiograph were performed before and after treatment, and the results were compared using paried t test. Results The average course of treatment was 5 months. After treatment, the angle of SNA increased 2.29°, the angle of SNB decreased 2.08°, the angle of ANB was 3.0°, the angle of Y axis increased 2.14°.Significant forward extension of point A (subspinale point) was detected, and the soft tissue profile changed from the concave facial form before treatment to the straight facial form after treatment. Conclusion By using of maxillary protraction combined with fixed occlusal pad for ClassⅢmalocclusion in early permanent dentition, it can not only significantly promote the forward growth of the maxilla, but also can effectively control the rotation and growth rate of the mandible, with greatly improves in the patient's facial appearance.

     

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