快速扩弓结合上颌前方牵引治疗上颌骨发育不足的研究.doc

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1、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O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ClassIII矫正为ClassI类，牵引结束上颌骨A点平均移动2.03mm(P<0.001)。SNA平均前移0.92度(P<0.01),上切牙向前移动平均2.75mm(P<0.001),上切

2、牙至SN角度平均改变5.01度(P<0.01)oClassIII关系有复发趋势,可能是下颌生长导致。结论：ClassIII错接近于4〜5nini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5mm就成为禁忌证。上颌骨前移的效果基本稳定，ClassIII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：Toevaluatethecurativeeffectofmaxi1laryprotractioncombinedwithr

3、apidmaxi1laryexpansionintreatmentofskeletalanteriorcrossbite・Method:18skeletalanteriorcrossbitepatientscausedbymaxillarydeficiencyfromdepartmentoforthodonticsinourhospitalfromJune2006toMay2012wereselected,8casesweremale,10caseswerefemaleinthelatemixeddentition.Theagerangedfrom8.5to13

4、.5years・Themeanagewas10.3years.Foreachpatient.,alateralcephalogramwastakenbeforetreatment(Tl),immediate]yposttreatinent(T2)andafteranobservationperiod(T3)averaging6months.Theindicesbeforeandaftertreatmentwerecomparedusinganalysisofvariance.Result：AllpatientswerecorrectedbyClassIIItoC

5、lassI.Itshowedthatimmediatelyposttreatinent,themaxillamovedanteriorlyameanof2.03mm(卩〈0.001)andApointincreased0.92degree(P<0.01).Themaxillaryteethmovedanteriorly2.75mm(P<0.001)andchanged5.01degree(P<0.01),whilethemandiblerotatedinadownwardandbackwarddirection.Long-term,theanteriorposi

6、tionofthemaxillawasmaintained,but.someoftheClassIIIcorrectionwaslostbecauseofmandibulargrowth.Conclusion：TheClassIIImalocclusionwithanegativeoverjetof4to5mmorsmallerisclosetothesuccessfultreatmentrange.Theresultsshowthatthedentalandskeletalchangesareequa1.Thisdoesnotnecessarilymeanth

7、attreatmentinchildrenwithanegativeoverjetgreaterthan5mmiscontraindicated.TheeffectofmaxillaryprotFactionbasicallystable.TherelapsetendencyofClassIIIismainlyduetothefurthergrowthofthemandible.[Keywords】Skeletaicrossbite；Cephalometrieanalysis；Maxillaryprotraction；Rapidmaxillaryexpansio

8、nFirst-autho