北京大学学报(医学版) ›› 2017, Vol. 49 ›› Issue (3): 531-539. doi: 10.3969/j.issn.1671-167X.2017.03.027

• 论著 • 上一篇    下一篇

种植体支抗整体远中移动下颌牙列治疗骨性Ⅲ类错牙合的疗效评价

范少轻1,周彦恒2△   

  1. (1. 北京大学口腔医学院·口腔医院, 第一门诊部口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室, 北京100034; 2. 北京大学口腔医学院·口腔医院, 正畸科口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室, 北京100081)
  • 出版日期:2017-06-18 发布日期:2017-06-18
  • 通讯作者: 周彦恒 E-mail: yanhengzhou@gmail.com

Evaluation of the correction of the skeletal class Ⅲ malocclusion by distalization of the whole mandible dentition with micro-implant anchorage

FAN Shao-qing1, ZHOU Yan-heng2△   

  1. (1. First Clinical Division, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China; 2. Department of Orthodontics,Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081,China)
  • Online:2017-06-18 Published:2017-06-18
  • Contact: ZHOU Yan-heng E-mail: yanhengzhou@gmail.com

摘要: 目的:研究使用种植体支抗整体远中移动下颌牙列治疗骨性Ⅲ类错牙合畸形的疗效。方法:选择轻到中度骨性Ⅲ类错牙合患者20例,男性8例,女性12例,年龄16~38岁,平均(21.5±5.6)岁。采用直丝弓矫治技术,使用下颌外斜线区种植体支抗整体远中移动下颌牙列。患者在治疗前后拍摄X线头颅定位侧位片,对共计26个软硬组织测量项目进行测量分析。结果:矫治结束后患者磨牙关系均达到中性关系,侧貌改善。治疗后ANB角增大(0.80±1.02)°,P<0.05,Wits值增大(1.67±1.74) mm,P<0.05;L1NB距离减小(2.64±1.50) mm,P<0.05;下颌第一磨牙近中颊尖远中移动(3.26±1.95) mm,P<0.05;下颌第一磨牙近中根尖远中移动(0.79±1.27) mm, P<0.05;下颌第二磨牙近中颊尖远中移动(3.06±1.80) mm,P<0.05。下颌牙齿与下颌平面的夹角:L1/MP角度减小(6.37±8.53)°,L5/MP角度减小(10.59±8.50)°,L6/MP角度减小(11.48±7.22)°,L7/MP角度减小(15.72±7.16)°,差异均有统计学意义(P<0.05);下唇和审美平面距离减小(1.70±1.59) mm, P<0.05。结论:种植体支抗整体远中移动下颌牙列能够有效治疗恒牙期骨性Ⅲ类错牙合,侧貌改善良好;下颌牙齿发生有控制的倾斜移动。

关键词:  错牙合, 骨性Ⅲ类, 种植体支抗, 头影测量

Abstract: Objective:To evaluate the clinical effect of distalizing mandibular dentition with micro-implant in patients with skeletal classⅢmalocclusion. Methods: In the study, 20 patients with skeletal class Ⅲmalocclusion were selected. They are consist of 8 males and 12 female with an age range from 16 to 38 years old and an average age of (21.5±5.6) years.They were treated with straight wire technique and the implant were inserted into the mandibular external oblique line to distlize the lower dentition to a class Ⅰmolar relationships.Cephalometrics films were taken before and after treatment. The changes of hard tissue and soft tissue were analyzed by evaluating 26 measurement measurements. Results: ClassⅠmolar relationships were achieved, and the profile were improved after treatment. ANB increased by(0.80±1.02)°,Wits increased by (1.67±1.74) mm,after treatment(P<0.05).The lower dentition were significantly retracted after treatment with L1-NB distance decreased by(2.64±1.50) mm, P<0.05; the mesial buccal cusp and mesial root of the lower first molars were retracted by (3.26±1.95) mm and (0.79±1.27) mm respectively (P<0.05); the mesial buccal cusp of the lower second molars were retracted by (3.06±1.80) mm (P<0.05). After treatment, mandibular teeth got uprighted distally. From incisors to molar, L1/MP, L5/MP, L6/MP, L7/MP angle decreased by(6.37±8.53)°, (10.59±8.50)°, (11.48±7.22)°, (15.72±7.16)°on average respectively (P<0.05), all of those changes had the statically significant effects. Soft tissue change after treatment, the distance from lower lip to esthetic plane were decreased by (1.70±1.59) mm on average (P<0.05). Conclusion: Distalizing mandibular dentition with micro-implant can get an satisfying result in patients with skeletal class Ⅲmalocclusion, the lower teeth were retracted by controlled tipping movement.

Key words: Malocclusion, Skeletal class Ⅲ malocclusion, Implant anchorage, Cephalometry

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