华西口腔医学杂志

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不同支抗控制下上颌前突矫治结果的三维模型研究

马宁 李巍然   

  1. 1.北京大学第三医院口腔科,北京 100191;
    2.北京大学口腔医学院•口腔医院正畸科,北京 100081
  • 出版日期:2015-02-01 发布日期:2015-02-01
  • 通讯作者: 李巍然,教授,博士,E-mail:weiranli2003@163.com
  • 作者简介:马宁,主治医师,博士,E-mail:kqmn@sina.com

Comparison of treatment outcomes in patients with maxillary dentoalveolar protrusion by applying different anchorage methods: a three-dimensional model study

Ma Ning, Li Weiran   

  1. 1. Dept. of Stomatology, Peking University Third Hospital, Beijing 100191, China; 
    2. Dept. of Orthodontics, Peking University School of Stomatology, Beijing 100081, China
  • Online:2015-02-01 Published:2015-02-01

摘要:

目的  利用三维模型测量的手段对比不同支抗控制下上颌前突的矫治结果。方法  选择上颌需要拔除双侧第一前磨牙且需要强支抗的上颌前突患者46名,随机分为种植体支抗组、口外弓组和Nance弓组。于正畸治疗前和上颌间隙关闭后制取上颌记存模型,通过三维模型测量手段,测量并对比不同支抗组上颌中切牙和上颌第一磨牙的三维位置改变。结果  种植体支抗组、口外弓组和Nance弓组患者上颌中切牙矢状向内收移动,位移分别为(-6.661±1.328)、(-5.939±1.806)、(-5.788±2.009) mm,组间比较差异无统计学意义(P=0.121)。上颌中切牙的垂直向移动,种植体支抗组平均压低(0.129±1.815) mm,而口外弓组和Nance弓组分别伸长了(-2.162±2.026)、(-2.623±1.776) mm。种植体支抗组和其他两组之间比较差异有统计学意义(P<0.05)。种植体支抗组、口外弓组和Nance弓组患者上颌第一磨牙的矢状向移动位移分别为(0.608±1.045)、(1.445±1.462)、(1.503±0.945) mm;上颌第一磨牙的垂直向移动,种植体支抗组平均压低(0.720±0.805) mm,口外弓组轻度压低(0.076±0.986) mm,Nance弓组轻度伸长(-0.072±0.690) mm。种植体支抗组和其他两组之间比较差异有统计学意义(P<0.05);3组均发生舌向移动,组间比较差异无统计学意义(P>0.05)。结论  种植体支抗在上颌前突矫治中对于上颌切牙的垂直向控制以及对上颌磨牙的矢状向、垂直向控制优于传统支抗。

关键词:  , 支抗, 上颌前突, 三维模型测量

Abstract:

 Objective  This study aims to compare the treatment outcomes in patients with maxillary dentoalveolar protrusion by applying different anchorage methods via three-dimensional model measurement. Methods  A total of 46 patients with maxillary dentoalveolar protrusion treated with bilateral maxillary first premolar extractions and high anchorage were selected. The subjects were randomly divided into three groups according to the type of anchorage applied, which included implant, extraoral, and Nance arch anchorages. The maxillary dental models were made before treatment and after space closure of maxilla. The movements of the maxillary central incisors and first molars were measured via a three-dimensional model measurement, and the amounts of movement were compared among the three groups. Results  The sagittal lingual movements of the maxillary central incisors were (-6.661±1.328), (-5.939±1.806), and (-5.788±2.009) mm for the implant, extraoral, and Nance arch anchorage groups, respectively, with no significant difference among the three groups (P=0.121). The corresponding vertical movements of the maxillary central incisors were (0.129±1.815) mm intrusion, and (-2.162±2.026), (-2.623±1.776) mm extrusion. Significant difference was found between the implant anchorage group and the other groups (P<0.05). The corresponding sagittal mesial movements of the maxillary first molars were (0.608±1.045), (1.445±1.462), and (1.503±0.945) mm. The corresponding vertical movements of the maxillary first molars were (0.720±0.805) mm intrusion, (0.076±0.986) mm intrusion, and (-0.072±0.690) mm extrusion. Significant difference was found between the implant anchorage group and the other two groups (P< 0.05). In the transverse direction, the first molars all moved lingually with no significant difference among the three groups (P>0.05). Conclusion  Implant anchorage may be superior in the vertical control of the maxillary incisors and in the sagittal, as well as in the vertical control of the maxillary molars, compared with the traditional anchorages during the treatment of patients with maxillary dentoalveolar protrusion.

Key words:  anchorage, maxillary dentoalveolar protrusion, three-dimensional model measurement