华西口腔医学杂志

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安氏Ⅱ类1分类拔牙病例正畸治疗后后牙关系的稳定性研究

刘妍,许天民,林久祥   

  1. 北京大学口腔医院 正畸科,北京100081
  • 收稿日期:2004-08-25 修回日期:2004-08-25 出版日期:2004-08-20 发布日期:2004-08-20
  • 通讯作者: 许天民,Tel:010-62179977
  • 作者简介:刘 妍(1973-),女,广东人,主治医师,博士
  • 基金资助:
    高等学校博士学科点专项基金资助项目(20020001098)

Stability of Molar Relationship after Orthodontic Treatment in ClassⅡDivision 1 Malocclusions Treated by Extraction 

LIU Yan,XUTian-min,LINJiu-xiang   

  1. Dept.ofOrthodontics,School ofStomatology,Peking University,Beijing100081, China
  • Received:2004-08-25 Revised:2004-08-25 Online:2004-08-20 Published:2004-08-20

摘要:

目的 探讨安氏Ⅱ类1分类患者正畸治疗前、后后牙关系的变化趋势,分析可能影响后牙关系复发的因素。方法 选取采用拔牙治疗的安氏Ⅱ类1分类患者29例,其中男12例,女17例。根据ANB角进一步分为牙性Ⅱ类14例,骨性Ⅱ类15例。分别对其正畸治疗前、后进行模型测量和X线头影测量。结果 所有患者的Ⅱ类磨牙关系在治疗后均得到明显改善,随访时仅有少量复发。牙性Ⅱ类患者治疗后下磨牙近中移动量(4·52±2·15) mm,大于上磨牙移动量(3·62±2·62)mm,而骨性Ⅱ类患者上下磨牙近中移动量相似,但ANB角由治疗前的(6·27± 1·08)°明显减小为(4·64±1·17)°。随访时两类错患者上下颌磨牙均近中移动,且上颌磨牙移动量大于下颌磨牙。多元回归分析提示下颌骨水平向生长和上前牙不齐指数与磨牙关系复发有关。结论 Ⅱ类错患者正畸治疗后磨牙关系较为稳定。牙性Ⅱ类错磨牙关系的解除有赖于上下颌磨牙相对移动调整,骨性Ⅱ类错则依靠上下颌骨间位置关系的改变。有利的下颌生长型和上颌前牙不齐程度等与磨牙关系的保持有密切关系。

关键词: 安氏Ⅱ类错, 关系, 稳定性

Abstract:

Objective To investigate the changes of occlusal relationship in posterior teeth among the pre-treatment, post- treatment, and to analyze some possible factorswhichmay relate tothe relapse of posterior occlusal relationship.Methods 29 fin- ishing ClassⅡdivision 1 cases treated by extractionwith full records selected were included. The sample consists of 12 males,17 females. The follow-up lateral head films and study castswere taken at least 2 years after orthodontic treatment. The cephalograms were measured by computerized program and the study casts measured by caliper.Results Improvements of molar relationship were shown during treatment and a little bit changes during follow-up. During the treatment, the amount of mesial movement of the lower molars was more than the uppermolars in dental ClassⅡmalocclusion and the amountwas similar between upper and lower molars in skeletal ClassⅡmalocclusion although the ANB angle decreased significantly. During the follow-up stage, the move- ment tendency between upper and lowermolarswas reverse. The sagittal growth pattern of mandible and Irregularity of upper inci- sors were nearly correlatedwiththe relapse ofmolar relationship.Conclusion The stability ofmolar relationship is acceptable dur- ing the follow-up stage in ClassⅡmalocclusion. The improvement of molar relationship depends on the difference of mesial move- ments between upper and lower molars in dental ClassⅡmalocclusion. However, in skeletal ClassⅡmalocclusion the improve- ment of jaw relationship does the effect. The positive growth of mandible and crowding of upper incisors may affect the relapse of molar relationship.

Key words: ClassⅡmalocclusion, molar relationship, stability