Therapeutic effect analysis of skeletal class Ⅲ malocclusion treatment by transmission straight wire technique

doi:10.7518/hxkq.2020.03.013

Abstract

Abstract:

Objective This study aimed to investigate the therapeutic effects and advantages of skeletal class Ⅲ malocclusion treatment by transmission straight wire technique. Methods Ninety-seven patients who received treatment for skeletal class Ⅲ malocclusion at the Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to January 2017 were selected for this retrospective study. All these patients refused surgery. They were divided into two groups in accordance with the type of skeletal malocclusion: mild-to-moderate skeletal malocclusion group (-4°≤ANB <0°) and severe skeletal malocclusion group (-8°≤ANB<-4°). Each of the two groups was divided further into two small groups in accordance with the technique used: T group (transmission straight wire technique) and M group (MBT technique). Results The crossbite of all 59 patients in the mild-to-moderate skeletal malocclusion group was successfully treated. The molars were classified as classⅠrelationship, and the facial profile improved. Significant differences were found in the values of U1/SN angle, L1/MP angle, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). In the severe skeletal malocclusion group, the crossbite of all 38 patients was cured or partially cured. Fourteen patients showed severe lower anterior teeth inclination (five in the T group and nine in the M group), and the profiles did not significantly improve. Significant differences were observed in the values of U1-NA value, U1/SN angle, L1-NB value, L1/MP angle, LLP, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). Conclusion Relative to the MBT technique, the transmission straight wire technique has great advantages in improving facial profile, reducing the compensatory inclination of the upper and lower anterior teeth, and reducing the risk of root resorption in the treatment of skeletal class Ⅲ malocclusion.

Key words: skeletal class Ⅲ malocclusion, transmission straight wire technique, camouflage treatment, root resorption

CLC Number:

R783.5

Cheng Feng, Jian Zhishan, Zhu Ying, Zhang Chunyan, Hu Li, Chen Lili. Therapeutic effect analysis of skeletal class Ⅲ malocclusion treatment by transmission straight wire technique[J]. West China Journal of Stomatology, 2020, 38(3): 301-307.

Figures/Tables 5

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参考指标	定义	临床意义
SNA角/°	蝶鞍中心（S）、鼻根点（N）及上齿槽座点（A）所构成的角	上颌骨相对于颅部的前后位置关系
SNB角/°	S、N及下齿槽座点（B）所构成的角	下颌骨相对于颅部的前后位置关系
ANB角/°	A、N及B所构成的角度	上下颌骨相对于颅部的相互位置关系
Wits值/mm	上下齿槽座点向功能性平面所做垂线的距离	上下颌骨前部的位置关系
Y轴角/°	Y轴（蝶鞍中心与颏顶点的交点）与眼耳平面（FH）相交之下内角	颏部的突度及面部生长发育的方向
NP-FH/°	面平面（NP）与FH的相交之后下角	下颌的突缩程度
U1-NA/mm	上中切牙切缘至鼻根点-上齿槽座点连线（NA）的垂直距离	上中切牙的倾斜度和突度
U1/SN/°	上中切牙长轴与SN平面相交的下内角	上中切牙相对于前颅底的倾斜度
L1-NB/mm	下中切牙切缘至鼻根点-下齿槽座点连线（NB）的垂直距离	下中切牙的倾斜度和突度
L1/MP/°	下中切牙长轴与MP平面相交的上内角	下中切牙相对于下颌平面的倾斜度
ULP/mm	上唇最突点（UL）到鼻下点-软组织颏前点连线（Sn-Pog’）的距离	上唇突度
LLP/mm	下唇最突点（LL）到鼻下点-软组织颏前点连线（Sn-Pog’）的距离	下唇突度
Lip-Diff/mm	ULP与LLP之差	上下唇位置关系
H角/°	Pog’-UL连线又名H线（Holdaway线）,与NB的交角	软组织颏部与唇的关系
NLA/°	是鼻下点与鼻小柱点连线和鼻下点与上唇突点连线的前交角	侧脸均衡的典型指标
上尖牙轴倾度/°	上尖牙临床冠长轴与平面垂线所组成的角	上尖牙的近远中倾斜程度
下尖牙轴倾度/°	下尖牙临床冠长轴与平面垂线所组成的角	下尖牙的近远中倾斜程度

测量指标	T组（n=30）				M组（n=29）				P值*
测量指标	矫治前	矫治后	差值	P值	矫治前	矫治后	差值	P值	P值*
SNA角/°	82.7±3.7	83.3±3.5	0.6±0.5	<0.05	81.7±3.5	82.3±3.6	0.6±0.5	<0.05	0.89
SNB角/°	84.7±3.2	84.2±3.2	-0.5±0.3	<0.05	83.9±3.0	83.6±3.0	-0.3±0.4	<0.05	0.10
ANB角/°	-2.0±0.8	-0.9±0.9	1.1±0.7	<0.05	-2.2±1.2	-1.3±1.2	0.9±0.7	<0.05	0.27
Wits值/mm	-4.0±1.6	-2.1±1.7	1.8±0.7	<0.05	-4.4±1.6	-2.5±1.6	1.9±0.9	<0.05	0.57
Y轴角/°	61.4±1.8	62.1±1.9	0.7±0.5	<0.05	60.1±1.6	60.9±1.6	0.8±0.7	<0.05	0.59
NP-FH/°	88.1±1.4	87.6±1.5	0.5±0.5	<0.05	87.3±2.1	87.0±2.1	0.4±0.2	<0.05	0.12
U1-NA/mm	0.5±0.3	0.7±0.3	0.2±0.2	<0.05	0.5±0.3	0.6±0.2	0.1±0.2	<0.05	0.07
U1/SN/°	108.1±2.2	112.4±2.3	4.3±0.8	<0.05	107.0±2.5	112.9±2.9	5.9±0.9	<0.05	<0.05
L1-NB/mm	0.5±0.3	0.4±0.4	-0.2±0.4	0.05	0.5±0.3	0.4±0.3	-0.2±0.2	<0.05	0.82
L1/MP/°	86.7±5.1	83.1±5.2	-3.6±0.8	<0.05	89.9±2.9	83.4±3.6	-6.5±2.0	<0.05	<0.05
ULP/mm	7.0±0.8	7.9±0.8	0.9±0.3	<0.05	6.8±0.7	7.6±0.8	0.8±0.5	<0.05	0.20
LLP/mm	10.4±1.0	9.1±1.1	-1.3±0.6	<0.05	10.1±0.7	8.9±0.8	-1.2±0.4	<0.05	0.16
Lip-Diff/mm	-3.4±0.6	-1.2±0.8	2.3±0.6	<0.05	-3.3±0.4	-1.3±0.7	2.0±0.5	<0.05	<0.05
H角/°	8.0±1.4	12.1±1.3	4.1±1.0	<0.05	8.2±1.0	12.5±1.5	4.3±1.1	<0.05	0.57
NLA/°	94.2±8.4	92.2±6.9	-2.0±3.2	<0.05	92.8±8.8	89.9±9.2	-2.9±2.7	<0.05	0.26
上尖牙轴倾度/°	11.6±2.1	9.4±0.9	-2.2±2.2	<0.05	9.7±2.5	9.3±0.6	-0.5±2.3	0.27	<0.05
下尖牙轴倾度/°	1.0±2.0	2.9±0.7	1.9±2.0	<0.05	1.6±1.3	2.7±0.7	1.1±1.3	<0.05	0.11

测量指标	T组（n=14）				M组（n=10）				P值*
测量指标	矫治前	矫治后	差值	P值	矫治前	矫治后	差值	P值	P值*
SNA角/°	82.3±3.7	83.2±3.6	0.8±0.5	<0.05	82.1±4.0	82.7±4.2	0.6±0.8	0.05	0.44
SNB角/°	87.9±4.0	87.4±4.1	-0.4±0.7	<0.05	88.0±4.3	87.4±4.4	-0.6±0.8	0.06	0.63
ANB角/°	-5.6±0.9	-4.3±1.2	1.3±0.8	<0.05	-5.9±0.8	-4.7±0.9	1.2±0.6	<0.05	0.85
Wits值/mm	-7.5±1.3	-5.9±1.3	1.6±0.7	<0.05	-8.3±0.9	-6.7±0.9	1.6±0.6	<0.05	0.91
Y轴角/°	57.2±8.3	59.0±8.0	1.8±0.7	<0.05	54.0±2.8	56.3±3.4	2.3±1.2	<0.05	0.27
NP-FH/°	94.4±5.9	92.7±5.7	-1.7±0.9	<0.05	94.1±4.0	92.2±4.0	-1.8±0.8	<0.05	0.63
U1-NA/mm	0.4±0.2	0.7±0.3	0.4±0.1	<0.05	0.5±0.2	0.6±0.3	0.2±0.1	<0.05	<0.05
U1/SN/°	102.9±9.2	108.0±8.6	5.1±1.9	<0.05	105.2±5.9	112.4±5.6	7.2±1.6	<0.05	<0.05
L1-NB/mm	0.5±0.3	0.0±0.3	-0.5±0.2	<0.05	0.4±0.2	0.2±0.2	-0.2±0.2	<0.05	<0.05
L1/MP/°	86.5±6.2	78.9±6.5	-7.7±2.0	<0.05	85.7±5.2	74.8±5.0	-10.9±2.6	<0.05	<0.05
ULP/mm	6.9±1.0	7.5±0.9	0.7±0.2	<0.05	6.2±0.8	7.1±0.8	0.9±0.2	<0.05	0.06
LLP/mm	12.9±1.3	9.0±1.3	-3.9±0.5	<0.05	12.1±1.9	10.0±2.1	-2.1±0.3	<0.05	<0.05
Lip-Diff/mm	-6.1±1.3	-1.5±1.3	4.6±0.5	<0.05	-5.9±1.8	-3.0±2.0	3.0±0.4	<0.05	<0.05
H角/°	5.8±0.9	11.7±1.5	5.8±1.0	<0.05	5.2±0.9	10.6±0.7	5.4±0.5	<0.05	0.21
NAL/°	95.1±5.9	91.0±5.8	-4.1±3.0	<0.05	95.3±5.1	89.6±5.5	-5.8±3.0	<0.05	0.22
上尖牙轴倾度/°	11.1±2.3	8.9±1.0	-2.2±2.9	<0.05	10.3±2.2	8.3±1.3	-2.0±1.7	<0.05	0.85
下尖牙轴倾度/°	1.5±2.4	3.2±0.9	1.7±2.9	0.05	1.4±1.9	3.0±0.5	1.7±1.8	<0.05	0.99

牙根吸收等级	T组		M组
牙根吸收等级	治疗前	治疗后	治疗前	治疗后
0	212/88.33	164/68.33	207/89.22	101/43.53
1	24/10.00	65/27.08	22/9.48	110/47.41
2	4/1.67	10/4.17	3/1.29	18/7.76
3	0/0	1/0.42	0/0	3/1.29
4	0/0	0/0	0/0	0/0
合计	240/100	240/100	232/100	232/100

牙根吸收等级	T组		M组
牙根吸收等级	治疗前	治疗后	治疗前	治疗后
0	95/84.82	73/65.18	69/86.25	28/35.00
1	15/13.39	33/29.46	10/12.50	38/47.50
2	2/1.79	5/4.46	1/1.25	10/12.50
3	0/0	1/0.89	0/0	4/5.00
4	0/0	0/0	0/0	0/0
合计	112/100	112/100	80/100	80/100