摘要
目的:对安氏Ⅲ类错颌畸形患者采取多曲方丝弓(Multiloop edgewise arch wire,MEAW)与直丝弓矫治技术,并观察其临床效果。方法:选取2021年11月至2024年1月我院植想来院区和我院经开院区接诊的64例安氏Ⅲ类错颌畸形患者作为研究对象,按照随机掷硬币法将其分为对照组和研究组,各32例。对照组采用直丝弓矫治技术联合支抗钉治疗,研究组在对照组基础上联合MEAW治疗。对比两组患者治疗前后的头影测量指标:由蝶鞍中心(Sella,S点)、鼻根点(Nasion,N点)及上齿槽座点(A-point,A点)构成的夹角(Steiner's SNA Angle,SNA),由S、N点及下齿槽座点(B点)构成的夹角(Steiner's SNB Angle,SNB),由A、N点及B点构成的夹角(Steiner's ANB Angle,ANB),上颌中切牙长轴与颅底平面相交形成的下内侧角(Upper Central Incisor to Sella-Nasion Plane Angle,U1-SN),上下前牙切缘水平距离(Overbite,OB),对比两组患者治疗前后齿排列对称性:上下切牙倾斜度、下颌平面角,并观察比较治疗期间的临床指标(前牙正常覆盖时间、总疗程)及不良反应发生情况。结果:两组患者治疗1年后的头影测量指标ANB、U1-SN、OB均高于同组治疗前,且研究组高于对照组(P<0.05),但比较两组患者的头影测量指标SNA、SNB参数水平,差异无统计学意义(P>0.05);对比同组治疗前,两组患者治疗1年后的上下切牙倾斜度、下颌平面角参数水平均更高,且研究组高于对照组(P<0.05);对比对照组,研究组患者的前牙正常覆盖时间及总疗程均更短(P<0.05);研究组患者的不良反应如牙齿松动、牙根吸收、牙龈刺激、口腔溃疡总发生率与对照组对比,差异无统计学意义(P>0.05)。结论:对安氏Ⅲ类错颌畸形患者采取MEAW与直丝弓矫治技术治疗,能促进患者牙内结构正常化,缩短患者前牙正常覆盖时间及总疗程,且具备安全性。
Objective:To perform multiloop edgewise arch wire(MEAW)and straight arch wire orthodontic technique for patients with Angle Class III malocclusion,and observe the clinical effect.Methods:From November 2021 to January 2024,64 patients with Angle Class III malocclusion admitted to Zhixianglai Oral Clinic and Jingkai Zhide Oral Clinic of the hospital were selected as study subjects,and were divided into control group and study group according to the random coin tossing method,with 32 cases in each group.The control group received straight arch wire orthodontic technique combined with anchorage nail therapy,while the study group was combined withMEAW on the basis of the control group.The cephalometric indicators such as SNA[Steiner’s SNA angle composed of Sella(S point),Nasion(N point)and A point],SNB[Steiner’s SNB angle composed of S point,N point and B point],ANB[Steiner’s ANB angle composed of A point,N point and B point],U1-SN(upper central incisor to sella-nasion plane angle)and OB(overbite)before and after treatment and symmetry of tooth arrangement(inclination of upper and lower incisors,mandibular plane angle)before and after treatment were compared between groups.The clinical indicators(normal coverage time of anterior teeth,total course of treatment)and occurrence of adverse reactions during treatment were observed and compared.Results:After 1 year of treatment,the cephalometric indicators such as ANB,U1-SN and OB in both groups were higher than those before treatment,and the indicators in study group were higher than those in control group(P<0.05),but there were no statistical differences in the cephalometric indicators such as SNA and SNB between groups(P>0.05).Compared with before treatment,the inclination of upper and lower incisors and mandibular plane angle in the two groups were higher after 1 year of treatment,and the indicators in study group were higher than those in control group(P<0.05).Compared with control group,the normal coverage time of anterior teeth and total course of treatment in study group were shorter(P<0.05).There was no statistical difference in the total incidence rate of adverse reactions such as tooth loosening,root resorption,gingival irritation and oral ulcer between study group and control group(P>0.05).Conclusion:MEAW and straight arch wire orthodontic technique can promote the normalization of dental structure,and shorten the normal coverage time of anterior teeth and total course of treatment in patients with Angle Class III malocclusion,and it has safety.
作者
马芳芳
孙舒寒
杨麟
Ma Fang-fang;Sun Shu-han;Yang Lin(Department of Orthodontics,Zhengzhou Zhide Dental Hospital,Zhengzhou 450000,China;Department of Stomatology,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)
关键词
安氏Ⅲ类
错颌畸形
多曲方丝弓
直丝弓
安全性
Angle Class Ⅲ
Malocclusion
Multiloop edgewise arch wire
Straight arch wire
Safety
