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目的:通过X线头影测量分析,评价前导矫形联合固定矫治器矫治和单纯拔牙固定矫治对生长发育期安氏Ⅱ类骨性错畸形的临床疗效。方法:选取31例生长发育期安氏Ⅱ类错畸形伴下颌后缩的病例。其中,18例采用Ⅰ期固定式Twin-block矫治器联合Ⅱ期固定矫治;13例采用传统的单纯拔牙后使用直丝弓矫治器进行治疗。在治疗前、Twin-block矫治完成后以及全部固定矫治结束后拍摄X线头颅侧位片,利用Pancherz测量分析法进行分析,使用SPSS15.0软件包分别比较前导矫形组、单纯拔牙组治疗前后的组内差异以及2组的组间差异。结果:前导矫形组下颌骨长度增加并向前移动,上切牙相对于上颌骨的位置向后方移动,下切牙、下颌第一恒磨牙相对于下颌骨的位置均向前方移动,覆盖减小(P<0.05)。单纯拔牙组上、下颌骨的位置、髁突位置及下颌骨的长度治疗前后均无显著变化。在前牙覆盖的纠正中,前导组牙性因素占39.5%,骨性因素占60.5%,拔牙组牙性因素占86.9%,骨性因素占13.1%;在磨牙关系的纠正中,前导组牙性因素占44.9%,骨性因素占55.1%,拔牙组牙性因素占90.3%,骨性因素占9.7%。结论:前导矫形联合固定矫治与单纯拔牙固定矫治相比,在治疗生长发育期骨性Ⅱ类下颌后缩的患者中,疗效近似,但能更显著地改善患者的骨性侧貌。
OBJECTIVE: To evaluate the clinical effect of orthodontic treatment with orthodontic appliance and orthodontic appliance in the growth and development of Class Ⅱ skeletal malformations by X-cephalometry. Methods: 31 cases of growth and development of Class Ⅱ malocclusion with mandibular retrusion cases. Among them, 18 cases were treated with stage I fixed Twin-block appliance combined with stage II fixation; 13 cases were treated with straight wire appliance after traditional simple tooth extraction. Before treatment, after the completion of Twin-block correction and all fixed orthodontic treatment, X-ray cephalometric slices were taken and analyzed by Pancherz measurement and analysis method. SPSS15.0 software package was used to compare pre-and post-treatment Intra-group differences and inter-group differences between the two groups. RESULTS: The length of the mandible increased and moved forward in the orthodontic group. The position of the upper incisor moved rearward relative to the maxilla. The position of the lower incisor and mandibular first permanent molar relative to the mandible all moved forward. The coverage decreased P <0.05). There was no significant difference in mandibular position, condylar position and mandible length before and after treatment in simple tooth extraction group. In the correction of anterior tooth covering, the leading group accounted for 39.5% of dental elements, bony factors accounted for 60.5%, tooth extraction group accounted for 86.9% of dental factors, bone factors accounted for 13.1%; in the correction of molar relationship, the leading group of teeth Sexual factors accounted for 44.9%, bony factors accounted for 55.1%, tooth extraction teeth accounted for 90.3%, bony factors accounted for 9.7%. CONCLUSION: Compared with simple orthodontic treatment, orthodontic combined orthodontic treatment has similar curative effect in the treatment of patients with skeletal Class Ⅱ mandibular retrusion during growth and development, but can significantly improve the bony profile of patients.