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背景:安氏Ⅱ类错是临床上常见的错畸形,主要表现为骨性错,其主要因素是下颌后缩,对于此类患者,多进行早期矫治,以纠正骨性畸形,明显改善颜面外观。目的:对比Twin-Block矫治器与直丝弓矫治器配合口外弓及Ⅱ类牵引早期矫治骨性安氏Ⅱ类1分类错的临床效果及生物力学变化。方法:选择处于生长发育高峰期的骨性安氏Ⅱ类1分类错患者30例,按随机数字表法分为两组,每组15例,分别用Twin-Block矫治器及直丝弓矫治器配合口外弓及Ⅱ类牵引治疗。对比及测量两组患者治疗前后头颅侧位片,并作统计学分析。结果与结论:矫治结束后,所有患者磨牙和尖牙均达到或接近中性关系,上下齿槽座角(ANB角)减少至正常范围。Twin-Block矫治器的骨效应明显大于直丝弓矫治器,使用Twin-Block矫治器,患儿下颌骨体长度及下面高增加更显著。提示Twin-Block矫治器对尚处于生长发育期的早期骨性Ⅱ类错患者疗效显著,可在生物力学的作用下,改变不协调的颌骨关系,实现组织重建,获得理想软组织侧貌。对于下颌后缩显著,上切牙较为唇倾,下切牙较为直立的病例侧貌改善效果更佳。
Background: Class Ⅱ malocclusion is a clinically common malocclusion, mainly manifested as skeletal malocclusion, the main factor is the mandibular retrusion, for such patients, and more early correction to correct the skeletal deformity, significantly Improve facial appearance. OBJECTIVE: To compare the clinical effects and biomechanical changes between Twin-Block appliance and straight-wire appliance combined with oral arch and Class Ⅱ traction for the early treatment of skeletal Class Ⅱ division 1 malocclusion. Methods: Thirty patients with skeletal Class Ⅱ division 1 malocclusion in the peak of growth and development were divided into two groups according to the random number table (n = 15), with Twin-Block appliance and straight wire appliance Device with the mouth outside the bow and traction class Ⅱ treatment. Contrast and measurement of two groups of patients before and after treatment of cephalometric films, and for statistical analysis. RESULTS AND CONCLUSION: After the treatment, the molars and canines of all the patients reached or approached the neutral relationship, and the angle of upper and lower alveolar (ANB) decreased to the normal range. The bone effect of Twin-Block appliance was significantly greater than that of straight appliance. With Twin-Block appliance, the length and height of mandibular body in children were significantly increased. Tip Twin-Block appliance is still in the early stage of growth and development in patients with skeletal Class Ⅱ malocclusion significant effect, under the biomechanical changes in the incompatible jaw relationship, to achieve tissue reconstruction, to obtain the ideal soft tissue profile. For the mandibular retrusion significantly, the upper lip is more lip-tilt, lower incisors are more upright to improve the profile of the case better.