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目的探讨改良HGAC和J钩牵引联合应用双期矫治恒牙早期安氏Ⅱ类1分类患者的疗效和作用机理。方法一期采用改良HGAC联合应用J钩高位牵引抑制上颌发育,上下前牙保留切牙帽设计以加强对切牙位置控制,二期采用直丝弓固定矫治,基本排齐上下牙列后,将J钩置于主弓丝尖牙托槽近中,高位牵引内收及压低上前牙。结果经过平均疗程17个月的双期矫治,恒牙早期安氏Ⅱ类1分类患者29例前牙覆覆盖恢复正常,上颌骨水平向生长受到明显抑制,下切牙未见明显唇倾。头影测量显示,ANB平均减少3.15°,U1-SN平均减少6.53°,颜面侧貌明显改善。结论改良HGAC联合J钩牵引对恒牙早期安氏Ⅱ类1分类错畸形患者双期矫治,可以控制上前牙唇倾及上颌前突,诱导下颌整体前移,建立正常的前牙覆覆盖和磨牙中性关系,得到良好疗效。
Objective To investigate the efficacy and mechanism of modified HGAC and J-hook traction combined with double-phase treatment for early Class Ⅱ division 1 patients with permanent teeth. Method A modified HGAC combined with high hook J hook to inhibit maxillary development, the upper and lower anterior teeth retaining incisors cap design to enhance the position control of the incisors, two straight wire fixation, the basic alignment of the upper and lower dentition, the J hook placed in the main arch wire brackets near the middle, high traction adduction and depression of the upper teeth. Results After an average of 17 months of treatment, the coverage of anterior commissure in 29 patients with early Class Ⅱ division 1 of permanent teeth returned to normal, the maxillary horizontal growth was significantly inhibited, and the incisors had no obvious lip-tilt. Cephalometrical measurements showed an average ANB reduction of 3.15 °, an average decrease of U1-SN of 6.53 ° and a significant improvement of facial appearance. Conclusions The improved HGAC combined with J-hook traction can effectively control the anterior class Ⅱ division 1 malocclusion in the early stage and control the anterior extraction of maxillary protraction and maxillary protrusion, Cover and molars neutral, get good curative effect.