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目的 :通过X线头影测量对软组织侧貌角度的分析,评价前导矫形联合固定矫治器与单纯拔牙对治疗生长发育期安氏Ⅱ类骨性错病例的临床疗效。方法:选取31例生长发育期安氏Ⅱ类错伴下颌后缩的病例。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直丝弓矫治进行治疗。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,进行软组织侧貌角度测量分析。使用SPSS15.0软件包比较前导矫形组、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 :2组中,软组织面角、全面凸角、下唇角、上下唇角治疗后均有明显变化。前导矫形组中,面凸角、上下唇基角以及下唇基角治疗前、后差异显著;而单纯拔牙组中,上唇角、Z角治疗后有明显变化。前导矫形组下唇颏唇沟部软组织与鼻底之间的改变大于拔牙组,而拔牙组的上唇软组织改变大于前导矫形组,2组间上唇角、上下唇基角治疗前后差值的差异均有统计学意义。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,固定式Twin-Block矫治器的应用更有利于面下1/3软组织侧貌的改善。
OBJECTIVE: To evaluate the clinical effect of orthodontic appliance combined with orthodontic appliance and simple tooth extraction on the treatment of skeletal Class Ⅱ malocclusion in growth and development by X-cephalography. 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, and 13 cases were treated with straight wire arch appliance after traditional simple extraction. Before treatment, after the completion of Twin-Block correction and all fixed orthodontic treatment, the X-ray cephalogram was taken and the soft tissue profile was measured. The SPSS15.0 software package was used to compare the differences between the groups before and after the treatment of the leading orthopedic group and the single tooth extraction group and between the two groups. Results: In the two groups, there were significant changes in soft tissue face angle, total lobe angle, lower lip angle, upper and lower lip angle after treatment. In the leading orthopedic group, there were significant differences between the facial lobes, the upper and lower lip base angles, and the lower lip base angle before and after treatment. In the simple tooth extraction group, there was a significant change after the upper lip angle and Z angle treatment. The difference between soft tissue and nasal floor in the chin groove of the lower lip of the anterior orthodontic group was greater than that of the tooth extraction group while the change of upper lip and soft tissue in the tooth extraction group was greater than that in the leading orthopedic group. There is statistical significance. Conclusion: Compared with the simple orthodontic treatment, the application of the fixed Twin-Block appliance is more beneficial to the lower 1/3 soft tissue side in the treatment of patients with skeletal Class Ⅱ mandibular retrusion during the growth and development Appearance improvement.