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目的评价骨性Ⅲ类错畸形患者术前正畸上颌拔牙矫治去代偿的效果。方法选取28例拟行正畸-正颌联合治疗的骨性Ⅲ类错患者,其中拔牙组12例术前正畸采取拔牙矫治,非拔牙组16例。对2组患者正畸前后的X线头颅定位侧位片及模型进行对比研究。结果术前正畸后,矢状向上拔牙组和非拔牙组下颌前牙均唇向直立,组间比较差异无统计学意义(P>0.05);拔牙组的上颌切牙U1-SN较非拔牙组明显内收(P<0.05)。横向比较,术前正畸后上颌UP2-UP2、UM1-UM1、UM2-UM2间宽度变化较非拔牙组缩小明显(P<0.05);下颌牙弓宽度两组均表现增加,差异无统计学意义(P>0.05)。结论在骨性Ⅲ类错畸形的术前正畸治疗中,拔除上颌第一前磨牙进行术前正畸能够更好地去除上颌牙性代偿,协调上下颌牙弓间横向关系,为正颌手术创建良好条件。
Objective To evaluate the effect of preoperative orthodontic maxilla extraction on patients with skeletal Class Ⅲ malocclusion. Methods Twenty - eight patients with skeletal Class Ⅲ malocclusion treated by orthodontic - orthognathic surgery were enrolled in this study. Among them, 12 cases of tooth extraction group were treated with extraction orthodontics and 16 cases of non - extraction group. The X-ray skull positioning lateral radiographs and models before and after orthodontics were compared in two groups. Results After preoperative orthodontic treatment, the mandibular anterior teeth in sagittal upward tooth extraction group and non-extractive tooth group all had lip upright with no significant difference between the two groups (P> 0.05). U1-SN of maxillary incisor in extraction group was higher than non- Group was significantly adduction (P <0.05). Laterally, the width of maxillary UP2-UP2, UM1-UM1 and UM2-UM2 in mandibular preoperative orthodontic group was significantly smaller than that in non-extracavitary group (P <0.05), and the width of mandibular arch was increased in both groups, with no significant difference (P> 0.05). Conclusions In preoperative orthodontic treatment of skeletal Class Ⅲ malocclusion, removal of the maxillary first premolar for preoperative orthodontic surgery can better remove the maxillary dental malocclusion and coordinate the lateral relationship between maxillary and mandibular dental arch, which is positive Jaw surgery to create good conditions.