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目的比较平面导板打开咬合对成人安氏Ⅱ类深覆患者髁突在关节窝中位置的影响。方法选择有正畸治疗需求的18~32岁安氏Ⅱ类错患者30例。矫治前行锥形束CT(cone beam CT,CBCT)扫描,对原始影像进行3D重建,利用QR-NNT软件测量重建后3D影像的关节前、上、后间隙,运用Pullinger分析法计算髁突在关节窝中的位置。矫治过程中,利用上颌活动式平面导板打开安氏Ⅱ类深覆患者前牙咬合,待前牙咬合打开、后牙建立稳定咬合接触后再次行CBCT,对矫治前后测量值进行统计学分析。结果平面导板打开咬合后,安氏Ⅱ类错患者关节前间隙减小[(2.16±0.13)mm vs(2.03±0.19)mm,P<0.000 1],关节上间隙增大[(2.81±0.32)mm vs(3.30±0.33)mm,P<0.000 1],后间隙增大[(2.68±0.41)mm vs(2.97±0.42)mm,P=0.000 3]。结论正畸治疗上颌活动式平面导板打开安氏Ⅱ类患者前牙咬合后,安氏Ⅱ类患者髁突在关节窝内有前移的趋势。
Objective To compare the effect of planar guide plate opening and occlusion on the position of condyles in adult patients with Class Ⅱ deep overburns. Methods Thirty patients aged 18-32 years with Class Ⅱ malocclusion were selected for orthodontic treatment. The images were reconstructed by cone beam CT (CBCT) scan before reconstruction. The anterior, posterior and posterior gap of the reconstructed 3D images were measured by QR-NNT software and the condyle was calculated by Pullinger method The location of the socket. During orthodontic treatment, maxillary movable flat guide plate was used to open the occlusion of the anterior teeth of the patients with Class Ⅱ deep overburden. When the occlusion of the anterior teeth occured, the CBCT was established again after the occlusion of the posterior teeth was established, and the measured values before and after the correction were statistically analyzed. Results Compared with those with Class Ⅱ malocclusion, the anterior gap was significantly decreased in patients with Class Ⅱ malocclusion [(2.16 ± 0.13) mm vs (2.03 ± 0.19) mm, P <0.0001] and the gap in the joint was increased [(2.81 ± 0.32 ) vs (3.30 ± 0.33) mm, P <0.0001], and the posterior gap increased [(2.68 ± 0.41) mm vs (2.97 ± 0.42) mm, P = 0.0003]. Conclusion After orthodontic treatment of maxillary movable flat guide plate to open Class Ⅱ division of anterior teeth in patients with Angle, Class Ⅱ patients with mandibular condyles have a forward trend.