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目的研究快速扩弓前方牵引与单纯前方牵引矫治早期骨性Ⅲ类错临床疗效的异同。方法选择31例替牙期骨性Ⅲ类错患者分为A、B组,A组15例采用快速扩弓前方牵引矫治,B组16例采用单纯前方牵引矫治。2组患者矫治前后分别拍摄头颅定位侧位片,选择23个测量项目,比较矫治前后的变化,并用Pancherz分析法进行分析。结果A组疗程平均10.14个月,B组平均9.77个月(P>0.05)。Pancherz分析结果表明,A、B组上颌基骨分别前移2.99mm和3.33mm;A组下颌基骨后移0.07mm,B组下颌基骨前移0.80mm;A、B组前牙覆盖分别增加4.51mm和6.37mm,磨牙关系改善分别为4.97mm和4.73mm。以上项目除前牙覆盖的变化2组间有统计学差异外(P<0.05),其余项目无统计学差异(P>0.05),均达到满意的临床效果。A组下颌磨牙在下颌基骨中前移了1.18mm,B组下颌磨牙在下颌基骨中后移了1.20mm(P<0.05)。从2组矫治前后治疗变化量的比较来看,矫治后2组上颌前牙的唇倾度均有增加,但B组较A组增加更多(P<0.05)。结论对早期骨性Ⅲ类错采用前方牵引矫治,无论快速扩弓与否,均可获得满意的临床疗效。
Objective To study the clinical effects of rapid protraction and anterior traction on the early stage of skeletal Class Ⅲ malocclusion. Methods A total of 31 patients with stage Ⅲ malocclusion were divided into group A and group B. Group A was treated with rapid anterior arch traction in group A and group B with traction alone in 16 cases. Two groups of patients were taken before and after treatment of cranial positioning flaps, select 23 measurement items, compare the changes before and after treatment, and analyzed by Pancherz analysis. Results The average duration of treatment was 10.14 months in group A and 9.77 months in group B (P> 0.05). Pancherz analysis showed that the maxillary base bone in groups A and B were advanced by 2.99mm and 3.33mm, respectively. In group A, the base bone was displaced by 0.07mm and the basement mandibular bone in group B was advanced by 0.80mm. The anterior teeth coverage in group A and B were increased 4.51mm and 6.37mm, molars improved respectively 4.97mm and 4.73mm. The above items in addition to the changes of anterior teeth covered two groups were statistically different (P <0.05), the remaining items were not statistically different (P> 0.05), have reached satisfactory clinical results. In group A, mandibular molars advanced 1.18 mm in the base of the mandible and group B shifted 1.20 mm in the base of the mandible (P <0.05). From the comparison of the change of the treatment before and after treatment, the lip inclination of the anterior teeth of the two groups all increased, but the B group increased more than the A group (P <0.05). Conclusion Early skeletal class Ⅲ malocclusion using the front traction treatment, regardless of rapid expansion or not, can be satisfied with the clinical efficacy.