Effect of micro-implant screw combined with transverse palatal rod anchorage on the vertical orientation, arch width and posterior cheek inclination of class Ⅱ high-angle patients
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摘要:
目的 比较微螺钉种植体支抗系统(MAS)联合横腭杆支抗(TPA)对安氏Ⅱ类高角患者的治疗效果。 方法 选取2014年6月—2015年6月邢台医学高等专科学校第二附属医院收治的安氏Ⅱ类高角患者40例,根据随机数字表法分为MAS组和MAS联合TPA组,每组各20例。采用X线头颅定位侧位片测量矫治前后磨牙垂直向距离,使用电子游标卡尺测量矫治前后的石膏模型上下颌牙弓横向宽度,对2组患者矫治前后采用锥形束CT(CBCT)测量分析第一磨牙颊倾度。比较2组患者磨牙垂直向距离、牙弓宽度以及后牙颊倾度的变化情况。 结果 经矫治后MAS联合TPA组的磨牙垂直向距离(L6-MP、LI-MP、U6M-SV、U6-PP和UI-PP)和MAS组(均P>0.05),牙弓宽度各指标(U33、U55、U66、L33、L55、L66)和MAS组比较差异有统计学意义(均P < 0.05)。MAS联合TPA组的磨牙旋转角度、磨牙颊向移动距显著高于MAS组[(2.23±0.45)°vs. (1.06±0.24)°; (1.23±0.08)mm vs. (0.15±0.01)mm],但磨牙位移显著低于MAS组[(3.13±0.66)mm vs. (5.21±0.82)mm,均P<0.05]。 结论 MAS联合TPA可有效降低磨牙垂直向的变化,促进牙弓宽度的增加,改善颊倾度,其对于安氏Ⅱ类高角患者的矫治效果显著优于MAS,值得临床推广。 Abstract:Objective To compare the effects of micro-implant screw anchorage system (MAS) combined with transverse palatal rod anchorage (TPA) on the angle Ⅱ high-angle patients. Methods Forty Class Ⅱ high-angle patients who were admitted to the Second Affiliated Hospital of Xingtai Medical College from June 2014 to June 2015 were selected. The patients were randomly divided into the MAS group and MAS combined with TPA group according to the number of entry time, with 20 cases each group. The vertical distance of molars before and after orthodontic treatment was measured by X-ray cephalometric lateral film. An electronic vernier caliper was used to measure the transverse width of the mandibular and upper dental arch before and after orthodontic treatment. The buccal inclination of the first molar was measured and analysed by CBCT before and after treatment. The changes of the vertical distance, the width of the arch and the buccal inclination of the posterior teeth were compared between the two groups. Results After correction, the vertical distance of the molar (L6-MP, LI-MP, U6M-SV, U6-PP and UI-PP) in the MAS combined with TPA group has no significant difference than that in the MAS group (all P>0.05), and each index of arch width (U33, U55, U66, L33, L55 and L66) in the MAS combined with TPA group the difference were statistically significant (all P < 0.05). The molar rotation angle and buccal distance in the MAS combined with TPA group were significantly higher than those in the MAS group [(2.23±0.45)° vs. (1.06±0.24)°; (1.23±0.08) mm vs. (0.15±0.01) mm], whilst the molar displacement was significantly lower in the MAS combined with TPA group than in the MAS group [(3.13±0.66) mm vs. (5.21±0.82) mm, all P < 0.05]. Conclusion MAS combined with TPA can effectively reduce the vertical change of molars, promote the increase of the arch width and improve buccal inclination. The effect of MAS combined with TPA is better than that of MAS in the treatment of Class Ⅱ high-angle patients, which is worthy of clinical application. -
Key words:
- Vertical /
- High-angle /
- Micro-screw implant /
- Angle class Ⅱ
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表 1 2组安氏Ⅱ类高角患者磨牙垂直方向指标比较(x±s,mm)
组别 例数 UI-PP U6-PP U6M-SV LI-MP L6-MP 矫治前 矫治后 矫治前 矫治后 矫治前 矫治后 矫治前 矫治后 矫治前 矫治后 MAS组 20 29.23±1.30 30.95±1.37a 21.54±0.83 22.45±0.89a 40.73±1.83 41.75±1.67a 41.24±1.66 41.87±1.23 31.21±1.46 31.69±1.48 MAS联合TPA组 20 29.41±1.36 29.53±1.30 21.24±0.78 21.62±0.95 39.43±1.84 39.87±1.57 40.83±1.78 40.54±1.38 31.43±1.32 31.72±1.42 t值 0.244 1.923 1.178 1.821 1.809 1.717 0.477 1.314 0.500 0.065 P值 0.808 0.062 0.246 0.077 0.078 0.094 0.636 0.197 0.620 0.948 注:与矫治前比较,aP < 0.05。 表 2 2组安氏Ⅱ类高角患者牙弓宽度比较(x±s,mm)
组别 例数 U33 U55 U66 矫治前 矫治后 矫治前 矫治后 矫治前 矫治后 MAS组 20 34.02±1.05 34.78±0.83a 35.04±1.11 35.61±1.03 46.35±1.06 46.97±1.10 MAS联合TPA组 20 34.22±1.08 35.32±0.73a 35.12±1.10 36.22±1.07a 46.23±1.02 47.67±1.06a t值 0.594 2.185 0.229 2.138 0.365 2.049 P值 0.556 0.035 0.820 0.039 0.717 0.047 组别 例数 L33 L55 L66 矫治前 矫治后 矫治前 矫治后 矫治前 矫治后 MAS组 20 26.73±1.13 27.14±0.89 41.40±1.02 41.87±1.03 41.23±0.84 41.84±0.80a MAS联合TPA组 20 26.54±1.06 27.74±0.92a 41.48±1.17 42.57±1.16a 41.38±0.77 42.40±0.89a t值 0.548 2.096 0.230 2.118 0.589 2.093 P值 0.587 0.043 0.819 0.041 0.560 0.043 注:与矫治前比较,aP < 0.05。 表 3 2组安氏Ⅱ类高角患者颊倾度比较(x±s)
组别 例数 磨牙旋转角度(°) 磨牙颊向移动距(mm) 磨牙位移(mm) MAS组 20 1.06±0.24 0.15±0.01 5.21±0.82 MAS联合TPA组 20 2.23±0.45 1.23±0.08 3.13±0.66 t值 10.260 59.908 8.837 P值 < 0.001 < 0.001 < 0.001 -
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