Role of expansion screw in treatment of skeletal Class Ⅲ malocclusion with maxillary protraction in mixed dentition
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摘要: 目的 探讨螺旋扩弓器对前方牵引治疗替牙期安氏Ⅲ类骨性错牙合疗效的影响。 方法 选择8.5~11.0岁替牙期安氏Ⅲ类骨性错牙合的患者32例,随机分为2组,A组16例采用单纯前方牵引,B组16例先行上颌快速扩弓2周后再行前方牵引。治疗时间为6~9个月。疗程结束后,将2组患者的术前、术后头颅侧位片进行描点测量,用SPSS 13.0统计软件进行统计处理,对2组矫正前后的变化进行配对t检验分析。 结果 ①A组中有3例在疗程结束时前牙呈对刃关系,其余13例治疗结束后反牙合解除,前牙覆牙合、覆盖正常;B组患者16例在疗程结束时反牙合全部解除,前牙覆牙合、覆盖正常。②矫治后2组SNA、Ptm-A、ANB、Wits、U1-SN、ANS-Me、FH-MP均明显增大,差异有统计学意义(P<0.05),且联合扩弓组的Wits、ANS-Me、FH-MP增大较单纯牵引组显著,差异有统计学意义(P<0.05);单纯牵引组的U1-SN增大及SN-PP、L1-MP的减小较联合扩弓组显著,差异具有统计学意义(P<0.05),组间差异也有统计学意义(P<0.05)。 结论 前方牵引治疗替牙期安氏Ⅲ类骨性错牙合,无论是否联合扩弓,都能取得显著的效果,联合扩弓的方法可减少上下前牙的唇倾、减少腭平面的逆时针旋转,效果更令人满意。Abstract: Objective To investigate the effect of anterior protraction with expansion screw in the treatment of skeletal Class Ⅲ malocclusion in mixed dentition. Methods Thirty-two children with skeletal Class Ⅲ malocclusion were randomly divided into two groups.Sixteen patients of group A received simple protraction,while the other sixteen patients of group B received the rapid maxillary expansion for two weeks followed by maxillary protraction.The treatment time was six to nine months.After the treatment,the cephalometric measurement in lateral X-ray film was done to compare the difference using t-test by SPSS. Results ①In group A,the anterior teeth of both jaws met along their incisal edges in 3 cases,and crossbite was relieved,anterior overbite and override recovered in 13 cases;While in group B,crossbite was relieved,anterior overbite and override recovered in all 16 cases.②After the treatment,SNA,Ptm-A,ANB,Wits,U1-SN,ANS-Me,FH-MP increased significantly in both groups(P<0.05).Wits,ANS-Me,FH-MP in group A increased more significantly when compared with group B(P<0.05).The increase of U1-SN and the decrease of SN-PP and L1-MP in group B changed more significantly as compared with group A. Conclusion The maxillary protraction,with or without rapid expansion,can obtain significant effect in the treatment of skeletal Class Ⅲ malocclusion.The combined treatment can reduce the labial axial inclination of anterior teeth,and mandibular counterclockwise rotation.
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Key words:
- Expansion screw /
- Protraction /
- Class Ⅲ malocclusion /
- Mixed dentition
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