減數上頜第一前磨牙矯治安氏Ⅱ類錯的臨床研究

吳海燕+宋建紅+周靜+劉紅彥+李惠山

【摘要】 目的：探討減數上頜第一前磨牙矯治安氏Ⅱ類錯畸形的效果，觀察矯治前后軟硬組織變化。方法：選取2008-2013年就診于本院處于青春發育期的22例正畸患者，通過減數上頜第一前磨牙，結合種植體支抗技術矯治安氏Ⅱ類錯畸形，應用X線頭影測量技術分析矯治前后軟硬組織變化。結果：所有病例矯治結束后的SNA角、ANB角、U1-NA角、U1-NA距離（mm）、前牙覆合、前牙覆蓋、上唇突度、下唇突度、角U1-L1、角L1-MP、A-Npog等結果較矯治前比較差異均有統計學意義。牙列整齊，覆合覆蓋正常，側貌良好，上下唇突度減小，上唇突度減小更加明顯。結論：在臨床中選擇合適的適應證，單純減數上頜第一前磨牙，可以取得較為理想的面型及咬關系。

【關鍵詞】 安氏Ⅱ類錯畸形； X線頭影測量； 軟組織側貌

The Clinical Study on Reduction of Maxillary First Premolars in Treatment of Class Ⅱ Malocclusion/WU Hai-yan，SONG Jian-hong，ZHOU Jing，et al.//Medical Innovation of China，2014，11（28）：013-015

【Abstract】 Objective：To investigate the effect on reduction of maxillary first premolars class Ⅱ malocclusion，observe hard and soft tissue changes before and after treatment.Method：22 orthodontic patients in puberty in our hospital from 2008 to 2013 were selected，maxillary first premolar extraction and implant anchorage were applied in 22 patients to treat Angle Ⅱ malocclusion，and X-ray cephalometric technology was utilized to analyze the change in hard and soft tissue before and after the treatment.Result：After the treatment，∠SNA，∠ANB，∠U1-NA，U1-NA（mm），anterior teeth overbite，overjet，upper lip protrusion，lower lip protrusion，∠U1-L1，∠L1-MP，A-Npog after the treatment had significant difference compared with before treatment，the dentition fitted tightly，overbite was adequate，facial profile was good，the convexity of the lips had obvious reduction.Conclusion：The conclusion is that proper selection of indications and maxillary first premolar extraction in clinical treatment can achieve relatively ideal surface shape and occlusal relationship.

【Key words】 Class Ⅱ malocclusion； X-ray cephalometric； Soft tissue profile

First-authors address：Dalian Friendship Hospital，Dalian 116001，China

doi：10.3969/j.issn.1674-4985.2014.28.005

安氏Ⅱ類錯畸形是臨床上常見的錯畸形，在亞洲人群里有較高的發病率，不但影響顏面發育及咀嚼效率，嚴重者可導致上氣道結構性狹窄，發生上氣道狹窄[1]。安氏Ⅱ類錯畸形的治療常采用減數拔牙，常選擇拔除四個第一前磨牙，拔牙數目多，療程相對長。本研究中，22例安氏Ⅱ類錯畸形病例均采用拔除上頜兩個第一前磨牙，結合上頜種植體支抗，矯治結束后，患者咬合關系良好，側貌理想，達到了預期矯治目標。在臨床中，對于某些下頜、下牙列基本正常或者伴輕中度擁擠的安氏Ⅱ類錯患者，可以單純減數上頜第一前磨牙得到較為理想的矯治效果，而不必為了達到中性關系而對稱拔除下頜前磨牙牙，現具體報告如下。……