正畸临界病例拔牙与非拔牙治疗其硬组织变化的长期观察

目的:对比正畸临界病例采用拔牙与非拔牙治疗其硬组织的长期变化.方i主:由北京大学口腔医院正畸科5位具有副高职称的医师对一批正畸病例进行拔牙或不拔牙或临界的判断,判断得到治疗资料完整的临界病例54例.追踪随访治疗结束至少2年病例,共获得21例,其中拔牙组8例,非拔牙组13例.对样本治疗前后及随访时的头颅侧位片进行计算机定点测量.结果:拔牙组随访阶段骨骼指标变化差异有统计学意义(P<0.05),矢状向上SNB、SNPg角增大,垂直向上MP/SN减小,ArGo/ANSMe增大;上切牙唇向回复,U1/PP、U1/NA、U1-AP增大(P<0.05),但覆盖无明显同复.非拔牙组随访阶段骨骼变化差异无统计学意义,仅下切牙舌向同复,L1/MP减小,且覆盖有所增大(P<0.05).两组对比,治疗前骨骼和牙齿指标中仅MP/SN、ArGoGn差异有统计学意义;治疗结束时上下切牙倾斜度及唇舌向位置(L1/NB、L1-NB、L1-AP、U1-AP、U1/L1)在两组间差异有统计学意义;随访时仅非拔牙组的L1/MP明显大于拔牙组(P<0.05).结论:临界病例拔牙组与非拔牙组在随访阶段前牙均表现出一定的回复趋势,从而使治疗对两组造成的差异逐渐缩小.但拔牙组表现出下颌骨逆时针旋转的骨性变化,从而覆盖保持稳定;非拔牙组下切牙少量舌向回复且无骨骼变化,覆盖有所增大.

Long-term changes of hard-tissue in borderline cases with extraction vs. nonextraction treatment

Objective:To investigate hard-tissue changes in borderline cases with extraction and non-extraction during treatment and follow-up stages.Methods:Five associate professors,who were from Peking University School and Hospital of Stomatology,were asked to make judgment on the cases with full pre-treatment records for discriminating the borderline cases from extraction and non-extraction cases.Fifty-four borderline cases with full treatment records which had been out of treatment for at least 2 years were follo...