种植体支抗结合多曲方丝弓技术矫治成年Ⅱ类高角骨面型错(牙合)的临床研究

目的 探讨种植体支抗结合多曲方丝弓技术矫治成年Ⅱ类高角骨面型错(牙合)的机制与疗效.方法 对11例成年Ⅱ类高角骨面型错(牙合)患者采用固定矫治技术配合种植体支抗关闭拔牙间隙,根据上前牙压低和内收方式的小同选用牵引钩的长度及牵引方向.矫治后期用多曲方丝弓技术调整(牙合)关系,并将传统Ⅱ类颌间牵引改良为颌内牵引.对矫治前后头影测量项目进行配对资料的t检验.结果 矫治后SNA角减少(2.86±1.05)°,ANB角减少(2.82±0.96)°,眼耳平面-下颌平面角(FMA角)减少(2.95±1.35)°.上前牙牙根得到较好的控制,未见上前牙舌倾与伸长;下前牙未见唇倾;磨牙未见伸长,上颌磨牙远中移动(3.00±2.19)mm.结论 用种植体支抗结合多曲方丝弓技术矫治成年Ⅱ类高角骨面型错(牙合),上齿槽座点(A点)可不同程度后退,正侧貌改善明显,并可有效免Ⅱ类颌间牵引在Ⅱ类高角骨面型错(牙合)矫治中的副作用.

Treatment of skeletal Class Ⅱ adult patients with microscrew implant anchorage and multi-loop edgewise arch wire

Objective To evaluate the effects and mechanisms of the mieroscrew implant anchorage (MIA) combined with multi-loop edgewise arch wire (MEAW) technique in the treatment of skeletal Class Ⅱ. Adult patients. Methods Eleven adult patients with skeletal Class Ⅱ high-angle maloeelusions were treated with fixed appliances. The spaces were closed by the springs from the MIA to the hook on the arehwire. The height of the hook and the direction of the force were different according to the intrusion and retraction of upper anterior teeth. In the finishing stage, MEAW technique and modified class Ⅱ elastics (from the first loop of MEAW to the MIA) were used for final detailing. Cephalometric analysis was used to evaluate the effect after treatment. Results After treatment, the decrease of SNA, ANB and FMA were ( 2. 86 ± 1.05 )° , ( 2. 82±0. 96 )° and ( 2.95 ± 1.35 )° , respectively. The torque control of upper anterior teeth was good. The protrusion of lower incisors and the molar extrusion were avoided. The upper molars were moved distally by ( 3. 00 ± 2. 19) nun. Conclusions The treatment of adult patients with skeletal Class Ⅱ high angle maloeelusions with MIA and MEAW technique could not only improve the facial esthetics but also avoided the common side effects of traditional Class Ⅱ elastics .