恒牙期前牙开(牙合)正畸和外科治疗颅面形态变化的比较研究

通过对正畸治疗和外科治疗成功的病例进行比较分析 ,探讨恒牙期前牙开牙合者正畸治疗和外科治疗引起的颅面形态的变化所在。方法　选择正畸治疗和外科治疗患者各 12人 ,外科治疗组中 5人为外科正畸联合治疗 ,7人为单纯外科治疗。应用计算机X线头影测量对治疗前后颅面软硬组织的形态变化进行比较和统计学分析。结果　正畸治疗的主要作用部位是牙齿和齿槽骨 ,牙齿关系的变化有显著的统计学意义 ;外科治疗组除牙齿关系 (覆牙合、覆盖、下切牙伸长度、上切牙倾斜度 )发生显著变化外 ,骨骼的变化也比较显著 ;正畸治疗组和外科治疗组相比 ,前者牙牙合关系的改善更明显 ,而后者主要以上下颌骨的矢状不调改善为主。正畸外科联合治疗比单纯外科治疗者矢状方向的改变明显且牙齿倾斜度改善。结论　正畸治疗可通过拔牙矫治调整前后牙齿移动的比例 ,达到纠正开牙合 ,改善软组织侧貌的目的 ;正畸治疗以牙齿倾斜度的变化为主 ,而外科治疗还可产生骨骼的变化 ,面型更趋和谐 ;术前术后正畸治疗应列为外科治疗的常规。

Comparative study of the effect of orthodontic and surgical treatment on craniof acial morphology in permanent anterior open bites

Objective In this study,we compared permanent anterior open bite cases treated successfully with orthodontic and surgery to discuss what morphologic changes happened in the craniofacial complex.Methods Two groups were selected with 12 patients each.In surgical group,5 persons were treated orthodontic-surgery combined,while the rest were surgically treated only.Computer aided X-ray cephalometry and SPSS software were involved.Results Significant changes of dental and alveolar area were observed in orthodontic group,while skeletal changes took place in surgical group.In orthodontic-surgery combined group,more changes were detected both in antero-posterior relation and dental inclination than in pure-surgery group.Conclusion Orthodontic treatment through extraction can close the bite by adjusting the space closure and improve the profile.Main craniofacial changes in orthodontic group happen in the dental area,but skeletal changes play an important role in the surgical group.Surgical patients combined with orthodontic treatment improve more apparently than those who have surgery only.Orthodontic treatment before and after surgery is recommended as a routine procedure.