两种矫正技术矫治替牙期前牙畸形的疗效比较

目的比较导弓式活动矫正器与2×4矫治技术在替牙期前牙畸形矫形中的治疗效果。方法将23例牙性替牙期前牙畸形矫形分为导弓式活动矫正器治疗组（9例）与2×4矫治技术治疗组（14例），分别采用导弓式活动矫正器与2×4矫治技术进行矫正。两组患儿均于治疗前后取记存模型，拍摄颜面、口内、头颅侧位和全景x线片，并在治疗结束后均随访2年以评价疗效。结果导弓式活动矫治组的9例患者在矫形前3个月均见到明显效果，之后治疗进程随着下切牙的内收、间隙的关闭有所放缓。所有患者在经过5～8个月的治疗后，反牙合均解除，随访2年未见复发。然而患者牙列未能排齐，仍需要二期矫正。2×4矫治组的14例患者经过3—9个月治疗，均取得了满意的效果。解除了前牙反殆，下颌前突减轻，覆殆覆盖正常，后牙咬合关系良好，面中1／3凹陷明显改善，随访2年未见明显复发。此外，前牙排齐，中线对齐，中性或偏远中的磨牙关系也建立起来。所有牙矫治后无异常松动。结论导弓式活动矫正器与2×4矫治技术均可有效纠正替牙期前牙反殆，2×4矫治技术不仅能纠正反殆，还同时排齐了牙列，解决牙列扭转、间隙等畸形，避免了二期治疗，因而优于传统的活动矫治器治疗，是替牙期前牙反殆的首选矫正方法。

Comparison of the efficacy of two corrective techniques in correcting malformation of anterior teeth duringthe mixed dentition

Objective To compare the clinical effect of removable interocclusal lip arch appliance and the 2× 4 corrective techniques in correcting malformation of anterior teeth during the mixed dentition. Methods 23 cases of correcting malformation of anterior teeth during the mixed dentition were divided into removable interocclusal lip arch appliance treatment group （ 9 cases ） and 2 × 4 corrective technique treatment group （ 14 cases ）. The memory model were taken before and after treatment. The face, mouth,lateral cephalometric and panoramic X-ray film were all taken. And after treatment, the patients were followed up for 2 years to evaluate the efficacy of the treatment. Results 9 patients of guide arch type removable appliance treatment group were not seen obvious effect in first 3 months, then, the treatment process with lower incisor retraction, gap closed slowed. After treatment for 5-8 months, all of the patients＇crossbite were removed, followed up for 2 years without recurrence. However, patients＇dentition was not aligned, still needed the second period correction. The 14 patients of 2× 4 orthodontic technique treatment group obtained satisfactory results after treatment for 3-9 months. The anterior crossbite relieved, mandibular prognathism re- duced,overbite was normal,posterior occlusal relationship was good. The 1/3 face sag improved significantly,2 years follow-up showed no recurrence. In addition, the anterior teeth alignment, midline alignment, neutral or remote in the molar relationship was established. No abnormal loose occurred in all dental treatment. Conclusion Removable in- teroeclusal lip arch appliance and the 2 ×4 corrective technique are both effective in correcting anterior crossbite dur- ing the mixed dentition. The 2 × 4 orthodontic technique not only can correct crossbite, also align the teeth, solve the deformity of dentition torsion, clearance, avoid the second period of treatment. The 2 × 4 corrective technique is superi- or to the traditional activities appliance,is the preferred correction method for the anterior crossbite during the mixed dentition.