成人骨性Ⅱ、Ⅲ类错郃不同垂直骨面型拔牙矫正后颏部软组织变化

目的 对比成人骨性Ⅱ、Ⅲ类错郃三种不同垂直骨面型拔牙矫正后颏部软组织变化,探讨拔牙矫治对Ⅱ、Ⅲ类错郃颏部软组织的影响,评估不同骨性错郃及骨面型对拔牙矫正侧貌改善的敏感性。方法 随机选择成年骨性Ⅱ、Ⅲ类错郃患者50例,按垂直骨面型进行分组,每组患者10例。矫治前后分别拍摄头颅侧位片进行测量和统计学分析。结果 矫治后,骨性Ⅱ类、Ⅲ类错郃高、均角组颏唇角(LL-B′-Pog′)均明显减小,P＜0.01,且高角组矫治前后的变化值高于均角组,P＜0.05。骨性Ⅱ类错郃高角组矫治后颏前部厚度(Pog-Pog′)、颏沟倾角(Pog′B′-FH)、下唇倾角(B′LL-FH)均增大,P＜0.05;颏部长度(LL-Pog′)减小,P＜0.01;低角组下唇突度(LL-E)减小,P＜0.01。骨性Ⅲ类错郃治疗后高角组下唇突度(LL-E)、B′LL-FH、颏前部厚度(Pog-Pog′)均明显减小,P＜0.05,颏唇沟深度(B′-LLPog′)、Pog′B′-FH均增大,P＜0.01。均角组仅B′LL-FH明显减小,P＜0.01。高角组中,骨性Ⅲ类错郃LL-B′-Pog′、Pog-Pog′、B′LL-FH矫正前后的变化值均高于骨性Ⅱ类错郃,P＜0.01,均角组中,骨性Ⅲ类错郃LL-B′-Pog′矫正前后的变化值高于骨性Ⅱ类错郃,P＜0.01。 结论 成人骨性Ⅱ、Ⅲ类错郃不同垂直骨面型患者拔牙矫正后颏部软组织与侧面容貌均趋于和谐。拔牙矫治对高角型患者颏部软组织的改变相对明显,尤其对骨性Ⅲ类错郃的改变更为显著。

Comparative analysis of chin soft tissue angle before and after orthodontic treatment with extractionin skeletal class Ⅱ and class Ⅲ Malocclusion adults with different skeletal vertical patterns

Objective To evaluate and compare the change of chin soft tissue in skeletal class Ⅱ, Ⅲ malocclusion adults with different skeletal vertical patterns before and after orthodontic treatment, and to evaluate the sensitivity of improvement of soft tissue profile after orthodontic treatment between the different skeletal malocclusion and vertical patterns.Methods Skeletal class Ⅱ and class Ⅲ malocclusion adult patients were randomly selected, and divided according to the vertical growth pattern, with 10 cases in each group. X-ray lateral cephalograms were taken at pre-and post-orthodontic treatment, and the related variables of chin soft tissues were measured and statistically analyzed.Results After treatment, the LL-B′-Pog′ was significantly reduced in the groups of high-angle and normal-angle in skeletal class Ⅱ and class Ⅲ malocclusion, P＜0.01, but the high-angle group showed a more significant reduction than the normal-angle group, P＜0.05. There were increases in Pog-Pog′, Pog′B′-FH, and B′LL-FH in the group of high-angle after treatment, P＜0.05, whereas the LL-Pog′ showed a reduction, P＜0.01. In the group of low-angle, the LL-E was markedly reduced, P＜0.01. Obvious reductions showed in LL-E, B′LL-FH, and Pog-Pog′ in the group of high-angle in skeletal class Ⅲ malocclusion after treatment, P＜0.05, meanwhile, distinct increases showed in B′-LLPog′ and Pog′B′-FH, P＜0.01. There were no statistical differences in the normal-angle group except the reduction of B′LL-FH, P＜0.01. In the group of high-angle, the skeletal class Ⅲ malocclusion showed a more significant variation than the class Ⅱ malocclusion in the LL-B′-Pog′, Pog-Pog′, and B′LL-FH, P＜0.01, the change of mentolabial angle was more distinct in the skeletal class Ⅲ malocclusion than the skeletal class Ⅱ malocclusion in normal-angle group, P＜0.05.Conclusion The chin soft tissue and lateral appearance tend to be in harmony after orthodontic treatment with extraction in adults. There was a more significant change of the chin soft tissue in the high-angle group on account of orthodontic treatment with extraction, especially in the skeletal class Ⅲ malocclusion.