微型种植体在加强正畸支抗中的应用

目的：分析微型种植体支抗在口腔正畸中的应用效果。方法：以＂支抗,种植体＂为中文关键词,检索2000-01/2010-12相关文章。纳入与支抗与种植体相关研究文献;排除重复研究。以16篇文献为主重点进行讨论。并选择34例错牙合畸形患者作为临床验证。采用直丝弓矫治技术,在排齐和整平牙列之后采用0.046cm×0.064cm不锈钢方丝滑动法内收前牙。同时在上颌两侧第1恒磨牙与第2前磨牙之间龈缘下5~8mm处植入微型纯钛种植体,在种植体与上颌侧切牙远中牵引钩之间采用弹性牵引关闭拔牙间隙。每侧以150~200g力滑动内收6个前牙。结束后拍摄X射线头颅定位侧位片,并进行X线头影测量分析,与矫治前进行对比。结果：目前在口腔正畸中,增强支抗的常用方法有口外弓、横腭杆、Nance弓、种植体等。研究表明,传统方法难以获得完全的绝对支抗,临床上很难实现支抗磨牙不移动的治疗效果。经临床验证,采用微型种植体支抗,SNA、SNB、ANB的改变均不大,差异无显著性意义,上、下切牙牙轴、凸度均有明显改变,U1-NA距离减少了4.5mm,L1-NB距离减少了2.6mm,差异均有显著性意义,上颌第1磨牙牙冠向近中仅移动了0.4mm,其变化无显著性学意义（P〉0.05）。结论：微种植体虽不是绝对支抗,但是可以最大限度保护磨牙支抗,控制磨牙前移,获得理想的治疗效果。

Application of micro-implants in strength of orthodontic anchorage

OBJECTIVE： To analyze the effect of micro-implant anchorage on orthodontics. METHODS： Taking ＂anchorage, implant＂ in Chinese as search terms, the related articles from January 2000 to December 2010 were retrieved. Literatures related to anchorage and implant were included, repetitive researches were excluded. Totally 16 literatures were involved for analysis. Thirty-four cases with deformities of teeth and mandible patients were selected as clinical verification. Straight wire appliance was used in the align and leveling with 0.046 cm × 0.064 cm stainless steel rectangular wire sliding method to adduct anterior teeth. At the same time, micro-pure titanium implant was implanted into first molar and second premolar gingival margin of 5-8mm in both sides of the maxillary. Elastic traction was used to shut interdental space between implant and upper lateral incisor distal traction hook. Each side with 150-200 g forces sliding adduction six front teeth. After implantation, X ray cephalometry was shot, cephalometric roentgenogram was analyzed, and then compared with before treatment. RESULTS： At present in orthodontics, common methods of enhancement of anchorage including facebow, palatal arch, Nance bow, implant. Studies have demonstrated that traditional method is difficult to obtain completely absolute anchorage, and difficult to achieve curative effect of unmovable anchorage molar. According to clinical validation, the change of SNA, SNB and ANB with micro-implant anchorage is little, and there was no significant difference. The axis and crown of upper and lower incisor teeth have obvious changes; U1-NA distance was reduced 4.5 mm, L1-NB distance was reduced 2.6 mm, there was significant difference. Maxillary first molar crown only moved 0.4 mm to mesiocclusion, there was no obvious significance （P 0.05）. CONCLUSION： Although micro-implant is not absolute anchorage, it can maximize to protect molar anchorage, control molar anterior displacement, in order to achieve ideal therapeutic efficacy.