上颌前牵引中两种口内固位装置的临床对比研究

目的探讨快速扩弓与包绕 垫式口内固位装置结合上颌前牵引矫治的效果差异，为临床治疗提供理论依据和参考。 方法选择23例骨性Ⅲ类上颌后缩患者，分为快速扩弓结合上颌前牵引组（13例）和包绕 垫结合上颌前牵引（10例）。对两组患者治疗前及前牵引后的头颅定位侧位片进行头影测量分析，并进行配对t检验；对两组患者治疗前、前牵引后的差值变化进行组间独立样本t检验。 结果两组患者矫治后均出现SNA增大、ANB减小、下颌骨长度增加、Y-axis、MP/FH、MP/SN、PP/MP、U1-SN增大、前下面高、前面高、后面高增加。这些指标的变化差异有统计学意义。快速扩弓组患者前颅底长、上颌骨长度（Ptm-A）明显增加，下切牙明显舌倾。包绕 垫组患者后颅底长明显增加，面角明显减小，前面高明显增加。两组间对比：S-Ba、NPg-FH变化两组差异有统计学意义（P < 0.05），其余测量值变化差异无统计学意义（P > 0.05）。 结论使用快速扩弓与包绕 垫加上颌前牵引矫治骨性Ⅲ类上颌后缩患者在临床上是确实可行的，可取得满意的疗效。

Comparison of two types of intra-oral fixation devices in maxillary protraction

ObjectiveTo investigate the difference of the treatment effect of the maxillary protraction therapy with rapid palatal expansion appliance or with wrapped bite-plate removable appliance as intra-oral fixation devices. MethodsTwenty-three skeletal ClassⅢ maxillary retrusion patients were selected and treated with maxillary protraction, the intra-oral devices were rapid palatal expansion appliance in 13 patients and wrapped bite-plate removable appliance in 10 patients. Paired t-test was used to compare the lateral cephalometric radiographs before and after treatment; the difference before and after treatment of two groups was compared with t-test of independent samples in group. ResultsSNA, Co-Po, Y-axis, MP/FH, MP/SN, PP/MP, U1/SN, ANA-Me, N-Me, S-Go increased, ANB decreased significantly in both groups. In rapid palatal expansion group, S-N, Ptm-A increased significantly, the lower incisors tipped lingual significantly. In wrapped bite-plate group, S-Ba, N-Me increased, facial angle decreased significantly (P<0.05) . The difference before and after maxillary protraction of two groups had no significant except S-Ba and NPg-FH (P>0.05) . ConclusionMaxillary protraction combined with rapid palatal expansion or with wrapped bite-plate removable appliance was effective in the treatment of Class Ⅲ patients with maxillary deficiency, the treatment effects had no significant difference in two groups.