改良固定反式双阻板矫治器联合前牵矫治安氏Ⅲ类前牙反对颞颌关节的影响

目的探讨改良固定反式双阻板矫治器联合前牵矫治安氏Ⅲ类前牙反对颞颌关节的影响。方法应用改良固定反式双阻板矫治器(Twin-block appliance,TBA)联合前牵治疗15例安氏Ⅲ类轻、中度骨性前牙反,测量分析治疗前后颞颌关节中位断层片变化情况。结果未发现1例患者出现颞颌关节病症状。治疗前后线性百分比分别为24.67%和11.62%,N/M值治疗前后分别为1.82和1.07,A值及P值的变化均较明显。关节前间隙增大、后间隙减少,髁突明显后移位,髁突位置基本居中。结论反式双阻板矫治器TBA联合前牵全天作用引起颞颌关节适应性改建,适当的持续矫治力不会对颞颌关节产生不利影响。

Temporomandibular joint investigation of modified fixed reverse Twin-block combine maxillary protraction appliance in treatment of Angle Ⅲ skeletal anterior crossbite

Objective To investigate the temporomandibular joint(TMJ) of the modified fixed reverse Twin-block(TBA) combine maxillary protraction in treatment of early Angle Ⅲ skeletal anterior crossbite.Methods The appliance was used for 15 growing subjects with early Angle Ⅲ skeletal malocclusion and then we compared the changes in X-ray cephalometry before and after treatment.Results No TMD appeared in the treated group.The linear percentages were 24.67 and 11.62 and the N/M was 1.82 and 1.07 before and after treatment,respectively.Meanwhile,A and P changes could be achieved in combined treated group.Conclusions All findings indicated that the modified fixed reverse TBA combine maxillary protraction can lead to the reconstruction of TMJ.Suitable continuous orthodontic force does not lead to temporomandibular disorders.