微种植支抗联合Sliding jig推磨牙向后的临床研究

目的 评价微种植支抗联合Sliding jig技术推磨牙向后的临床效果。方法 选择2008年11月—2009年10月在浙江大学附属第一医院口腔科就诊的10例骨性Ⅰ类安氏Ⅱ类错患者,上颌拥挤度3～5mm,下颌正常或轻度拥挤,侧貌基本为直面型。在上颌第二前磨牙与第一磨牙之间的颊侧附着龈上植入微种植钉,在上颌尖牙的远中与第一磨牙的近中放置Sliding jig悬于主弓丝上,用橡皮链连接种植体与Sliding jig的近中端,加载2.94N的拉力,推磨牙向远中。对于治疗前后的模型和头颅侧位片进行比较分析。结果 10例患者均解除了拥挤,纠正了Ⅱ类磨牙关系。磨牙平均远中移动4.12mm,远中倾斜8.35°,垂直压低2.19mm,以上数据均有统计学意义(P<0.01)。磨牙平均颊向移动距离0.03mm(P>0.05)。中切牙舌向移动0.65mm(P>0.05)。结论 微种植钉联合Sliding jig在推磨牙向后中发挥了绝对支抗的作用,前牙无唇倾,面型保持不变,值得临床推广。

Clinical study of micro-implant as anchorage in distalization of molar

Objective To evaluate the clinical efficiency of the micro-implant anchorage joint Sliding jig for molar distal movement.Methods 10 cases of Class Ⅱ malocclusion patients were slelected as subjects who were treated in The First Affiliated Hospital of Zhejiang University from November 2008 to October 2009.There was 3-5mm arch-length discreparcy in the upper arche,and the lower arche was normal or mildly crowded.Their profiles were straight.Micro-implant anchorages were embedded in the buccal attached gingiva between maxillary second premolar and first molar.Between the distal of canine and mesial of first molar Sliding jig were hanged in the main arch wire,and the power chain connecting the micro-implants and the mesial end of Sliding jig with 2.94 N power,pushing first molar to distal position.Casting model and cephalometric analysis were used.Results 10 patients all relieved congestion,and corrected the class Ⅱ molar relationship.The molar moved distal 4.12mm,tilted 8.35 °,vertical intrusion with 2.19mm.These were statistically significant（P〈 0.01）.The average buccal movement distance of molar was 0.03mm（P〉 0.05）,which was not statistically significant.The average lingual movement distance of incisors was 0.03mm（P 〉0.05）,which was not significant too.Conclusions Micro-implant joint Sliding jig had played an important role of absolute anchorage in pushing first molar to distal position.The technology is worth clinically popularizing.