口外弓支抗对青少年骨性Ⅱ类错牙合畸形患者软组织侧貌改善效果评价

目的　评价青少年骨性Ⅱ类错牙合畸形患者通过口外弓配合固定矫治器治疗后软组织侧貌的改善效果。方法　选择2016年12月至2017年12月期间于上海交通大学医学院附属第九人民医院正畸科就诊的骨性Ⅱ类错牙合畸形患者20例，其中男8例，女12例；年龄10 ~ 13岁。所有患者均为早期恒牙列，骨性Ⅱ类错牙合畸形，远中磨牙关系，上牙列轻、中度拥挤，均角的非拔牙病例。应用口外弓配合固定矫治器进行治疗，对患者矫治前后的X线头颅侧位片进行侧貌软组织相关指标的头影测量及比较分析，评价矫治前后相关软组织侧貌轮廓的变化。结果　20例患者均通过口外弓配合固定矫治器将骨性Ⅱ类、远中磨牙关系的错牙合畸形矫正为骨性Ⅰ类、中性磨牙关系，患者侧貌改善，获得满意矫治效果。与矫治前比较，矫治后鼻唇角增大、上唇倾角减小、上唇突点到审美平面的距离（UL-EP）减小、上唇突度减小，差异均有统计学意义（均P < 0.05），表明上唇得到了内收；颏沟倾角增大，说明颏部向前生长；下唇倾角增大，说明下颌向前生长。结论　通过口外弓配合固定矫治器治疗青少年骨性Ⅱ类患者，可明显改善软组织侧貌。

Effects of the cervical headgear in improving soft tissue profile of adolescents with skeletal class Ⅱ malocclusion

Objective　To characterize the effects of cervical headgear combined with fixed appliance in improving the soft tissue profile of adolescent with skeletal class Ⅱ malocclusion. Methods　Twenty patients with skeletal class Ⅱ malocclusion who were treated at the Orthodontic Department of the Shanghai Ninth peoples′ Hospital from December 2016 to December 2017 were selected，including 8 males and 12 females，aged 10 -13 years old. All patients were the cases of early permanent dentition，skeletal class Ⅱmalocclusion，distal molar relationship，mild to moderate crowding and average angle. During the treatment，there was no tooth extraction. Cervical headgear and fixed appliances were used for treatment. Cephalometric measurements and statistical analysis were performed on the lateral radio graphs of the patients before and after treatment. Evaluat the changes of soft tissue profile before and after orthodontic treatment. Results　All 20 patients were successfully treated by using cervical headgear and fixed appliances. Their skeletal class Ⅱ malocclusion and distal molar relationship were corrected. All the patients′ profile was improved and they were satisfied with the treatment effect. Nasolabial angle increased，while SnUL-SN，UL-EP and UL-SnPos decreased （P < 0.05）. All of theses changes indicated that the upper lip had been adducted and B′ Pos-SN increased，indicating that the chin grew forward. B′ LL-SN increased，indicating that the mandible moved forward. Conclusion　For adolescents with skeletal class Ⅱ malocclusion，cervical headgear with fixed appliances can significantly improve the soft tissue profile.