3种功能矫治器矫治骨性Ⅱ类错的临床疗效对比研究

目的探讨Twin- block、Activator和Herbst功能矫治器治疗骨性Ⅱ类错的临床疗效是否存在差异。方法 选择使用Twin- block、Activator和Herbst功能矫治器矫治成功的60例骨性Ⅱ类错患者为研究对象。根据使用矫治 器的不同，将其分为Twin- block组、Activator组和Herbst组，每组均为20例患者。在正畸治疗前和功能矫治完成后 （第一恒磨牙建立中性关系）对每位患者拍摄X线头颅侧位片，对其治疗前后X线头影测量值进行比较。结果3 组患者功能矫治器治疗后，矢状向关系上ANB角、SNB角、Go- Gn、Co- Gn、L1-MP的变化具有统计学意义，垂直 向关系上N-Me、ANS-Me、S- Go、SN-MP及Co- Go的变化具有统计学意义。与Twin- block组、Activator组相比， Herbst组患者下前牙的唇倾（L1-MP）更明显，但抑制上前牙前倾（U1- SN）的效果不明显。3组患者上颌向前生长 （Ptm- A）及垂直向变化（OB、N-Me、ANS-Me、S- Go、Co- Go）无明显差异。结论Twin- block、Activator和Herbst 矫治器对骨性Ⅱ类错的早期矫治机制是相似的，但Herbst矫治器对下颌的矫形和下前牙的唇倾作用更明显。

Comparative study of the clinical effects of three different functional appliances on the treatment of skeletal class II malocclusion

OBJECTIVE: To evaluate whether there was any difference on the clinical effects of Twin-block, Activator and Herbst appliances on the clinical effects of growing children with skeletal Class II malocclusion. METHODS: 60 patients with skeletal Angle Class II malocclusion were divided into three groups (Twin-block group, Activator group, Herbst group), 20 in each group. The patients of three groups were respectively treated by Twin-block, Activator and Herbst appliances. The patients were 10-13 years old(mean 11.6) before treatment, and were mainly with mandibular retrognathia. Data of pre- and post-treatment were measured and analyzed. RESULTS: There was statistically significance of ANB, SNB, Go-Gn, Co-Gn, L1-MP in sagittal changes, and N-Me, ANS-Me, S-Go, SN-MP, Co-Go in vertical changes after treatment of three groups. Herbst group was more effective than Twin-block group and Activator group in the increase of L1-MP, but the effects on maxilla were not significant among them. There was no statistical significance of Ptm-A, OB, N-Me, ANS-Me, S-Go and Co-Go between 3 groups. CONCLUSION: Treatment effects of three different functional appliances (Twin-block, Activator and Herbst) are similar in the early treatment of skeletal Class II malocclusion. Compared with Twin-block and Activator, Herbst has more effects on orthopedic of mandibular and lower anterior teeth.