快速扩弓和固定矫治联合应用于高角病例的临床观察

目的 评价上颌快速扩弓和固定矫治器联合应用对牙弓、基骨矢状向和垂直向的影响。方法 对30例恒牙列轻中度拥挤病例以上颌快速扩弓和固定矫治器进行非拔牙治疗，分为两组：高角组(下颌平面角>32°；n=20)和均角组(下颌平面角≥22°且≤32°;n=10),分别在T1(治疗前)、T2(快速扩弓3个月后)和T3(固定矫治结束)进行头影测量分析。结果 高角均角患者经过快速扩弓联合固定矫治器治疗后在骨性垂直高度上的变化无差异。下颌平面角在3个时间点均有显著性变化。Y轴角、全面高、前上面高在T1-T2以及T1-T3间有明显增大。结论 快速扩弓虽然会导致上、下颌骨的向下旋转，但由于其变化量的绝对值小，无临床意义。高角不是快速扩弓治疗的禁忌证。

Clinical observation of combined application of rapid maxillary expansion and fixed appliance in hyperdivergent cases

Objective To evaluate the effects of combined application of rapid maxillary expansion and fixed appliance on dental arch,basal bone sagittal and vertical. Methods Rapid maxillary expansion and fixed appliances were used in non extraction treatment on 30 mild to moderate crowding cases of permanent dentition and they are divided into two groups:a hyperdivergent group (mandibular plane angle >32 °; n=20) and a normal vertical dimension group (mandibular plane angle ≥22 ° and ≤ 32 °; n=10). Cephalometric analysis was done at T1 (pre treatment),T2 (rapid maxillary expansion after 3 months) and T3 (after fixed appliance treatment). Results No significant differences in treatment effects were found in vertical dentoskeletal variables examined in two groups. There were significant differences in mandibular plane angle at the 3 time points.Y axis,total facial height,upper anterior facial height increased significantly during T1 T2 and T1 T3. Conclusions Rapid maxillary expansion will lead to downward rotation of the maxillary and mandibular,but there is no clinical significance due to the small variation of the absolute value. Hyperdivergent is not a contraindication for rapid maxillary expansion therapy.