微种植体支抗远中移动上、下牙列矫治成人双牙弓前突15例临床分析

目的通过对患者治疗前、后X线头影测量分析,探讨利用微钛钉种植体支抗牵引上、下牙列,整体远中移动矫治成人轻、中度双牙弓前突的新途径。方法15例双牙弓轻、中度前突的成年患者,拔除第三恒磨牙,上颌种植钉植入颧牙槽嵴,下颌种植钉植入内、外斜线颊棚区,利用镍钛螺旋弹簧牵引上、下牙列,整体向远中移动。对所有病例矫治前、后的头颅定位侧位片、全口曲面体层片进行测量,采用SPSS13.0软件包对所得数据进行统计学分析。结果①60颗微钛钉种植体均保持稳固。②SNA、SNB等骨骼方面的测量值矫治前、后无显著改变（P>0.05）;U1/NA、U1-NA、L1/NB 、L1-NB、U1/L1的变化差异具有显著性（P<0.05）,表明上、下前牙突度和倾斜度明显减小。③鼻唇角（Cm-Sn-UL）、颏唇沟角（LL-B’-Pos）治疗后显著增大（P<0.01）,上、下唇相对于审美平面的突度减小,鼻、唇、颏的协调关系明显改善,面部侧貌改善。④上、下颌磨牙、切牙均不同程度远中移动。结论微钛钉种植体能提供稳定的支抗,牵引上、下牙列整体远中移动,矫治成人轻、中度双牙弓前突,硬组织和软组织均发生明显变化。

Treatment of adult bimaxillary arch protrusion with micro-implant anchorage

PURPOSE: In this study, micro-implants were used in 15 adult patients with mild and moderate bimaxillary arch protrusion or crowding. Cephalometric analysis was used to analyze hard and soft-tissues change before and after treatment, with the aim to investigate the effects of treatment on adult bimaxillary arch protrusion with micro-implant anchorage. METHODS: Fifteen adult patients with mild and moderate bimaxillary arch protrusion were selected in this study. Micro-implants were inserted into the zygomaticoalveolar ridge of maxilla and the external oblique line of mandible. A NiTi coil spring was attached to the micro-implant to drag the whole upper and lower dentition for distal movement. Cephalometrics were taken before and after treatment, and the changes of soft and hard-tissue profile were studied. SPSS13.0 software package was used to analyze the data. RESULTS: ①Sixty micro-implants remained stable.②SNA, SNB had no significant changes (P>0.05), and the relationship between the maxilla and the mandible did not change significantly. U1/NA, U1-NA, L1/NB, L1-NB and U1/L1 changes in hard tissue had significant difference in cephalometric measurement (P<0.05). The upper and lower anterior teeth were more retrusive, and the tipping of incisor decreased significantly.③Cephalometric analysis showed that lateral appearance improved and soft tissue cephalometric-related measurements such as Cm-Sn-UL,LL-B’-Pos increased significantly (P<0.01). ④Molars and incisors acquired distal movement. CONCLUSIONS: Micro-implant can provide not only excellent skeletal anchorage but also a novel way to distalize the whole dentition efficiently.