目的 ：通过X线头影测量对软组织侧貌角度的分析,评价前导矫形联合固定矫治器与单纯拔牙对治疗生长发育期安氏Ⅱ类骨性错病例的临床疗效。方法：选取31例生长发育期安氏Ⅱ类错伴下颌后缩的病例。其中,18例采用Ⅰ期固定式Twin-Block矫治器联合Ⅱ期固定矫治,13例采用传统的单纯拔牙后直丝弓矫治进行治疗。在治疗前、Twin-Block矫治完成后以及全部固定矫治结束后拍摄X线头颅侧位片,进行软组织侧貌角度测量分析。使用SPSS15.0软件包比较前导矫形组、单纯拔牙组治疗前、后的组内差异以及2组的组间差异。结果 ：2组中,软组织面角、全面凸角、下唇角、上下唇角治疗后均有明显变化。前导矫形组中,面凸角、上下唇基角以及下唇基角治疗前、后差异显著;而单纯拔牙组中,上唇角、Z角治疗后有明显变化。前导矫形组下唇颏唇沟部软组织与鼻底之间的改变大于拔牙组,而拔牙组的上唇软组织改变大于前导矫形组,2组间上唇角、上下唇基角治疗前后差值的差异均有统计学意义。结论：前导矫形联合固定矫治与单纯拔牙固定矫治相比,在治疗生长发育期骨性Ⅱ类下颌后缩的患者中,固定式Twin-Block矫治器的应用更有利于面下1/3软组织侧貌的改善。
PURPOSE： This cephalometric study was designed to evaluate the soft tissue profile effects of Twin-Block combined with straight wire appliances in the treatment of skeletal Class Ⅱ malocclusion with mandibular retrognathia in growing individuals by angulation. METHODS： The sample comprised 31 growing individuals with skeletal Class Ⅱ and mandibular retrognathia, which were divided into 2 groups. One group （18 patients） was treated with fixed Twin-Block combined with fixed appliance, the other group （13 patients） was only treated with fixed appliance after tooth extraction. Pretreatment and posttreatment lateral cephalograms were taken before and after Twin-Block treatment and after all the fixed appliance treatment. Angular cephalometric measurements of soft tissue were analyzed statistically. Intragroup and intergroup changes of the 2 groups were evaluated by Student＇s t test using SPSS 15.0 software package. RESULTS： Significant difference of FH-N＇Pg＇, G-Pn-Pg＇, LiSi-SN and SnLs-SiLi were discovered in both groups （P〈0.05）. With Twin-Block combined with fixed appliance, N＇-Sn-Pg＇, Sn-N＇-Si and Si-N＇-S changed significantly, while LsSn-SN and Z angle differed significantly before and after treatment with extraction and fixed appliance. After treatment of Twin- Block combined with fixed appliance, Sn-N＇-Si decreased significantly, and the difference between the change of the 2 groups was significant. Meanwhile LsSn-SN was stable in combined treatment group while it decreased greatly after extraction. CONCLUSIONS： Compared with extraction with fixed appliance treatment, Twin-Block combined with fixed appliance treatment is more favorable in promoting lower facial profile in growing skeletal Class Ⅱ individuals with mandibular retrognathia.
Shanghai Journal of Stomatology