上颌粘接式变异横腭杆和下颌活动矫治器矫正第二磨牙正锁(牙合)的临床研究

摘要

目的 探讨上颌粘接式变异横腭杆和下颌活动矫治器矫正正锁(牙合)的治疗效果.方法 选取第二磨牙正锁(牙合)的错(牙合)畸形患者10例,制作上颌粘接式变异横腭杆及下颌活动矫治器,上颌每28~30天更换新的橡皮链持续加力,下颌患者每24h自行更换橡皮圈加力,当上下颌第二磨牙均回到正常牙列内并建立正常覆(牙合)覆盖关系后固定矫治器治疗.测量患者治疗前后上、下颌第一磨牙间宽度,上、下颌第二磨牙间宽度,以及上下颌第一磨牙远中颊尖及上下颌第二磨牙近中舌尖的连线与腭中缝、下颌中线之间角度的变化,对比矫治前后头颅侧位片中MP-FH、MP-SN角度的变化,进行统计学分析.结果 10例患者使用上颌粘接式变异横腭杆及下颌活动矫治器后,第二磨牙正锁(牙合)的矫治均在3.5~4.5个月内完成,后牙达到正常覆(牙合)覆盖关系.模型测量分析发现,上下颌第一磨牙间宽度在矫治前后无明显统计学差异,上下颌第二磨牙间宽度在矫治前后有明显统计学差异.上下颌第一磨牙远中颊尖及上下颌第二磨牙近中舌尖的连线与腭中缝、下颌中线之间角度变化有明显统计学差异.矫治前后头颅侧位片中MP-FH、MP-SN角度变化无明显统计学差异.结论 上颌粘接式变异横腭杆及下颌活动矫治器是一种简便有效矫治上颌第二磨牙严重正锁(牙合)的口内装置.%Objective To evaluate the clinical effect of correction of severe buccal crossbite by maxillary adhesive formula variation TPA and mandibular removable appliance. Methods Ten patients with second molar buccal crossbite were selected. The adhesive formula maxillary variation TPA and mandibular removable appliance were designed by authors. The upper molar was pulled by power chain from TPA every 28-30 days. The lower molar was corrected by elastic band from the removable appliance every 24 hours. Before and after the treatment, the width between upper and lower first molar and second molar and the rotation angle of the second molars and MP-FH,MP-SN were measured. All the data were compared. Results The buccal crossbite of second molar was corrected for 3.5 to 4.5 months by maxillary adhesive formula variation TPA and mandibular removable appliance. There was no significant difference in the first molar width and the angle of MP-FH and MP-SN before and after treatment. Significant difference was found in the distance between upper and lower second molar before and after treatment. Conclusion Maxillary adhesive formula variation TPA and mandibular removable appliance are simple and effective devices to correct severe second molar buccal crossbite.