不同微种植体与口外弓支抗矫治上牙弓前突的临床分析

摘要

目的：观察微种植体支抗（MIA）或自攻钛种植体（SDIA）与口外弓支抗治疗上牙弓前突的临床效果及并发症，分析两种治疗方式的特点。方法选取该科室诊治的上牙弓前突患者为研究对象，共计50例纳入研究，分为观察组、对照组各25例，观察组采用微种植体治疗，其中14例采用 MIA ，11例采用 SDIA 治疗，对照组采用口外弓支抗治疗。比较两组患者矫治时间长短，治疗前后影像学指标的变化，以及 MIA 与 SDIA 微种植体并发症发生情况。结果观察组正畸平均疗程为（19．85±2．01）个月，对照组为（23．58±1．79）个月，观察组疗程显著低于对照组（P＜0．05）。观察组上中切牙长轴与颅底平面的下内交角（U1-SN ）角度减小（16．8±1．9）°，对照组减小（20．2±2．1）°；垂直向上，观察组中切牙和第一磨牙分别降低（2．0±0．8）mm 和（1．6±1．0） mm ，对照组中切牙和第一磨牙分别伸长（0．7±0．5）mm 和（0．3±0．7）mm ；矢状向上，观察组第一磨牙位移（0．6±1．1）mm ，对照组为（1．7±0．8）mm ；观察组 U1-SN 、上中切牙与 X 轴距离（U1-X）、上第一磨牙至 X 轴距离（U6-Y）、上颌第一磨牙至 X 轴距离（U6-X）的治疗前、后差值与对照组的前、后差值比较差异有统计学意义（P＜0．05），而治疗前、后两组 U1-Y ，UL-X ，UL-Y 的差值无统计学差异（P＞0．05）。 MIA 与 SDIA 脱落率差异较小（P＞0．05），但 SDIA 引起牙龈红肿、增生率显著高于 MIA（P＜0．05）。结论微种植体较口外弓支抗改善上牙弓前突具有更大的优势，例如垂直向上降低上切牙、第一磨牙，并避免第一磨牙位移，MIA或 SDIA 的微种植体均有一定的脱落率，但 SDIA 可引起牙龈红肿、增生。%Objective To compare clinical effect and complications of micro-implant anchorage(MIA ) or self -driven titanium implant(SDIA) with headgear anchorage in treatment of maxillary dentoalveolar protrusion .Methods 50 patients with maxillary dentoalveolar protrusion were selected and divided into observation group and control group .Each group contained 25 patients .14 patients in observation group received MIA treatment while 11 patients received SDIA treatment .All patients in control group re-ceived headgear anchorage treatment .Comparison was made in respects of course of treatment ,clinical effect and complications .Re-sults The course of treatment in observation group was (19 .85 ± 2 .01) months while in control group was(23 .58 ± 1 .79) months . The treatment time in control group were longer than observation group (P < 0 .05) .U1-SN angle in observation group were de-creased(16 .8 ± 1 .9)° while the control group decreased(20 .2 ± 2 .1)° .In the vertical direction ,the observation group maxillary inci-sor and first molars were shorten (2 .0 ± 0 .8)mm and(1 .6 ± 1 .0)mm respectively ,while the control group were shorten (0 .7 ± 0 .5) mm and(0 .3 ± 0 .7)mm .In the sagittal direction ,the observation group maxillary first molars were moved (0 .6 ± 1 .1)mm while the control group were moved (1 .7 ± 0 .8)mm .The difference of U1-SN ,U1-X ,U6-Y ,U6-X between two group were statistically sig-nificant .The comparison of expulsion rate between MIA and SDIA had no statistical significance .But the rate inflammation symp-tom and hyperplasia of the gum in SDIA patients were higher than MIA patients .Conclusion MIA and SDIA had better ability in treatment of maxillary dentoalveolar protrusion in vertical direction than headgear and improve the curative effect of maxillary den -toalveolar protrusion and both of them had same fell off rate ,but SDIA had higher rate of inflammation .