微钛钉种植体支抗和传统支抗矫正上颌前突畸形的疗效比较

摘要

目的 分析微钛钉种植体支抗和传统支抗在上颌前突畸形中的临床疗效以及安全性.方法 选取2015年1月至2016年9月莱芜市人民医院收治的上颌前突畸形患者100例作为观察对象,按照随机数表法分为观察组与对照组,每组50例.对照组采取传统支抗治疗模式,观察组采取微钛钉种植体支抗治疗措施.在治疗前后拍摄头颅X线片,观察两组患者上颌前突畸形矫正情况[上中切牙切缘到牙周距离(U1-Y)、下中切牙切缘到Y轴的距离(L1-Y)、上第一磨牙冠近中点到Y轴的距离(U6-Y)、上中切牙长轴与前颅底平面形成的后下夹角(U1-SN)、下中切牙长轴与下颌平面形成的夹角(L1-MP)、上下中切牙长轴之间的夹角(U1-L1)]以及并发症发生率.结果 所有患者在治疗后,上前牙突出角度和轴倾度均得到较好的矫正,拔牙间隙也得到缩减.两组患者治疗前各指标比较差异无统计学意义(P>0.05),观察组在U1-Y、U1-SN以及U1-L1改善幅度显著优于对照组,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为8.0%,明显低于对照组的18.0%,差异有统计学意义(P<0.05).结论 微钛钉种植支抗治疗上颌前突畸形能够更好地矫正患者的上颌前突,其临床疗效显著优于传统口外支抗,值得临床中推广使用.%Objective To analyze the clinical efficacy and safety of micro-implant for orthodontic anchorage and traditional anchorage in the treatment of patients with maxillary protrusion deformity. Methods A total of 100 pa-tients with maxillary protrusion deformity who admitted to our hospital from January 2015 to September 2016 were se-lected. All patients were randomly divided into observation group and control group according to random number table, with 50 patients in each group. The control group adopted traditional anchorage therapy , and observation group was treated with micro-implant for orthodontic anchorage. Skull X-ray was performed before and after treatment. The maxil-lary protrusion deformity correction (distance between the incisal edge of upper central incisor and periodontium (U1-Y), distance between the incisal edge of lower central incisor and Y-axis (L1-Y), the distance between the upper first molar and Y-axis (U6-Y), the angle between the long axis of the upper central incisor and the anterior skull base plane (U1-SN), the angle formed between the long axis of the lower central incisor and the mandibular plane (L1-MP), the angle between the long axis of the upper and lower central incisors (U1-L1) and the complication rate were observed between the two groups. Results After treatment, the angle of protrusion and axial inclination of the anterior teeth were corrected significantly, and the extraction space was reduced. There were no statistically significant differences in the in-dexes of patients before treatment between two groups (P>0.05). The improvement range of U1-Y, U1-SN and U1-L1 of observation group was significantly better than that of control group (P<0.05). The complication rate in observation group was 8.0%, which was significantly lower than 18.0%in the control group (P<0.05). Conclusion Micro-implant for orthodontic anchorage in the treatment of maxillary protrusion malformations has significantly better clinical efficacy than traditional anchorage, which can better correct the patient's maxillary protrusions. It is worthy of clinical promotion and application.