两种不同拔牙方式矫治成人骨性反合的硬软组织改变对比研究

摘要

目的：：研究对比两种不同拔牙方式矫治成人骨性反合的硬软组织改变。方法：选择2013年8月至2014年8月在我院口腔正畸科接受治疗的成人骨性反合患者82例作为研究对象。依照患者上颌是否拥挤将82例患者划分为观察组(42例)及对照组(40例)。对观察组行双颌拔牙矫治术,对照组行下颌单颌拔牙矫治术,两组患者均通过直丝弓矫治,比较两组治疗前后的硬、软组织 X 线检测差值及患者对矫治后效果的满意度。结果：观察组治疗前后的硬组织 X 线检测差值中,U1－SN 角、U1－NA角及 U1－NA 距小于对照组,U1－L1角大于对照组,差异均有统计学意义(P<0.05)。观察组治疗前后的软组织 X 线检测差值中,上唇凸距及上唇－审美距小于对照组,鼻唇角大于对照组,差异均有统计学意义(P<0.05)。观察组对矫治后效果的满意度为97.62％,与对照组的90.00％相比,差异无统计学意义(P>0.05)。结论：对于成人骨性反合患者的治疗,使用双颌拔牙及下颌单颌拔牙均具有较好的矫治效果,但前者适应征为上颌合并中重度拥挤的有中度骨性反合症状的患者,而后者适应征主要为上颌轻度拥挤以下的有轻、中度骨性反合症状的患者。%Objective: To compare the changes of hard and soft tissues of adult skeletal Class Ⅲ maloc-clusion with two different extraction methods. Methods: 82 cases of adult patients with oral orthodontic treat-ment with osteoarthritis were studied from Aug. 2013 to Aug. 2014 in our hospital. According to the patients’ degree of maxillary crowding, the patients were divided into observation group (42 cases) and control group (40 cases). The observation group was given with double jaw extraction, the control group was treated with mandibular single tooth extraction, and the two groups were treated by straight wire appliance. The difference between the two groups were compared. Results: In the observation group before and after treatment, the difference of the X-ray examination of hard tissue, U1-SN angle, U1-NA angle and U1-NA distance were significantly less than the control group, U1-L1 angle was significantly greater than that of the control group, the difference was statistically significant (P < 0.05). The observation group before and after treatment of soft tissue X-ray detection difference, upper lip protruding from the upper lip and aesthetic distance was signifi-cantly less than that in the control group, nasolabial angle was significantly higher than that of the control group, the differences were statistically significant ( P < 0.05). The satisfaction degree of the observation group was 97.62%, and the difference was not statistically significant (P > 0.05). Conclusion: For the treat-ment of adult patients with skeletal back teeth, the use of double jaw extraction and mandibular single jaw tooth extraction have better effect, but the former is characterized by a moderate and severe crowding in pa-tients with moderate bone symptoms, and the latter is mainly for the patients with mild and moderate skeletal symptoms of the patients with mild and moderate.