目的：评价采用拔除一颗下颌切牙掩饰性矫治骨性反(牙合)病例的临床效果。方法：选取年龄19-34岁(平均24.5岁)伴下颌轻度拥挤的骨性反(牙合)病例18例(男10例，女8例)，拔除一颗下颌切牙，应用标准方丝弓固定矫治技术，分析治疗前后X线头影测量数据，并在石膏模型上进行测量。结果：所有病例在矫治结束后磨牙和尖牙均达到良好的咬合关系，覆(牙合)覆盖基本正常。患者硬组织改变无显著性(P≥0.05)。L1-MP角平均减小7.1。，U1-L1角平均增大10.5°，L1-NB角平均减小8.2°，L1-NB平均减小4.7 mm，差异均有显著性(P＜0.01)。软组织侧貌改善较明显，Li-E、Li-H平均减小量分别为3.1 mm，2.8 mm。UL-E、LL-E平均减小量分别为0.9 mm，1.7 mm(P＜0.01)，尖牙宽度减小2.4 mm(P＜0.05)差异均有显著性。结论：采用拔除一颗下切牙治疗骨性反(牙合)是一种非常规性的掩饰性治疗手段，鉴于疗程短，效果显著可作为临床治疗轻度骨性反(牙合)可选择的方法之一.%Objective: To evaluate the clinical effect of the orthodontic treatment and provide a new way for the treatment of skeletal crossbite cases. Method: the cases consisted of 8 female and 10 male patients with an average age of 24.5 years. In these cases, a single mandibular incisor was extracted. The standard edgewise technique was adopted.Lateral cephalometric radiographs and plastic models were taken before and after treatment for measurement and analysis. Result: At the end of the treatment) normal overjet and overbite were established with a canine and molar good relationship. There appeared to be no significant skeletal changes with treatment (P ≥0.05).LI-MP angle decreased by 7.1°,U1-L1 angle increased by 10.5°.L1-NB angle decreased by 8.2°,L1-NB distance decreased by 4.7mm.Statistically significant differences were found in these changes (P <0.01).The soft-tissue profile improved significantly. Li-E distance and Li-H distance decreased by 3.1 mm-.2.8 mm respectively. UL-E distance and LL-E distance decreased by 0.9 mm、 1.7 mm respectively (P < 0.01).The distance between lower canine decreased by 2.4 mm (P <0.05). Statistically significant differences were found in these changes. Conclusion: Correction of mild skeletal Class III malocclusion by extraction of a single mandibular incisor is an unusual therapeutic way, but it is a useful method for the treatment of mild skeletal crossbite.
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