摘要：Objective To evaluate the effects of rapid maxillary expansion on treatment in Class Ⅲ patients with maxillary portraction. Methods A total of 54 children with Class Ⅲ malocclusion were selected and divided into two groups. Twenty-six patients (group A) received maxillary protraction without RPE and the other 28 patients (group B) received maxillary protraction combined with RME. Cephalometric radiographs were taken and analyzed before and after treatment.Changes between the two groups were analyzed. Results The trends were similar in ANB, PP-MP,Ptm-A, Co-A, Co-Gn, A-Np, Pog-Np, Pog-NB and Wits value etc. Significant differences in treatment duration, in SN-PP and ANS-Me and in labial inclination of upper incisors were found between the two groups. Conclusions Maxillary protraction combined with or without rapid maxillary expansion was effective in the treatment of Class Ⅲ patients with maxillary deficiency.%目的 评价快速扩弓对上颌前方牵引治疗效果的影响.方法 选择54例替牙期以上颌发育不足为特征的骨性安氏Ⅲ类错(牙合)患者,随机分为单纯前牵引组(A组,26例)和前牵引联合快速扩弓组(B组,28例)进行矫治.分别在治疗开始(T0)和结束(T1)时拍摄头颅定位侧位片,进行定点测量,使用SPSS13.0统计软件进行t检验.结果 A组治疗时间(11.0±3.4)个月,B组(10.4±2.3)个月,(P＜0.05).矫治后,两组患者上下颌骨及牙齿的变化趋势相似,颅颌关系改善:ANB角增加,SNB角减小;颌骨变化明显:Ptm-A增加,Co-Gn增加,Wit's值增加,以上项目治疗前后变化均显著(P＜0.05)但组间差异并不显著.另外,A组SN-PP减小1.24°,B组减小0.6l°,组间差异显著(P＜0.05).在垂直向上下面高、下面高/全面高的变化B组较A组增加显著.U1-NA角增大,L1-MB角减小,在B组中的改变均较A组明显,Ms6-PP距增加在B组中较显著.治疗后面型角的变化在B组中较明显,而颏唇角、上、下唇-E线距的变化两组间无差异.结论 替牙期骨性Ⅲ类错(牙合),无论是否联合快速扩弓,上颌前方牵引均可产生显著治疗效果.上颌前方牵引联合快速扩弓,可以减轻腭平面的逆时针向旋转,减小前牙代偿,缩短矫治时间.