PASS矫治技术对成年安氏Ⅱ1类错牙合畸形患者支抗控制的临床研究

Clinical study of Physiology Anchorage Spee's-wire System for anchorage control in adults with ClassⅡ Division 1 malocclusion

关键词:  安氏Ⅱ1类错牙合畸形  PASS矫治技术  支抗

Key words:  Class II Division 1 malocclusion  PASS  anchorage

摘要:

目的 探讨PASS矫治技术在成年安氏Ⅱ1类错牙合畸形患者的治疗中支抗控制的有效性。方法 选取2015年1月至2018年1月在承德医学院附属医院口腔正畸诊治的30例成年安氏Ⅱ1类错牙合畸形且上颌需要中强支抗、下颌需弱支抗的患者为研究对象，应用PASS矫治技术治疗。收集患者治疗前后头颅侧位片并测量分析：∠SNA，∠SNB，∠ANB，∠MP-SN，∠U1-NA，∠U1-SN，∠UM-PP，∠UM-SN，UMA-PP距，UMC-PP距，UMA-PtPt'距，UMC-PtPt'距。结果 平均疗程23.4个月，治疗前后∠SNA、∠ANB、∠U1-NA、∠U1-SN变化有统计学意义（P<0.05），患者的上颌前突及上前牙唇倾得到改善。治疗前后∠SNB变化无统计学意义，下颌骨的改变不明显。治疗前后∠UM-PP、∠UM-SN差异无统计学意义，上颌第一磨牙未发生近中倾斜而造成支抗丧失。治疗前后∠MP-SN、UMA-PP距、UMC-PP距差异无统计学意义，上颌第一磨牙未发生明显的垂直向支抗丧失。治疗前后UMA-PtPt'距，UMC-PtPt'距的差异有统计学意义（P<0.05）。UMA-PtPt'距的差值为（2.61±1.96）mm，UMC-PtPt'距的差值为（3.41±1.22）mm，上颌第一磨牙发生了近中移位，但达到了中强支抗的效果。结论 PASS矫治技术在不使用任何额外支抗的情况下对成年Ⅱ1类错牙合畸形患者能有效控制支抗。

Abstract:

Objective To study the effectiveness of anchorage control in the treatment of adult patients with Class II Division 1 malocclusion by Physiology Anchorage Spee's-wire System (PASS). Methods Totally 30 adult patients were enrolled in the study, who were diagnosed with Class II Division 1 malocclusion and treated by PASS in the Department of Stomatology at the Affiliated Hospital of Chengde Medical University from January 2015 to January 2018. All patients needed moderate or strong anchorage on upper dentition and weak anchorage on lower dentition. Lateral cephalogram was performed before and after treatment. ∠SNA, ∠SNB, ∠ANB, ∠MP-SN, ∠U1-NA, ∠U1-SN, ∠UM-PP, ∠UM-SN, UMA-PP distance, UMC-PP distance, UMA-PtPt' distance, and UMC-PtPt' distance were measured and analyzed. Results The average course of treatment was 23.4 months. The changes of ∠SNA, ∠ANB, ∠U1-NA, and ∠U1-SN before and after treatment were statistically significant, and the maxillary anterior process and upper anterior lip tilt were improved. There was no significant change in ∠SNB before and after treatment, and the position of the mandible did not change significantly. There was no significant difference in ∠UM-PP and ∠UM-SN before and after treatment. The maxillary first molars did not have a mesial tilt and lost anchorage. There was no significant difference in MP-SN, UMA-PP distance, and UMC-PP distance before and after treatment. No significant vertical displacement of the maxillary first molar occurred. The difference between UMA-PtPt' distance and UMC-PtPt' distance before and after treatment was statistically significant. The maxillary first molar had a mesial displacement; the difference between UMA-PtPt' distance before and after treatment was (2.61±1.96) mm. The difference of PtPt' distance was (3.41±1.22) mm, which achieved the effect of medium and strong support. Conclusion The Anchorage Spee's-wire System technique could be an effective and convenient way to control the anchorage in adult patients with Class II Division 1 malocclusion without using extra affiliated anchorage enhancement appliances.