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目的:观察双侧上颌颧下嵴区骨钉支抗配合前方牵引治疗上颌发育不足骨性Ⅲ类错的临床疗效。方法:选择替牙晚期或恒牙早期骨性Ⅲ类错患者共17例,男8例,女9例,平均12.1岁。均为上颌发育不足,可伴有下颌轻度前突,在双侧上颌颧下嵴区植入骨钉作为支抗配合前方牵引,与平面成向前下30°夹角,力值维持在350g左右,每日戴用时间10～12h。对比牵引前后头颅侧位X线片,进行13项骨骼测量项目分析,对测量结果配对t检验;并观察治疗后患者侧貌的改善程度。结果:SNA角平均增大4.1°,A点平均前移3.41mm,与治疗前相比差异有统计学意义(P<0.05);17例患者治疗结束后软组织侧貌改善明显。结论:双侧上颌颧下嵴区植入骨钉作为支抗配合前方牵引,能有效改善上颌发育不足骨性Ⅲ类错。
OBJECTIVE: To observe the clinical effect of bilateral maxillary zygomatic crest bone nailing with anterior traction for the treatment of maxillary underdeveloped bony class Ⅲ malocclusion. Methods: A total of 17 patients with skeletal Class Ⅲ malocclusion in the early or early stage of permanent tooth replacement were selected, including 8 males and 9 females, with an average age of 12.1 years. All were maxillary hypoplasia, may be associated with mild mandibular protrusion, in the bilateral maxillary zygomatic lower crest area implanted with bone nail as support with the front traction, and the angle of 30 ° into the anterior angle, the force value maintained at 350g or so, daily wear time 10 ~ 12h. Before and after traction compared to the skull X-ray films, 13 bone measurement project analysis, paired t-test results; and observe the improvement of the patient’s profile after treatment. Results: The average SNA angle increased by 4.1 ° and the average point A was 3.41 mm. The difference was statistically significant compared with that before treatment (P <0.05). The appearance of soft tissue in 17 patients improved significantly after treatment. CONCLUSION: Bone spikes implanted in bilateral lower maxillary zygomatic area can be used as support for anterior traction, which can effectively improve skeletal Class Ⅲ malocclusion.