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目的:探讨上颌前牵引联合快速扩弓对儿童骨性Ⅲ类错的矫治效果。方法:对28例儿童骨性Ⅲ类错病人(7～10岁)进行上颌前牵引治疗,在前牵引前快速扩弓1周。分别在治疗开始(T0)和结束(T1)时拍摄头颅定位侧位片,进行定点测量分析。结果:①硬组织变化:ANB角增加5.37°(P<0.05),Wit’s值增加5.74 mm(P<0.05),Ptm-A增加2.49 mm(P<0.05),Yaxis增加1.82°(P<0.05);SNB角减小0.75°(P>0.05),Go-Me、Co-Gn分别增加0.64 mm、2.21 mm,但P>0.05,SN-PP减小0.61°(P>0.05),PP-MP增加5.54°(P<0.05),下面高、下面高/全面高分别增加3.98(P<0.05)、1.61(P>0.05);U1-NA角增加3.10°(P<0.05),L1-NB角减小1.23°(P<0.05),Ms6-PP距增加1.13 mm(P<0.05);②软组织测量项目变化:面型角增大5.98°,颏唇角减小2.45°、H角增大5.2°,上唇-E线距增大1.42 mm,下唇-E线距减小1.18 mm(P<0.05)。结论:前牵引联合快速扩弓矫治儿童骨性Ⅲ类错,可产生显著治疗效果,能促进上颌骨的生长,使面型改善,但下颌出现顺时针旋转,高角病人慎用。
Objective: To investigate the effect of maxillary anterior traction combined with rapid protraction on correction of skeletal class Ⅲ malocclusion in children. Methods: Twenty-eight pediatric patients with skeletal Class Ⅲ malocclusion were treated by maxillary anterior traction and rapidly expanded for 1 week before anterior traction. At the beginning of treatment (T0) and the end (T1), the cephalometric slices were taken and sentinel measurements were made. RESULTS: ① The changes of hard tissue: The ANB angle increased 5.37 ° (P <0.05), the Wit’s value increased 5.74 mm (P <0.05), the Ptm-A increased 2.49 mm ; The SNB angle decreased by 0.75 ° (P> 0.05), and the Go-Me and Co-Gn increased by 0.64 mm and 2.21 mm respectively 5.54 ° (P <0.05). The height of the lower and the lower of the lower increased 3.98 (P <0.05) and 1.61 (P> 0.05), the angle of U1-NA increased 3.10 ° (P <0.05). The changes of soft tissue measurement: the facial angle increased by 5.98 °, the angle of the lip of the chin decreased by 2.45 ° and the angle of H increased by 5.2 ° , The upper lip-E increased 1.42 mm and the lower lip-E reduced 1.18 mm (P <0.05). CONCLUSION: Anterior traction combined with rapid expansion can correct the skeletal class Ⅲ malocclusion in children, which can produce significant therapeutic effect. It can promote the growth of the maxilla and improve the facial appearance. However, the mandibular appears clockwise rotation, caution in high angle patients.