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目的:对生长发育高峰期后伴下颌后缩的Ⅱ类错患者应用固定矫治器结合Forsus矫治器进行矫治,分析其矫治后的骨骼及牙槽改变。方法:研究对象包括10例患者,其主要临床表现为上前牙前突,下颌及颏部后缩,平均年龄15.6岁,侧位片颈椎发育生长高峰期C4期及以后。矫治时间平均25个月,均采用不拔牙矫治。在排齐整平后,戴用Forsus矫治器(3M),平均戴用时间为5.6个月。治疗后前牙覆盖均至正常,对治疗前后的头侧位片及模型进行分析。结果:治疗前后前牙覆盖平均减小7.5mm,治疗前后面型改变明显。下颌表现出少量生长,A点无明显变化,Pog点平均前移2.3mm,ANB角减小1.03°,下颌平面角增加1.7°以及平面角显著增加4.7°,治疗后上颌前牙显著内收1.8mm,下前牙前倾,切端前移4.9mm。提示治疗后上颌骨无明显改变,下颌骨少量的前下生长以及后下旋转,牙齿代偿明显,上颌前牙一定内收,下颌前牙大量前移以及前倾。结论:对于已过生长高峰期的患者,采用Forsus矫治器可显著减小覆盖改善面型,有的患者会有良好的骨矫形效应,但矫治效果以牙槽代偿为主。矫治中应加强下颌支抗,控制前牙唇倾,尽量利用剩余的生长潜力,改善治疗效果。
OBJECTIVE: To evaluate the skeletal and alveolar changes of patients with type Ⅱ malocclusion after mandibular growth after peak growth by using fixed appliance combined with Forsus appliance. Methods: The study included 10 patients, the main clinical manifestations of the anterior process of the anterior teeth, mandibular and chin constricted, with an average age of 15.6 years old, lateral cervical growth and development of C4 and beyond. Correction time average of 25 months, are not extracted teeth correction. After aligning and flattening, wearing Forsus appliance (3M), the average wearing time of 5.6 months. After treatment, the coverage of anterior teeth were normal, and the anterior and posterior slices of the model and the model were analyzed before and after treatment. Results: Before and after treatment, the average coverage of anterior teeth decreased by 7.5mm, and the surface type changed obviously before and after treatment. The mandible showed a little growth. There was no significant change in point A, Pog point average 2.3mm forward, ANB angle decreased 1.03 °, mandibular plane angle increased 1.7 ° and plane angle increased significantly 4.7 °, after treatment, the maxillary anterior teeth significant adduction 1.8mm, lower anterior teeth, anterior cut 4.9mm. Tip of the treatment of the maxillary no significant change in a small amount of mandibular anterior growth and subsequent rotation, the obvious compensatory teeth, maxillary anterior teeth adduction, mandibular anterior large forward and forward. CONCLUSIONS: Forsus appliances can significantly reduce the coverage area and improve the orthopedic effect in some patients who have already passed the peak of growth. However, the orthodontic effect is mainly based on alveolar compensation. Mandibular support should be strengthened to control the anterior lip lip, try to make use of the remaining growth potential and improve the therapeutic effect.