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目的探讨替牙期不同类型骨性安氏Ⅲ类错的矫治设计要点。方法选择2001年1月至2008年12月于大连市口腔医院正畸科就诊的上颌骨后缩为主的骨性安氏Ⅲ类错畸形患者20例,根据患者的下颌平面角度及下颌能否进行部分功能后退分成2组。第1组12例,下颌平面角为均角或略偏高角,下颌不能进行部分功能后退,采用前方牵引刺激上颌骨发育、恒牙期综合治疗调整关系的方法;第2组8例,下颌平面角为均角或低角,下颌能够部分功能后退,此类患者多存在不良口腔习惯或咬合干扰、替牙障碍,治疗中采取纠正不良习惯,使用牙合垫配合颌间牵引改变下颌矢状向位置、去除干扰,适当扩大上牙弓,矫治替牙障碍,诱导上颌骨正常发育的方法。两组患者均由同一医生对矫治前后头颅侧位定位片进行测量分析。结果以上两种不同类型的病例治疗后均取得较满意疗效。第1组治疗后SNA角(蝶鞍点-鼻根点-上齿槽座点角)增大,表明上颌骨获得了更明显的生长;第2组治疗后SNB角(蝶鞍点-鼻根点-下齿槽座点角)减小,表明下颌矢状向位置后移。两组治疗后下颌平面角均增大,表明治疗后下颌骨均发生顺时针旋转。结论结合病因采取不同的设计方案是正确治疗替牙期不同骨性安氏Ⅲ类错的关键。合理的早期矫治,可降低恒牙期综合治疗的难度。
Objective To explore the key points of orthodontic treatment of different types of skeletal Class Ⅲ malocclusion during dentition. Methods From January 2001 to December 2008 in Dalian Oral Hospital orthodontics treatment of maxillary bone shrinkage of skeletal Class Ⅱ malocclusion patients 20 cases, according to the patient’s mandibular plane angle and mandibular energy No part of the function back into two groups. The first group of 12 cases, the mandibular plane angle for the average angle or a little high angle, the mandibular can not be part of the function of the back, the use of the front traction to stimulate maxillary development, permanent dental comprehensive treatment to adjust the relationship between ; Group 2 8 cases, mandibular Flat angle for the average angle or low angle, the mandible can function partially back, such patients often have bad oral habits or bite interference, tooth dysfunction, treatment to take bad habits, the use of occlusal pad with intermaxillary traction to change the sagittal To the location, remove interference, appropriate expansion of the upper arch, orthodontic treatment of orthodontic disorders, normal maxillary bone induction method. Two groups of patients by the same doctor before and after treatment of cephalometric positioning measurement. Results The above two different types of cases have achieved more satisfactory results after treatment. The SNA angle (sellar point - nasal root point - superior alveolar seat angle) increased after treatment in group 1, indicating that the maxilla obtained more obvious growth. After treatment, the SNB angle (sellar point - nasal root point - Lower cusp seat point angle) decreases, indicating that the mandibular sagittal position backward. After treatment, the mandibular plane angles of both groups were increased, indicating that the mandible occurred clockwise rotation after treatment. Conclusion Combining the etiological factors with different design schemes is the key to correct treatment of Angle ¢ ò skeletal Class III malocclusion during dentition. Reasonable early treatment, can reduce the difficulty of the comprehensive treatment of permanent teeth.