口腔医学研究

口腔医学研究 ›› 2018, Vol. 34 ›› Issue (2): 198-202.DOI: 10.13701/j.cnki.kqyxyj.2018.02.022

• 口腔正畸学研究 • 上一篇    下一篇

替牙期伴功能性旋转前牙反牙合矫治方法的回顾性研究

陈慧霞1, 何展飞2, 秦燕军1, 李媛3*   

  1. 1. 常州市口腔医院正畸科 江苏 常州 213003;
    2. 常州市口腔医院放射科 江苏 常州 213003;
    3. 南京医科大学附属口腔医院正畸科 江苏 南京 210029;
  • 收稿日期:2017-11-15 出版日期:2018-02-28 发布日期:2018-02-26
  • 通讯作者: 李媛,E-mail: tina199921@hotmail.com
  • 作者简介:陈慧霞(1981~ ),女,河南人,副主任医师,博士在读,主要从事口腔正畸临床及基础研究。

Retrospective Study on Orthodontic Appliances Used to Correct Anterior Crossbite with Functional Mandibular Shift in Mixed Dentition

CHEN Hui-xia1, HE Zhan-fei2, QIN Yan-jun1, LI Yuan3*   

  1. 1. Department of Orthodontics, Changzhou Stomatology Hospital. Changzhou 213003, China;
    2. Department of Radiology, Changzhou Stomatology Hospital. Changzhou 213003, China;
    3. Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University. Nanjing 210029, China.
  • Received:2017-11-15 Online:2018-02-28 Published:2018-02-26

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摘要： 目的:回顾性评价替牙期伴有下颌功能性旋转前牙反牙合常用矫治方法的有效性及效率。方法:选择2014年1月~2017年9月在常州市口腔医院正畸科诊疗的患者47名:替牙期、牙性或功能性前牙反牙合伴下颌功能性旋转、上牙弓轻度拥挤、非拔牙矫治、可后退至切对切、无系统性疾病史、无明显上下颌骨异常、无口颌面肌功能异常、无口腔不良习惯、知情同意。由同一名高年资医师根据患者的实际情况分别采用活动/固定或功能矫治器进行治疗:活动组1采用带双曲舌簧的牙合垫式矫治器配合前方牵引,活动组2仅采用带双曲舌簧的牙合垫式矫治器,固定组采用2*4矫治技术配合下颌牙合垫去除咬合干扰,功能组采用FRIII配合肌功能训练,记录治疗成功率、矫治周期、复诊次数、矫治费用等,并进行对比分析。结果:除了自行终止治疗者,所有前牙反牙合均得到了纠正。活动组2复诊间隔时间短,矫治周期也最短(P<0.01);而复诊次数各组间无差别(P>0.05);矫治费用活动组2低于活动组1和固定组(P<0.05)。固定组在纠正反牙合的过程中排齐并关闭前牙散在间隙,患者及家长对治疗结果更加满意,这是活动及功能矫治无法比拟的;而固定矫治过程中对口腔卫生要求更高,牙面常发生脱钙,且矫治结束后需制作仅包裹四颗上切牙的压膜保持器,这又是固定矫治不利的一面。结论:伴有下颌功能性旋转的替牙期前牙反牙合在患者良好的配合下通过一个较短时间的矫治均可以得到纠正。

关键词: 替牙期, 前牙反牙合, 正畸矫治, 功能性旋转

Abstract: Objective: To compare the effectiveness and efficiency of orthodontic appliances used in correcting anterior crossbite with functional mandibular shift in the mixed dentition. Methods: Forty-seven patients treated in our department were selected. The inclusion criteria was: mixed dentition, anterior crossbite with functional mandibular shift, mild space deficiency in the maxilla, a non-extraction treatment plan, retracted to an edge-to-edge incisor relationship, no history of systemic disease, and written consent obtained. The patients were treated either with a removable appliance with protruding springs combined with/without facemask protraction or a fixed appliance with multi-brackets combined with removable mandibular appliance or a FRIII combined with myofunctional training. The main outcome measures assessed were success rate, duration of treatment, times of visit, and costs of treatment. Results: The anterior crossbite was successfully corrected in all patients except one self-terminated case. The average duration and cost of patients treated with removable appliance without facemask were significantly lower (P<0.05). The alignment of four maxillary incisors in the fixed appliance group was more aesthetic, however, extraordinary retention was needed. Conclusion: Anterior crossbite with functional mandibular shift in the mixed dentition can be successfully corrected by either removable or fixed or FRIII appliance therapy in a short-term perspective.

Key words: Mixed dentition, Anterior crossbite, Orthodontic treatment, Functional shift

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