【摘要】：目的：通過比較上頜單頜拔牙與雙頜拔牙矯治前后軟硬組織的變化，探討掩飾性治療成人安氏II類1分類錯牙合的適合矯治方案。 方法：成人安氏II類1分類錯牙合患者36例，18例實行上頜拔除兩個第一前磨牙方案；18例實行上頜拔除兩個第一前磨牙、同時拔除下頜兩顆第二前磨牙，將矯治前、后的X線投影測量結果進行對比研究。 結果：治療前，單頜拔牙者FMA, Y軸角較雙頜拔牙者小，頦唇溝角較雙頜拔牙組大。治療后A組中∠L1-MP，∠OP-SN，∠U1-LI，Z角，頦唇溝角，明顯增大；H角，UL-E, LL-E, U1-AP, UL-Pn，，LL-Pn，∠U1-FH明顯減��；B組中∠U1-L1,OP-SN，Z角，頦唇溝角，明顯增大；UL-E，LL-E, UL-Pn，LL-Pn，U1-AP,U1-NA，U1-NB，∠U1-FH,∠L1-MP, H角，明顯減小。兩組治療前后差值對比中，∠L1-MP，∠U1-FH，∠U1-L1，U1-AP，LL-E，UL-Pn，LL-Pn，的變化差別有統計學意義，UL-E兩組間變化無統計學差異。 結論： 1、兩種拔牙矯治方法均能達到內收上前牙，改善軟組織側貌的治療目的。 2、雙頜拔牙方案矯治效果更為突出，上下切牙及上下唇的內收量更為顯著，更容易獲得協調、美觀的外貌。單頜拔牙更適合頦唇溝較淺，下唇外翻較為輕微的患者。臨床應用中應根據主訴及具體情況選擇好適應癥。 3、作為軟組織側貌的測量參考平面，Pn平面（又稱為Dreyfus線）比E平面更為客觀。
[Abstract]:Objective: to compare the changes of soft and hard tissues before and after orthodontic treatment of maxillary single-jaw extraction and bimaxillary extraction, and to explore the suitable treatment scheme for adult II class 1 malocclusion. Methods: 36 cases of adult II class 1 malocclusion were treated with maxillary extraction of two first premolars and 18 cases with maxillary extraction of two first premolars and two mandibular second premolars. The results of X-ray projection measurement were compared and studied. Results: before treatment, the FMA, Y axis angle of single jaw extraction group was smaller than that of double jaw extraction group, and the mental labial groove angle was larger than that of double maxillary extraction group. In group A, the angle of L1-MP2, OP-SN, angle U1-LIZ, genial-labial sulcus angle, UL-E, LL-E, U1-APand UL-Pn,LL-Pn, U1-FH significantly increased, and the angle of U1-L1OP-SNZ and genial-labial sulcus decreased significantly in group B, and the angle of UL-EL-EL-EL-EL, UL-Pn,LL-Pn,U1-AP,U1-NA,U1-NB, angle U1-FH, margin L1-MPH, H-angle decreased significantly after treatment. There was no significant difference between the two groups in the differences of L1-MP1, U1-FHand U1-L1U1-APU1-APL-LL-PnP and LL-Pnn. there was no significant difference between the two groups in the changes of LL-E and UL-Pn. there was no significant difference between the two groups in the difference between the two groups before and after treatment. Conclusion: 1, the two methods of tooth extraction can achieve the purpose of the treatment of adducing anterior teeth and improving soft tissue profile. 2, the effect of bimaxillary extraction is more prominent, and the adductive amount of upper and lower incisors and upper and lower lips is more significant. Easier to get coordinated, beautiful appearance. Single jaw extraction is more suitable for patients with shallow genial-labial sulcus and slight lower labial valgus. In clinical application, the indications should be selected according to the main complaint and the specific situation. 3. The measurement of soft tissue profile is more objective than the E plane, which is the reference plane for the measurement of soft tissue profile and the PN plane (also known as the Dreyfus line).
【學位授予單位】：暨南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R783.5

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