【摘要】：雙牙-雙牙槽前突患者常需要拔除前磨牙，利用拔牙間隙內(nèi)收前牙，改善過突的雙唇，協(xié)調(diào)鼻-唇-頦軟組織側貌。拔牙矯治內(nèi)收前牙引起的軟硬組織變化是近年來的一個研究熱點，闡明軟硬組織的變化規(guī)律及二者的關聯(lián)對于指導醫(yī)生制定更為合理的治療方案以及獲得理想的預期治療效果意義重大。 目的：通過測量采用拔牙矯治的39例雙牙 牙槽前突女性患者矯治前后的側位片，分析得出水平及垂直方向上治療前后軟硬組織發(fā)生的變化及二者之間的相關性，并且推算出利用硬組織預測軟組織變化的公式。在二維方向上為預測雙牙 牙槽前突患者拔牙矯治的軟組織變化提供可靠依據(jù)，同時為選擇拔除牙位、支抗類型提供理論依據(jù)。 方法：選取在吉林大學口腔醫(yī)院正畸科門診就診，拔除四顆前磨牙矯治的雙牙-牙槽前突的女性患者39例。入選對象無頜骨畸形，磨牙關系基本中性，輕度或中度擁擠，拔除四個前磨牙，治療起始時，年齡≥15歲，無全身系統(tǒng)性疾病、顱面部畸形及先天缺牙，無正頜手術或面部整容史，治療前后側位片清晰。矯治前平均年齡為21.50±4.01歲，總療程平均為18.56±4.23個月。將SN以S點為圓心順時針旋轉7o作為X軸，過S點做X軸的垂線為Y軸，建立參考坐標系。在矯治前及矯治后拍攝的X線側位片上選取6個硬組織標記點，7個軟組織標記點，分別測量治療前后的16個線距測量值及兩個角度測量值，共計18個測量值。運用SPSS19.0對治療前后的18個測量值進行配對T檢驗，對相應的軟硬組織進行相關性分析，并建立線性回歸方程。 結果： 1：治療后，水平向及垂直向上軟硬組織線距發(fā)生顯著變化，上下切牙及上下唇突度明顯變小，鼻唇角明顯減小，頦唇角變化無統(tǒng)計學意義，側貌更加協(xié)調(diào)。治療后，上、下唇長度及厚度變化無統(tǒng)計學意義。 2.水平及垂直方向上，軟硬組織變化均存在較強的相關性，其中水平方向上相關性更強。 3.水平方向上，切牙頸點與上下唇相關性更強，上下中切牙點與上下唇相關性相對較弱。 4.上齒槽緣點水平向上內(nèi)收1mm，上唇凸點內(nèi)收0.643mm；下切牙切點及下齒槽緣點水平向上內(nèi)收1mm，下唇凸點內(nèi)收0.889mm；上切牙切點壓低1mm，，上唇凸點上移0.503mm；下齒槽緣點壓低1mm，下唇凸點下移0.376mm。
[Abstract]:Patients with double teeth and double alveolar protrusions often need to remove the premolars and use the extraction space to collect the anterior teeth to improve the protruding lips and coordinate the soft tissue profile of the nasal-labial and mental. The changes of soft and hard tissues caused by extraction of the adductive anterior teeth are a hot research topic in recent years. It is of great significance to clarify the changes of soft and hard tissue and their correlation to guide doctors to make more reasonable treatment plan and to obtain the desired therapeutic effect. Objective: to measure the lateral radiographs of 39 female patients with anterior alveolar protrusion treated by extraction of teeth, and to find out the changes of soft and hard tissues before and after treatment in horizontal and vertical directions and the correlation between them. The formula for predicting the change of soft tissue by hard tissue was deduced. It provides a reliable basis for predicting the change of soft tissue in the patients with anterior alveolar protrusion in two dimensional direction, and also provides theoretical basis for the selection of extraction position and the type of Anchorage. Methods: 39 female patients with double teeth and alveolar protrusions were selected from orthodontic department of Jilin University Stomatology Hospital. The subjects had no maxillary deformity, neutral molar relationship, mild or moderate crowding, extraction of four premolars, age 鈮

本文編號：2416651