单颌与双颌拔牙矫治成人安氏Ⅱ类1分类的疗效对比研究

发布时间：2018-09-04 10:57

【摘要】：目的：通过比较上颌单颌拔牙与双颌拔牙矫治前后软硬组织的变化，探讨掩饰性治疗成人安氏II类1分类错牙合的适合矫治方案。方法：成人安氏II类1分类错牙合患者36例，18例实行上颌拔除两个第一前磨牙方案；18例实行上颌拔除两个第一前磨牙、同时拔除下颌两颗第二前磨牙，将矫治前、后的X线投影测量结果进行对比研究。结果：治疗前，单颌拔牙者FMA, Y轴角较双颌拔牙者小，颏唇沟角较双颌拔牙组大。治疗后A组中∠L1-MP，∠OP-SN，∠U1-LI，Z角，颏唇沟角，明显增大；H角，UL-E, LL-E, U1-AP, UL-Pn，，LL-Pn，∠U1-FH明显减小；B组中∠U1-L1,OP-SN，Z角，颏唇沟角，明显增大；UL-E，LL-E, UL-Pn，LL-Pn，U1-AP,U1-NA，U1-NB，∠U1-FH,∠L1-MP, H角，明显减小。两组治疗前后差值对比中，∠L1-MP，∠U1-FH，∠U1-L1，U1-AP，LL-E，UL-Pn，LL-Pn，的变化差别有统计学意义，UL-E两组间变化无统计学差异。结论： 1、两种拔牙矫治方法均能达到内收上前牙，改善软组织侧貌的治疗目的。 2、双颌拔牙方案矫治效果更为突出，上下切牙及上下唇的内收量更为显著，更容易获得协调、美观的外貌。单颌拔牙更适合颏唇沟较浅，下唇外翻较为轻微的患者。临床应用中应根据主诉及具体情况选择好适应症。 3、作为软组织侧貌的测量参考平面，Pn平面（又称为Dreyfus线）比E平面更为客观。
[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).
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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