微种植体支抗结合片段弓远中移动牙列的临床研究
发布时间：2019-03-17 19:21
【摘要】：目的:利用微种植体支抗结合片段弓技术远中移动上下牙列,与拔除第二前磨牙矫治牙列轻中度拥挤作比较,探究解决患者牙列轻中度拥挤的方法。并分析在磨牙远移过程中,磨牙的远移量和远移方式。方法:采用回顾性研究,选取于青岛大学附属医院口腔正畸科就诊的患者20例,牙列轻中度拥挤。其中10例为微种植支抗结合片段弓远中移动上下牙列矫治,治疗开始前拔除第三磨牙。另外10例为拔除四颗第二前磨牙矫治。分别测量治疗前后x线头颅定位侧位片,对两组治疗前后的软硬组织测量结果及矫治时间进行比较分析,组内结果进行配对t检验,比较两组治疗前后软硬组织及牙齿的变化情况,组间使用独立样本t检验进行分析,应用SPSS19.0软件对各组数据进行统计学分析,以评定疗效。结果:两组患者上下牙列的拥挤均得以解除,且切牙均得到一定程度内收。种植支抗组:骨性指标SNA角、SNB角、ANB角、面角、Y轴角、FMA角在治疗前后无显著性变化;牙性指标U1/NA角、U1/NA距、U1/SN角、L1/NB角、L1/NB距、L1/MP角、U1/L1角在治疗前后均有显著性变化,差异有统计学意义(P0.05);上下颌第一磨牙牙冠平均向远中移动3.2mm和3.1mm,上下切牙牙冠分别内收2.3mm和2.0mm。软组织指标NLA角、UL-EP距、LL-EP距治疗后有显著变化,差异有统计学意义(P0.05)。在远移的过程中,磨牙基本上为整体移动,伴随着轻微的远中倾斜。拔牙组:骨性指标SNA角、SNB角、ANB角、面角、Y轴角、FMA角在治疗前后无显著性变化;牙性指标U1/NA角、U1/NA距、U1/SN角、L1/NB角、L1/NB距、L1/MP角、U1/L1角在治疗前后均有显著性变化,差异有统计学意义(P0.05);上下颌第一磨牙牙冠平均向近中移动3.1mm和3.0mm,上下切牙牙冠分别内收2.6mm和2.2mm;软组织指标NLA角、UL-EP距、LL-EP距治疗后有显著变化,差异有统计学意义(P0.05)。种植支抗组与拔牙组治疗前后的变化量:骨性指标SNA角、SNB角、ANB角、面角、Y轴角、FMA角,牙性指标U1/NA角、U1/NA距、U1/SN角、L1/NB角、L1/NB距、L1/MP角、U1/L1角,软组织指标NLA角、UL-EP距、LL-EP距,两组比较差异没有统计学意义(P0.05)。两组矫治时间的比较:种植支抗组平均治疗时间15.8±2.25个月,拔牙组平均治疗时间为19.6±3.40个月。两组比较差异具有统计学意义(P0.05)。结论:利用微种植支抗结合片段弓技术远移上下牙列是矫治轻中度拥挤的有效方法。其治疗效果与拔除第二前磨牙的治疗效果无明显差异。微种植支抗结合片段弓远移上下牙列矫治技术与传统拔牙矫治相比,极大地缩短了临床治疗时间。
[Abstract]:Aim: to investigate the treatment of mild to moderate dentition crowding by microimplant Anchorage and fragment arch technique, and compare it with extraction of the second premolars for the treatment of mild to moderate crowding of dentition in order to find out the way to solve the problem of mild to moderate overcrowding of dentition in patients with mild to moderate dentition. In the process of molar distal migration, the distance displacement and the way of distal movement were analyzed. Methods: a retrospective study was conducted in 20 patients with mild to moderate overcrowding in the Department of Orthodontics, affiliated Hospital of Qingdao University. Among them, 10 cases were treated with distal movement of upper and lower dentition with microimplant Anchorage and fragment arch, and the third molar was extracted before treatment. The other 10 cases were treated with extraction of four second premolars. X-ray cephalometric lateral radiographs were measured before and after treatment, and the soft and hard tissue measurement results and correction time of the two groups were compared and analyzed before and after treatment. The results in the group were paired with t-test. The changes of soft and hard tissues and teeth before and after treatment were compared between the two groups. Independent sample t-test was used to analyze the data between the two groups. SPSS19.0 software was used to analyze the data of each group statistically in order to evaluate the curative effect. Results: the overcrowding of upper and lower dentition was relieved in both groups, and the incisors were received to a certain extent. In implant Anchorage group, SNA angle, SNB angle, ANB angle, facial angle, Y-axis angle and FMA angle had no significant change before and after treatment. There were significant changes in U1/NA angle, U1/NA distance, U1/SN angle, L1/NB distance, L1/MP angle and U1/L1 angle before and after treatment (P0.05). The upper and lower first molar crowns moved to the distal 3.2mm and 3.1 mm on average, and the upper and lower incisor crowns received 2.3mm and 2.0 mm, respectively. Soft tissue parameters such as NLA angle, UL-EP distance and LL-EP distance had significant changes after treatment, the difference was statistically significant (P0.05). In the process of distal migration, the molar is basically a whole movement, accompanied by a slight distal tilt. In extraction group, SNA angle, SNB angle, ANB angle, facial angle, Y-axis angle and FMA angle had no significant change before and after treatment. There were significant changes in U1/NA angle, U1/NA distance, U1/SN angle, L1/NB distance, L1/MP angle and U1/L1 angle before and after treatment (P0.05). The upper and lower first molar crowns moved to 3.1mm and 3.0 mm on average, and the upper and lower incisors received 2.6mm and 2.2 mm respectively. Soft tissue parameters such as NLA angle, UL-EP distance and LL-EP distance had significant changes after treatment, the difference was statistically significant (P0.05). The changes of bone index SNA angle, SNB angle, ANB angle, facial angle, Y axis angle, FMA angle, dental index U1/NA angle, U1/NA distance, U1/SN angle, L1/NB distance, L1/MP angle before and after treatment in implant Anchorage group and tooth extraction group. There was no significant difference in U1/L1 angle, soft tissue index NLA angle, UL-EP distance and LL-EP distance between the two groups (P0.05). The average treatment time was 15.8 卤2.25 months in the implant Anchorage group and 19.6 卤3.40 months in the tooth extraction group, and the average treatment time in the two groups was 15.8 卤2.25 months in the implant Anchorage group and 19.6 卤3.40 months in the extraction group. The difference between the two groups was statistically significant (P0.05). Conclusion: microimplant Anchorage combined with segmental arch technique is an effective method for the treatment of mild to moderate congestion. There was no significant difference between the treatment effect and the second premolar extraction. Compared with the traditional dental extraction treatment, the clinical treatment time is greatly shortened by micro-implant Anchorage combined with segment arch distal movement of upper and lower dentition.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.5
本文编号：2442619
[Abstract]:Aim: to investigate the treatment of mild to moderate dentition crowding by microimplant Anchorage and fragment arch technique, and compare it with extraction of the second premolars for the treatment of mild to moderate crowding of dentition in order to find out the way to solve the problem of mild to moderate overcrowding of dentition in patients with mild to moderate dentition. In the process of molar distal migration, the distance displacement and the way of distal movement were analyzed. Methods: a retrospective study was conducted in 20 patients with mild to moderate overcrowding in the Department of Orthodontics, affiliated Hospital of Qingdao University. Among them, 10 cases were treated with distal movement of upper and lower dentition with microimplant Anchorage and fragment arch, and the third molar was extracted before treatment. The other 10 cases were treated with extraction of four second premolars. X-ray cephalometric lateral radiographs were measured before and after treatment, and the soft and hard tissue measurement results and correction time of the two groups were compared and analyzed before and after treatment. The results in the group were paired with t-test. The changes of soft and hard tissues and teeth before and after treatment were compared between the two groups. Independent sample t-test was used to analyze the data between the two groups. SPSS19.0 software was used to analyze the data of each group statistically in order to evaluate the curative effect. Results: the overcrowding of upper and lower dentition was relieved in both groups, and the incisors were received to a certain extent. In implant Anchorage group, SNA angle, SNB angle, ANB angle, facial angle, Y-axis angle and FMA angle had no significant change before and after treatment. There were significant changes in U1/NA angle, U1/NA distance, U1/SN angle, L1/NB distance, L1/MP angle and U1/L1 angle before and after treatment (P0.05). The upper and lower first molar crowns moved to the distal 3.2mm and 3.1 mm on average, and the upper and lower incisor crowns received 2.3mm and 2.0 mm, respectively. Soft tissue parameters such as NLA angle, UL-EP distance and LL-EP distance had significant changes after treatment, the difference was statistically significant (P0.05). In the process of distal migration, the molar is basically a whole movement, accompanied by a slight distal tilt. In extraction group, SNA angle, SNB angle, ANB angle, facial angle, Y-axis angle and FMA angle had no significant change before and after treatment. There were significant changes in U1/NA angle, U1/NA distance, U1/SN angle, L1/NB distance, L1/MP angle and U1/L1 angle before and after treatment (P0.05). The upper and lower first molar crowns moved to 3.1mm and 3.0 mm on average, and the upper and lower incisors received 2.6mm and 2.2 mm respectively. Soft tissue parameters such as NLA angle, UL-EP distance and LL-EP distance had significant changes after treatment, the difference was statistically significant (P0.05). The changes of bone index SNA angle, SNB angle, ANB angle, facial angle, Y axis angle, FMA angle, dental index U1/NA angle, U1/NA distance, U1/SN angle, L1/NB distance, L1/MP angle before and after treatment in implant Anchorage group and tooth extraction group. There was no significant difference in U1/L1 angle, soft tissue index NLA angle, UL-EP distance and LL-EP distance between the two groups (P0.05). The average treatment time was 15.8 卤2.25 months in the implant Anchorage group and 19.6 卤3.40 months in the tooth extraction group, and the average treatment time in the two groups was 15.8 卤2.25 months in the implant Anchorage group and 19.6 卤3.40 months in the extraction group. The difference between the two groups was statistically significant (P0.05). Conclusion: microimplant Anchorage combined with segmental arch technique is an effective method for the treatment of mild to moderate congestion. There was no significant difference between the treatment effect and the second premolar extraction. Compared with the traditional dental extraction treatment, the clinical treatment time is greatly shortened by micro-implant Anchorage combined with segment arch distal movement of upper and lower dentition.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.5
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