[1]浦益萍,谢千阳,夏韫晖,等.微种植体支抗加力方式对上颌前突患者关闭拔牙间隙后颌面部软、硬组织影响的研究[J].中国美容医学,2024,(10):62-67.
　PU Yiping,XIE Qianyang,XIA Yunhui,et al.Infl uence of Implant Anchorage Loading Methods on Craniomaxillary Soft Tissue and Hard Tissue after Closing the Extraction Space in Patients with Maxillary Protrusion[J].Medical Aesthetics and Beauty,2024,(10):62-67.
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微种植体支抗加力方式对上颌前突患者关闭拔牙间隙后颌面部软、硬组织影响的研究()

《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:
期数:
2024年10期
页码:
62-67
栏目:
出版日期:
2024-09-26

文章信息/Info

Title:
Infl uence of Implant Anchorage Loading Methods on Craniomaxillary Soft Tissue and Hard Tissue after Closing the Extraction Space in Patients with Maxillary Protrusion
文章编号:
1008-6455（2024）10-0062-06
作者:
浦益萍1 ; 谢千阳1 ; 夏韫晖2 ; 金文忠3
(上海交通大学医学院附属第九人民医院 1.口腔外科;2.口腔颅颌面科;3.信息中心 上海 200011)
Author(s):
PU Yiping1 ;  XIE Qianyang1 ;  XIA Yunhui2 ;  JIN Wenzhong3
( 1.Department of Oral Surgery, 2.Department of Oral and Maxillofacial Surgery, 3.Information Center, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China )
关键词:
上颌前突; 微种植体支抗治疗; 加力方式; 软硬组织; 拔牙间隙
Keywords:
maxillary protrusion;  implant anchorage therapy;  loading methods;  soft and hard tissues;  extraction space
分类号:
R783.5
文献标志码:
A
摘要:
目的：探讨微种植体支抗加力方式对上颌前突患者关闭拔牙间隙后颌面部软、硬组织的影响。方法：选取2020年4 月-2023年6月在上海交通大学医学院附属第九人民医院口腔外科、口腔颅颌面科收治的156例上颌前突患者作为研究对象。 所有患者均需拔除上颌双侧第一前磨牙并使用微种植体支抗内收上前牙，采用随机数字表法将患者分入A组（予以短牵引钩 和直接支抗法，n=52例）、B组（予以长牵引钩和直接支抗法，n=52例）和C组（予以短牵引钩和间接支抗法，n=52例）关闭 拔牙间隙。比较三组治疗前后颌面部软硬组织变化。结果：关闭间隙前，三组患者颅颌软组织、硬组织指标比较差异无统计 学意义（P＞0.05），但B组鼻根点与上、下齿槽座点三者连线的夹角（ANB）大于A组、C组（P＜0.05）。关闭间隙后，三组 患者蝶鞍点与鼻根点，上齿槽座点三者连线的夹角（SNA）、蝶鞍点与鼻根点，下齿槽座点三者连线的夹角（SNB）、下颌平 面角（SN-MP）、上中切牙内收量（U1-SN）、鼻唇角、牙冠舌向移动量（U1c-Sv）、覆盖、上颌第一磨牙近中颊尖点、近 中根尖点压低量（U6c-H、U6r-H）变化值比较差异无统计学意义（P＞0.05），ANB、颌平面角（SN-OP）、上颌第一磨牙内 收量（U6-SN）、牙根舌向移动量（U1r-Sv）、上中切牙切缘点、牙根尖点压低量（U1c-H、U1r-H）、上颌第一磨牙近中颊 尖点、近中根尖点与Sv距离（U6c-Sv、U6r-Sv）、上颌第一磨牙近中颊尖点、近中根尖点压低量（U6c-H、U6r-H）、覆牙合 变化值比较差异有统计学意义（P＜0.05）；且B组ANB、Ls-E线变化值大于C组（P＜0.05），A组SN-OP、U6-SN、U1c-Sv变化 值大于C组（P＜0.05）；B组U1r-Sv、U1c-H变化值大于A组、C组，且C组大于A组（P＜0.05）；B组U1r-H变化值大于A组、C 组，且A组大于C组（P＜0.05）；C组U6c-Sv变化值大于B组（P＜0.05）；A组U6c-H、U6r-H变化值大于B组（P＜0.05）； B组覆牙合变化值大于A组、C组（P＜0.05）。结论：三种不同的微种植体支抗加力方式用于上颌前突患者均具有较好的支抗 效果，可改善上颌硬组织的形态，并引起相应软组织的改变。其中，短牵引钩配合直接支抗法能明显压低磨牙、使冠远中倾 斜，且牙合平面顺时针旋转；长牵引钩配合直接支抗法可获得更好的前牙控根移动和压低效果，且对上前牙垂直向改变效果也 较好，有益于覆牙合控制，与短牵引钩配合间接支抗法均可获得较好的滑动内收力，稳定牙合平面。
Abstract:
Objective To explore the infl uence of implant anchorage loading methods on the craniomaxillary soft tissue and hard tissue in patients with maxillary protrusion after closing the extraction space. Methods 156 patients with maxillary protrusion who were admitted to department of Oral Surgery and Craniomaxillofacial of the author’s hospital were selected as the research subjects from April 2020 to June 2023. All patients needed to extract the maxillary bilateral fi rst premolars and use implant anchorage to adduct the upper anterior teeth, and they were classifi ed into group A (short traction hook and direct anchorage method, n=52), group B (long traction hook and direct anchorage method, n=52) and group C (short traction hook and indirect anchorage method, n=52) by adopting the random number table method. The changes of craniomaxillary soft and hard tissues were compared among the three groups before and after treatment. Results Before closing the space, there were no signifi cant diff erences in craniomaxillary soft tissue and hard tissue indicators among the three groups (P＞0.05), but the upper coronal seat point-nose root point-lower alveolar seat angle (ANB) in group B was larger than that in groups A and C (P＜0.05). The anterior skull base plane-upper sulcus seat angle (SNA), the anterior skull base plane-lower sulcus seat angle (SNB), sella nasion-to-mandibular plane angle (SN-MP), upper incisor inclination (U1-SN), nasolabial angle, crown lingual movement (U1cSv), overjet, intrusion of the maxillary fi rst molar on the mesial buccal cusp and mesial root apex (U6c-H, U6r-H) revealed no obvious diff erences among the three groups of patients after closing the space (P＞0.05), but there were statistical diff erences in ANB, angle between plane and anterior skull base plane (SN-OP), retraction amount of maxillary fi rst molar (U6-SN), lingual root movement amount (U1r-Sv), incisal edge point of upper central incisor, root apex intrusion amount (U1c-H, U1r-H), mesial buccal cusp of maxillary fi rst molar, distance between mesial apical point and Sv (U6c-Sv, U6r-Sv), maxillary fi rst molar mesial buccal apex and mesial apical tip (U6c-H, U6r-H) and overbite change (P＜0.05). The changes of ANB and Ls-E line in group B were greater than those in group C (P＜0.05), and the changes of SN-OP, U6-SN and U1c-Sv were greater in group A than those in group C (P＜0.05). The changes of U1r-Sv and U1c-H were greater in group B than those in group A and group C (P ＜0.05), and the two indicators in group C were greater than those in group A (P＜0.05). The change of U1r-H was greater in group B than that in group A and group C (P＜0.05), and was greater in group A than that in group C (P＜0.05). The change of U6c-Sv in group C was greater than that in group B (P＜0.05). The changes of U6c-H and U6r-H were greater in group A than those in group B (P＜0.05). The change of overbite in group B was greater than that in group A and group C (P＜0.05). Conclusion Three different implant anchorage loading methods have a good anchorage effect on patients with maxillary protrusion, and they can improve the morphology of maxillary hard tissue and cause corresponding soft tissue changes. Among them, short traction hook combined with direct anchorage method can signifi cantly lower the molars, tilt the crown distally, and rotate the occlusal plane clockwise, and long traction hook combined with direct anchorage method can obtain good root control movement and intrusion eff ect of the anterior teeth, and good vertical change eff ect of the upper anterior teeth, and it is benefi cial to the overbite control. Both long traction hook and short traction hook combined with indirect anchorage method can obtain good sliding adduction force and stabilize the occlusal plane.

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更新日期/Last Update: 2024-10-08