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目的对恒牙期骨性Ⅲ类错畸形使用传动直丝弓技术联合口内自制牵引装置进行治疗后的面部软硬组织形态进行研究。方法选择2008~2010年来我科就诊的36例恒牙期重度骨性Ⅲ类错畸形患者,使用传动直丝弓矫治技术、自制固定前方牵引装置、配合Ⅲ类颌间牵引的方法治疗骨性Ⅲ类错。在骨性错治疗前、中、后分别拍摄曲面断层片、头颅侧位片;治疗前、中、后摄取患者正面像、45°侧面像、90°侧面像和牙齿正面像、侧面像、上下颌像;对治疗前、中、后的头颅侧位片、照片分别进行测量分析,对治疗前、中、后软组织面型的变化情况进行研究。结果研究发现,骨性错矫治时间平均为10.3个月。骨性错矫治后上颌骨前移而下颌骨相对后退;同时发现前面高有所增加,说明在进行骨性错矫治的同时,下颌的生长方向改为向前向下生长;矫治后前牙覆盖正常、wits距明显减小。骨性错矫治后的软组织变化情况:14项软组织测量项目中,13项经统计学分析,矫治前、后P<0.05,有显著性差异;下唇突距和治疗前相比,P=0.063>0.05,无显著性差异。但是14项软组织测量项目中,矫治后上、下唇都在向着形成更好的软组织侧面型的方向发展。结论该方法矫治重度骨性Ⅲ类错疗程短、见效快,同时减少了手术治疗的痛苦。面型由明显的月牙形脸变为直面形;正侧面观,基本达到Ⅰ类骨面型,上、下唇在美容线上或者在美容线后1~2 mm,均在标准范围内。
Objective To study the morphology of facial soft and hard tissue after permanent dentition skeletal class Ⅲ malocclusion using drive wire arch technique combined with oral self-made traction device. Methods Thirty - six patients with severe skeletal Class Ⅲ malocclusion undergoing orthopedics in our department from 2008 to 2010 were selected. The patients were treated with drive straight wire arch technique, self - made fixed anterior traction device and type Ⅲ intermaxillary traction to treat skeletal Ⅲ class wrong . Before, during and after treatment of skeletal malformations, the surface tomography and cranial lateral radiographs were taken respectively. The frontal view, 45 ° lateral view, 90 ° lateral view and tooth frontal view of the patient before, during and after treatment were taken, The mandibular images were measured and analyzed before and after treatment. The changes of the soft tissue surface before, during and after the treatment were studied. Results The study found that the average time of correction of bony misdiagnosis was 10.3 months. Orthodontic treatment of skeletal malocclusion maxilla forward and the mandibular relative retreat; also found in front of a high increase, indicating that the correction of skeletal malposition at the same time, the growth of the mandibular growth to forward and downward growth; after correction before Tooth coverage is normal, wits significantly reduced. Bone malocclusion after correction of soft tissue changes: 14 soft tissue measurement items, 13 were statistically analyzed before and after treatment P <0.05, there was a significant difference; lower lip protrusion compared with before treatment, P = 0.063> 0.05, no significant difference. However, in the 14 soft tissue measurements, the upper and lower lip of the orthodontic treatment developed in the direction of forming a better soft tissue profile. Conclusion The method of treatment of severe skeletal Class Ⅲ malocclusion treatment period is short, quick, and reduce the pain of surgical treatment. From the obvious crescent-shaped face into a straight face; positive side view, basically reached type Ⅰ bone surface type, the upper and lower lip on the beauty line or in the beauty line after 1 ~ 2 mm, are in the standard range.