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目的:评价骨钉在矫治恒牙晚期骨性Ⅲ类错中的应用效果。方法:选择11例骨性Ⅲ类错病例,男7例,女4例,年龄15～29岁,平均19.5岁。第一磨牙为近中或超近中关系,侧貌为Ⅲ类凹面型,下颌不能后退,ANB≤-1.5°。错异常表现多样,三维不调较为明显。全部病例均采用固定矫治技术治疗,均设计减数下颌双侧第三磨牙,双侧下颌颊棚区植入骨钉,用以内收下牙弓,4例上颌颧牙槽嵴植入骨钉,用于排齐上颌牙列。结果:矫治后全部病例的软组织侧貌均有明显改善,Ⅲ类凹面型特征有所减轻,前牙反解除,建立正常覆覆盖关系及磨牙、尖牙中性关系,部分病例矫治前存在的后牙宽度不调,高度不调,平面偏斜及牙弓矢状向不对称等异常均得到有效矫治。矫治期最短17个月,最长35个月,平均24个月。结论:应用骨钉可以实现下颌牙弓分段或全牙弓整体远中移动,不需通过以直立磨牙方式获得下颌牙弓远中移动的间隙,也避免了Ⅲ类牵引可能引发的副作用,同时还适用于Ⅲ类错伴发的三维不调病例的矫治。
Objective: To evaluate the effect of bone nail in the treatment of advanced skeletal Class Ⅲ malocclusion. Methods: Eleven cases of skeletal Class Ⅲ malocclusion were selected. There were 7 males and 4 females, aged 15-29 years (average 19.5 years). The first molar in the near or in the near-medium relationship, the profile of the concave type Ⅲ, mandibular can not retreat, ANB ≤ -1.5 °. Wrong abnormal performance varied, three-dimensional is not obvious. All cases were treated with fixed orthodontic treatment. Both mandibular third molar and mandibular buccal bone were implanted into the mandibular bone to receive the dental arch. Four cases of maxillary zygomatic alveolar ridge were implanted into the bone nail, Used to align the maxillary dentition. Results: The soft tissue appearances of all cases were significantly improved after treatment. The concave features of type Ⅲ were relieved. The anterior crossbite was relieved. The normal moss covered relationship and the molars and canines were established. Before the treatment, some cases existed Of the non-adjustable width of the posterior teeth, height is not adjusted, plane deflection and sagittal arch asymmetry and other anomalies have been effectively corrected. The shortest correction period of 17 months, up to 35 months, an average of 24 months. CONCLUSION: The application of bone nail can realize the whole arch movement of mandibular dental arch or whole dental arch. It is not necessary to obtain the space for distal movement of mandibular arch by the orthodontic molar method. It also avoids the possible side effects caused by type Ⅲ traction and is also applicable Three kinds of wrong associated with the three-dimensional non-adjusted cases of correction.