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目的评价骨性Ⅲ类畸形双颌手术患者术前正畸上颌拔牙与不拔牙去代偿的效果及对术后的影响。方法选取36例在中国医科大学口腔医院进行正畸正颌外科联合治疗的骨性Ⅲ类错畸形患者,其中18例术前正畸采取拔牙矫治,另18例未拔牙。对2组病例术前正畸后及治疗结束后的X线头颅定位侧位片进行对比研究。结果术前正畸后,拔牙组的U1-SN、鼻唇角(Cm-Sn-UL)和覆盖都较非拔牙组有明显变化,差异有统计学意义(P<0.05)。拔牙组下颌平均后退(8.66±1.42)mm,非拔牙组下颌平均后退(6.21±3.06)mm,二者间差异有统计学意义(P<0.05);治疗结束后,拔牙组ANB、U1-SN、NA-PA在正常值范围内(P>0.05)。结论在骨性Ⅲ类畸形的正畸正颌外科联合治疗中,上颌拔牙术前正畸能够更彻底地去代偿,真实反映原有骨性畸形,使下颌能够后退至更加理想的位置,从而更好地矫治凹面型。
Objective To evaluate the effect of preoperative orthodontic maxillary extraction and non-extraction on the patients with skeletal Class Ⅲ malocclusion and its effect on postoperative complications. Methods Thirty-six patients with skeletal class Ⅲ malocclusion under orthodontic orthognathic surgery at the Stomatological Hospital of China Medical University were enrolled in this study. Among them, 18 cases underwent orthodontic treatment by extraction and 18 cases did not. The two groups of patients with preoperative orthodontic and after treatment of X-ray skull positioning lateral radiographs were compared. Results After preoperative orthodontic treatment, the U1-SN, Cm-Sn-UL and coverage of the toothbrush in the tooth extraction group were significantly different from those in the non-tooth extraction group (P <0.05). In mandibular extraction group, mandibular average retreat was (8.66 ± 1.42) mm, in mandibular extraction group, mandibular average retreat was (6.21 ± 3.06) mm, there was significant difference between the two groups (P <0.05) , NA-PA in the normal range (P> 0.05). Conclusions In orthodontics combined with orthognathic orthognathic surgery for skeletal class Ⅲ malocclusion, orthodontics can be more thoroughly compensated for with maxillary extraction, which reflects the original skeletal deformity so that the mandible can retreat to a more ideal position. Better correction concave type.