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目的研究采用骨种植钉前牵引对骨性Ⅲ类错患者软、硬组织侧貌的改变。方法选取18例需行前牵引矫治的生长发育期骨性Ⅲ类错患者,采用双侧上颌颧牙槽嵴植入骨种植钉配合面框式前牵引,平均治疗时间为9个月,力值为(3.5±0.1)N。治疗前后头影测量采用Legan&Burstone软组织分析法以及相关硬组织测量,分析比较患者治疗前后软、硬组织变化情况。结果所有患者Ⅲ类错均得到改善,鼻底趋于丰满,颏部顺时针旋转,侧貌由凹面型变为直面型,下唇突度减小,软组织上下面高比、鼻唇角、上唇突度及颏唇沟深度无明显变化。上前牙无明显变化,下前牙舌倾,上颌骨向前生长,A点前移,SNA、ANB增大;SNB减小,下颌骨顺时针旋转。结论骨种植钉前牵引可促进上颌生长,使面中份丰满,且对上颌前牙轴倾度无影响,从而纠正骨性Ⅲ类错。
Objective To study the changes of the soft and hard tissue profiles of patients with skeletal class Ⅲ malocclusion using premedullary nailing. Methods 18 cases of patients with skeletal class Ⅲ malocclusion during growth and development were selected. The bilateral maxillary zygomatic alveolar ridge was implanted with bone implants and face-frame front traction. The average treatment time was 9 months. The value is (3.5 ± 0.1) N. Before and after treatment cephalometric measurements using Legan & Burstone soft tissue analysis and related hard tissue measurements, analysis of patients before and after treatment of soft and hard tissue changes. Results All patients with type Ⅲ malocclusion were improved. The nasal floor tended to be full, and the chin rotated clockwise. The appearance of the chin was changed from concave type to straight type, while the lower lip decreased in intensity. The ratio of upper and lower soft tissues, nasolabial angle, Upper lip protrusion and chin groove depth no significant change. There was no obvious change on the anterior teeth. The anterior teeth were tilted and the maxilla was moved forward. Point A was advanced and SNA and ANB were increased. The SNB was decreased and the mandible was rotated clockwise. Conclusion Bone implant pre-nail traction can promote the growth of the maxillary, so that the surface area fullness, and the maxillary anterior mandibular inclination has no effect, so as to correct the skeletal class Ⅲ malocclusion.