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目的对比分析骨性Ⅱ类与骨性Ⅰ类错畸形拔牙矫治前后软组织美学指标的变化差异。方法选取骨性Ⅱ类Ⅰ分类错畸形患者27例及骨性Ⅰ类双颌前突患者26例,采用直丝弓矫治技术进行矫治,每位患者均拔除了4颗双尖牙。将矫治前后的X线头颅侧位定位片进行软组织美学指标的测量分析。结果骨性Ⅱ类组患者矫治前后上唇倾角(A’Ls-FH)、颏沟倾角(Pg’B’-FH)、Z角和面突角(G-Sn-Pg’)的变化差异有统计学意义(P<0.01)。骨性Ⅰ类组患者矫治前后上唇倾角、颏沟倾角和Z角的变化差异有统计学意义(P<0.01);矫治前后两组在Z角、面突角均存在差异。矫治前后两组无论组内或组间面角(NsPg’-FH)的变化均无统计学意义(P>0.05)。结论拔牙矫治对骨性Ⅱ类Ⅰ分类及骨性Ⅰ类双颌前突错畸形患者面型影响均较大,两组拔牙矫治前后的侧貌差异主要存在于颏部。面角非衡量骨性Ⅱ类Ⅰ分类及骨性Ⅰ类双颌前突是患者拔牙矫治前后侧面型变化的敏感指标。
Objective To compare the changes of soft tissue aesthetic indexes before and after orthodontic treatment of skeletal Class Ⅱ and Class Ⅰ malocclusion. Methods Twenty-seven patients with skeletal Class Ⅱclass Ⅰ malocclusion and 26 patients with skeletal Class Ⅰ bimaxillary protrusion were selected and treated by straight wire arch correction. Four patients were removed from each patient. Before and after correction of X-ray cephalometric positioning of soft tissue aesthetics indicators of measurement analysis. Results The differences of A’Ls-FH, Pg’B’-FH, Z-angle and G-Sn-Pg ’before and after treatment were statistically significant Significance (P <0.01). There were significant differences in the inclination of upper lip, gingival groove inclination and Z angle before and after treatment in patients with osteosarcoma Ⅰ (P <0.01). There was a significant difference in Z angle and facial protrusion angle between the two groups before and after treatment. There was no significant difference in NsPg’-FH between the two groups before and after treatment (P> 0.05). Conclusion The extraction of orthodontic treatment has a significant effect on the type Ⅱ and type Ⅰ biliary malformations in patients with type Ⅰ bimodal malformations. The difference in the appearance of the two groups before and after tooth extraction mainly exists in the chin. Non-measurement of skeletal Class Ⅱ Ⅰ classification and skeletal Class Ⅰ bimaxillary protrusion is a sensitive index of lateral changes before and after extraction.