摘要
目的:评价和分析Damon自锁托槽矫治器非拔牙治疗牙列拥挤的临床效果和适应证。方法:选取上、下颌均用Damon技术做非拔牙矫治的骨性Ⅰ类中度以上牙列拥挤患者19例,包括治疗前(T1)需要拔牙但患者拒绝拔牙的病例7例。排齐上、下前牙后(T2),根据软组织侧貌的变化分为治疗成功组和治疗失败组,成功组T2时Z角≥70°或≥T1时Z角,反之为失败组。测量2组患者T1和T2的模型和X线侧位定位片,采用SPSS15.0软件包对数据进行t检验。结果:19例患者中,治疗成功11例,治疗失败8例(包括全部7例需要拔牙的病例)。牙弓周长和牙弓宽度在T1和T2时均无显著差异。2组患者在T2时上、下前牙和上唇位置均有明显前移,变化量无显著差异,但T1时成功组患者上、下前牙唇倾角和上唇至E线距离显著小于失败组(P<0.05)。下唇位置的前移量失败组为3.4mm,显著大于成功组的1.6mm(P<0.05)。失败组Z角减少10.7°.而成功组基本不变。软组织Holdaway分析显示,上唇紧张程度2组无显著差异,而颏部紧张程度成功组显著小于失败组(P<0.05)。结论:Damon矫治技术不能使需要拔牙的病例免除拔牙。平直的软组织侧貌和直立的上、下前牙,是非拔牙治疗的先决条件,而协调的颏唇关系是非拔牙治疗成功的关键。
PURPOSE： To analyze the indications for successful non-extraction correction of dental crowding with Damon appliance. METHODS： 19 patients with non-extraction orthodontic treatment were reviewed. They had Class I skeletal pattern and both arches were treated with Damon 3 or Damon MX appliances. According to the initial diagnosis before treatment （T1）, 7 cases needed extraction, but they rejected it. After correction of crowding （T2）, they were allotted into either successful group or unsuccessful group. The successful group contained those subjects in whom the Z angle at T2 was no less than 70° or that of T1. Others were allotted into the unsuccessful group. The dental casts and cephalometrie radiophotographs were analyzed at T1 and T2. The difference between the two groups was analyzed with SPSS15.0 software package for Student＇s t test. RESULTS： There were 11 cases in successful group. All the 7 cases rejecting extraction were finally allotted into the unsuccessful group. No significant difference in upper arch perimeter and arch width was detected between the two groups at both T1 and T2. The upper and lower incisors and upper lip showed a more retruded position in successful group at T1, although they showed a similar amount of protrusion from T1 to T2 in both groups. The forward movement of lower lip was 3.4mm in the unsuccessful group, which was significantly larger than that of 1.6mm in successful group （P〈0.05）. Z angle decreased 10.7° in the unsuccessful group, while no significant change was detected in the successful group. The Holdaway upper lip strain was comparable in two groups, but the successful group showed significantly less soft chin strain than unsuccessfid group （P〈0.05）. CONCLUSIONS： Damon appliance can not rescue extraction cases. Straight soft tissue profile and uptight incisor position are prerequisite for non- extraction treatment. And a harmonious chin and lip position is the key leading to the successful non-extraction treatment with Damon appliance.
出处
《上海口腔医学》
CAS
CSCD
2008年第4期364-371,共8页
Shanghai Journal of Stomatology
