不同位置正畸非拔牙治疗错颌畸形的效果对比

董文杰??王禹锟??李艳艳??张诗扬

[摘要] 目的 探讨不同位置正畸非拔牙治疗错颌畸形的效果对比。 方法 选取86例于2014年5月～2015年5月期间我院接收的错颌畸形患者，隨机分为舌侧组（n=43）与唇侧组（n=43），分别行舌侧正畸和传统唇侧正畸非拔牙治疗，于粘结托槽当天、7d、28d、56d评价患者进食困难、软组织不适感、外观影响、语音障碍4个主观指标，并于治疗前后进行头影测量。 结果 舌侧组操作时间、最终完成时间均显著高于唇侧组（P<0.05）；舌侧组相比于唇侧组，在对患者美观影响方面有明显优势（P<0.05）；在进食困难、语言障碍上，舌侧组与唇侧组间的差异持续到治疗28d（P<0.05），在软组织不适上，两组比较差异无统计学意义（P>0.05）；两组患者治疗前后下颌平面角、上前牙-前颅底平面角、下切牙-下颌面角、上-下中切牙角比较无统计学意义（P>0.05），治疗后，两组上述指标均显著优于治疗前（P<0.05）。 结论 进食困难和发音障碍是舌侧正畸最大的不足，在2个月以后可逐渐适应，然而其在美观方面具有显著的优势，在成人正畸中具有价高的应用价值。

[关键词] 错颌畸形；非拔牙；不同位置；效果

[中图分类号] R783.5 [文献标识码] A [文章编号] 2095-0616（2017）12-214-04

Comparison of orthodontic treatment of malocclusion with orthodontic extraction at different positions

DONG Wenjie1 WANG Yukun1 LI Yanyan2 ZHANG Shiyang1

1.Department of Dental，the Second Affiliated Hospital of Mudanjiang Medical University，Mudanjiang 157000，China； 2.Department of Ophthalmology，the Second Affiliated Hospital of Mudanjiang Medical University，Mudanjiang 157000，China

[Abstract] Objective To explore the comparison of orthodontic treatment of malocclusion with orthodontic extraction at different positions. Mehtods 86 cases of malocclusion cured in our hospital from May 2014 to May 2015 were selected and randomly divided into lingual group （n=43） and labial group （n=43），performed with orthodontic treatment of lingual orthodontics and traditional labial orthodontics，respectively.On the day of bonding brackets，7d，28d，56d，the 4 subjective indexes：eating difficulty，soft tissue discomfort，appearance influence and speech disorder were evaluated.And cephalometric studies were performed before and after treatment. Results The operation time and final completion time of the lingual group were significantly higher than those of the lip group （P<0.05）.Compared with the labial group，the lingual group had obvious advantages in the aesthetic effect of patients （P<0.05）.On eating difficulties and language disorders，the differences between the lingual and labial groups persisted in the treatment of 28d （P<0.05）.There was no significant difference between the two groups in the soft tissue disorder （P>0.05）.There were no significant differences between the two groups before and after treatment in the mandibular plane angle，the anterior teeth，the anterior skull base plane angle，the lower incisor mandibular angle，and the upper lower middle incisor angle （P>0.05）.After treatment， the above indexes in the two groups were significantly better than those before treatment （P<0.05）. Conclusion Eating difficulty and dysphonia are the biggest deficiencies of lingual orthodontics.After 2 months，it will gradually adapt.But it has a distinct advantage in beauty.The utility model has high application value in adult orthodontics.

[Key words] Malocclusion；Non extraction；Different positions；Effect

牙列错颌畸形一般發生在儿童生长发育阶段，发生因素包括先天性遗传因素、口腔疾病、口腔习惯不良或替牙障碍等。牙列错颌畸形对人的面部美观有严重影响，患者可表现为牙齿不齐，严重者可因颌骨的位置异常而引发面部畸形。传统唇侧

正畸治疗是临床最常用的方法，经过多年的临床验证具有较高的疗效，但其对美观的影响是阻碍其在临床上迅速推广的重要原因[1]。近年来，舌侧正畸计术随着理论和技术革新的逐渐完善，已成为对美观要求较高患者的首选。本研究通过资料回顾性分析，探讨唇侧正畸和舌侧正畸非拔牙治疗错颌畸形的效果，现报道如下。

1 资料与方法

1.1 一般资料

选取86例于2014年5月～2015年5月期间我……