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目的采用微种植体和传统Nance弓联合横腭杆作为支抗,治疗成人双颌前突,通过对比治疗前后硬、软组织变化,评价2种支抗的临床疗效。方法收集平均年龄为20.3岁的双颌前突患者32例,其中微种植体支抗的15例,Nance弓联合横腭杆支抗的17例,均采用MBT滑动直丝弓矫治器进行矫治,对治疗前、后头颅侧位片进行描绘和测量,运用统计学方法对比分析硬、软组织各指标的差异。结果微种植体较好地控制了磨牙支抗,上、下颌第1磨牙治疗前、后仅发生了较少的近移(小于1.5 mm),而Nance弓联合横腭杆组近移明显(约3.0 mm)。2组上颌磨牙近颊根尖前移量、上颌磨牙牙冠近中尖平均前移量及上颌切牙根尖内收量差异明显(P<0.01);上下颌切牙切端内收量有统计学差异(P<0.05)。软组织对比观察表明,2组的上、下切牙和唇部软组织均得到了明显内收,但微种植体支抗的内收量明显高于Nance弓联合横腭杆组(P<0.05)。结论微种植体较传统Nance弓联合横腭杆更能有效地控制磨牙支抗,内收切牙,显著改善患者的软组织侧貌,更好地满足患者对美观的需求。
OBJECTIVE: To evaluate the clinical efficacy of two kinds of anchors by comparing the changes of hard and soft tissues before and after treatment with micro-implants and traditional Nance arch combined with transverse palate as support to treat adult bimaxillary protrusion. Methods Thirty-two patients with bimaxillary protrusion who had an average age of 20.3 years old were collected. Among them, 15 cases were supported by micro-implant and 17 cases with Nance arch combined with transverse palatal pole support. All patients were treated with MBT sliding straight wire appliance, Before and after treatment, the skull lateral radiographs were drawn and measured, and statistical methods were used to analyze the differences of the indexes of hard and soft tissues. Results Micro-implants controlled the molar support better. There was less proximal movement (less than 1.5 mm) in the upper and lower mandibular first molars before and after treatment, while the Nance arch combined with the transverse palate group shifted significantly 3.0 mm). The maxillary molars near the buccal anterior shift, the maxillary molars near the cusp average shift and the maxillary incisors were significantly different (P <0.01); the maxillary and mandibular incisors were statistically significant Difference (P <0.05). The contrast of soft tissue showed that the upper and lower incisors and the soft tissues of the lips were significantly adducted in both groups, but the internal restenosis of micro-implants was significantly higher than that of Nance combined with transverse palate (P <0.05). Conclusion Compared with the traditional Nance arch combined with transverse palatal rod, the micro-implants are more effective in controlling the molar support and internal adduction, which can significantly improve the soft tissue profile of patients and better meet the aesthetic requirements of patients.