国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (2): 281-290.doi: 10.7518/gjkq.2026214

• 综述 • 上一篇    下一篇

上颌面罩前方牵引结合交替式快速扩缩弓治疗骨性Ⅲ类错的研究进展

黄艳梅(),方欣怡,封小霞()   

  1. 浙江大学医学院附属口腔医院 浙江大学口腔医学院 浙江省口腔疾病临床医学研究中心 浙江省口腔生物医学重点实验室 杭州 310000
  • 收稿日期:2024-11-01 修回日期:2025-09-23 出版日期:2026-03-01 发布日期:2026-02-13
  • 通讯作者: 封小霞
  • 作者简介:黄艳梅，住院医师，硕士，Email：huangym@zjkq.com.cn
  • 基金资助:
    浙江省自然科学基金(ZCLQN25H1401)

Research progress on maxillary protraction facial mask combined with alternate rapid maxillary expansion and contraction for skeletal Class Ⅲ malocclusion

Yanmei Huang(),Xinyi Fang,Xiaoxia Feng()   

  1. Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310000, China
  • Received:2024-11-01 Revised:2025-09-23 Online:2026-03-01 Published:2026-02-13
  • Contact: Xiaoxia Feng
  • Supported by:
    Zhejiang Provincial Natural Science Foundation(ZCLQN25H1401)

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摘要：

上颌面罩前方牵引（PFM）是早期矫治上颌发育不足的常用方法，交替式上颌快速扩缩弓（Alt-RAMEC）能有效打开和激活上颌骨周围骨缝，在PFM中配合Alt-RAMEC能否增强牵引效果颇受临床医生的关注。本文将对上颌PFM结合Alt-RAMEC治疗骨性Ⅲ类错𬌗畸形的生物学和生物力学原理、临床应用、临床效果及潜在风险等方面作一综述，以便为该技术的临床应用提供参考。

关键词: 骨性Ⅲ类错𬌗畸形, 上颌前方牵引, 交替式上颌快速扩缩弓

Abstract:

Maxillary protraction facial mask (PFM) is a commonly employed technique for the early treatment of ma-xillary deficiency. Alternate rapid maxillary expansion and contraction (Alt-RAMEC) can effectively open and activate maxillary sutures. The potential synergistic effects of Alt-RAMEC on enhancing maxillary protraction have attracted considerable attention among clinicians. This study reviews the biological and biomechanical bases, device application, clinical effects, and potential risks of maxillary PFM combined with Alt-RAMEC for the treatment of skeletal Class Ⅲ malocclusion. This study offers valuable insights for the clinical implementation of this integrated technique.

Key words: skeletal Class Ⅲ malocclusion, maxillary protraction, alternate rapid maxillary expansions and constrictions

中图分类号: 

  • R783.5

图 １

装置示意图A：上颌双铰链扩弓器；B：口内上颌前牵弹簧张口状态；C：口内上颌前牵弹簧咬合状态；D：Hyrax扩弓器??面观；E：Hyrax扩弓器侧面观；F：PFM。"

表 1

Alt-RAMEC/PFM和RME/PFM的上颌前移骨性效应的对比"

研究受试者干预措施效果
例数年龄Alt-RAMEC/PFMRME/PFM其他组Alt-RAMEC/PFMRME/PFM其他组
Akbulut等[48]30生长发育高峰期6~7周，0.4 mm/d，前牵力3.9~4.9 N扩弓至匹配的牙弓宽度，0.4 mm/d，前牵力3.9~4.9 N-3.11°（SNA’）1.45°（SNA’）-
Emek Kaya-fo?lu等[54]797~14岁9周，1 mm/d，前牵力3.9~4.9 N1周，1 mm/d，前牵力3.9~4.9 N-2.3°（SNA’）、1.89 mm（A’）1.83°（SNA’）、1.4 mm（A’）-
Sami等[49]608~12岁7周，1 mm/d，前牵力3.9 N1周，0.5 mm/d，前牵力3.9 N-3.23°（SNA’）2.30°（SNA’）-
Liu等[40]397~12 岁扩缩弓持续整个治疗，0.5 mm/d，前牵力2.9~4.9 N扩弓至后牙覆盖正常，0.5 mm/d，前牵力2.9~4.9 N仅行前牵，前牵力2.9~4.9 N3.3°（SNA’）、3.87 mm（A’）2.42°（SNA’）、3.04 mm（A’）1.54°（SNA’）、2.04 mm（A’）
Buyukcavus等[50]55CS2~45周，0.4 mm/d，前牵力3.9~4.9 N1周，0.4 mm/d，前牵力3.9~4.9 N骨支抗，前牵力3.9~4.9 N3.67°（SNA’）、3.65 mm（A’）2.01°（SNA’）、2.67 mm（A’）3.38°（SNA’）、4.01 mm（A’）
Onem Ozbilen等[55]40生长发育高峰期7周，1 mm/d，前牵力不详1周，0.5 mm/d，前牵力不详-2.71°（SNA）、2.73 mm（A’）2.68°（SNA）、2.53 mm（A’）-
Fischer等[46]34CS1~CS26周，0.4 mm/d，前牵力3.9~4.9 N扩弓至匹配牙弓宽度，0.2~0.4 mm/d，前牵力3.9~4.9 N-2.0 mm（ANS’）2.0 mm（ANS’）-
Liu等[5]447~13 岁7周，1 mm/d，前牵力3.9~4.9 N1周，1 mm/d，前牵力3.9~4.9 N-3.04 mm（A’）2.11 mm（A’）-
Masucci等[25]317~9岁4周，0.4 mm/d，前牵力3.9~4.9 N4周，0.4 mm/d，前牵力3.9~4.9 N未行干预组2.7°（SNA）1.5°（SNA）-1.5°（SNA）
Isci等[47]3011~13岁4周，0.4 mm/d，前牵力6.9 N4周，0.4 mm/d，前牵力6.9 N-4.13 mm（A’）2.33 mm（A’）-
Liou等[10]269~12岁9周，1 mm/d，前牵力3.9~4.9 N1周，1 mm/d，前牵力3.9~4.9 N-5.8 mm（A’）2.6 mm（A’）-
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