国际口腔医学杂志

国际口腔医学杂志 ›› 2012, Vol. 39 ›› Issue (1): 20-24.doi: 10.3969/j.issn.1673-5749.2012.01.006

• 论著 • 上一篇    下一篇

自攻型微螺钉支抗在上颌前突正畸矫治中的应用

罗小安1  郑晓丹2   

  1. 1.厦门市口腔医院正畸科   厦门  361003；2.厦门医学高等专科学校口腔医学系   厦门  361008
  • 收稿日期:2011-06-23 修回日期:2011-11-29 出版日期:2012-01-01 发布日期:2012-01-01
  • 通讯作者: 罗小安，Tel：18965816587
  • 作者简介:罗小安（1976—），男，福建人，硕士

Study on clinical application of self -drilled microscrew implant anchorage to patients with maxillary protrusion

Luo Xiaoan1, Zheng Xiaodan2.   

  1. 1. Dept. of Orthodontics, Xiamen Dentistry Hospital, Xiamen 361003, China; 2. Dept. of Stomatology, Xiamen Medical College, Xiamen 361008, China
  • Received:2011-06-23 Revised:2011-11-29 Online:2012-01-01 Published:2012-01-01

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摘要：

目的  探讨自攻型微螺钉作为正畸强支抗矫治上颌前突的治疗效果。方法   选择上颌前突患者50 例，上牙弓均拔除2 颗第一前磨牙，采用自攻型微螺钉加强支抗，微螺钉均植入到上颌双侧第一磨牙与第二前磨牙颊侧根尖部的牙槽间隔处，植入后以每侧加0.98 N 的力滑动内收上前牙，关闭间隙。于治疗前后行X 线头影测量分析。结果    1）治疗过程中所有微螺钉均稳固；2）所有病例矫治后拔牙间隙均关闭，牙弓突度得到明显改善，上颌切牙明显直立和内收，平均内收7.57 mm，上中切牙长轴与前颅底平面（SN）相交的下内角平均减少13.40°，上中切牙长轴与鼻根点至上牙槽座点（NA）平面之间的上交角平均减少12.82°，上、下中切牙长轴的后交角平均增大20.56°，前牙覆盖平均减少7.94 mm，上唇突点至审美平面的线距平均减少5.52 mm，治疗前后的差异均有统计学意义，上颌第一磨牙矢状向、垂直向的位移分别为0.01、0.09 mm，治疗前后差异无统计学意义；3）所有病例矫治后均获得理想的侧貌改变，前牙覆覆盖正常，后牙尖窝锁结关系良好。结论  自攻型微螺钉是一种稳固、舒适、高效的支抗，可即刻受力，能使支抗磨牙处于稳定状态，最大限度地内收上颌前牙，有效矫治上颌前突畸形。

关键词: 自攻型微螺钉支抗, 上颌前突, 正畸矫治

Abstract:

Objective To evaluate the treatment results of patients with maxillary protrusion by using self-drilled microscrew implant as strong anchorage． Methods The study comprised 50 patients with maxillary protrusion. All patients were treated with maxillary first premolar extraction by using self-drilled microscrew implant anchorage. Self-drilled microscrew implants were inserted into the bilateral buccal alveolar bone between maxillary second premolar and first molar. 0.98 N force each side was added to the microscrews and retracted anterior teeth until the extraction spaces were closed entirely. The cephalometric films before and after treatment were measured and compared. Results 1）All microscrew implants remained steady throughout the orthodontic treatment． 2）The extraction spaces were closed entirely and the dentition arch protrusions improved greatly． The edges of maxillary incisors were retracted by 7.57 mm at average． The angle between the axis of incisor and SN decreased 13.40° at average． The angle between the axis of incisor and NA decreased 12.82° at average． The back angle between the axis of upper incisor and lower incisor increased 20.56° at average． The anterior overjet decreased 7.94 mm at average． The linear distance between the conflict point of upper lip and aesthetic plane decreased 5.52 mm at average． The differences of upper incisors before and after treatment were statistically significant． Upper first molars moved mesially by 0.01 mm and vertically by 0.09 mm at average． There were no significant changes in anteroposterior and vertical directions for upper first molars． 3）All patients’facial profile were improved greatly. They all set up correct overbite and overjet and good molar relationship. Conclusion Self -drilled microscrew implants were stable，comfortable and efficient and could provide good anchorage control in the maxillary protrusion treatment with no loss of molar anchorage. The maxillary anterior teeth were retracted together effectively by using self-drilled microscrews as strong anchorage and the maxillary protrusions were corrected effectively.

Key words: self -drilled microscrew implant an - chorage, maxillary protrusion, orthodontics

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