双颌前突正畸拔牙矫治与外科根尖下截骨术矫治的比较

目的 比较严重双颌前突分别采用正畸拔牙矫治和外科根尖下截骨手术矫治的效果,并探讨两种矫治方法的适应证.方法 选择严重双颌前突病例20例,其中15例经正畸拔牙矫治(正畸组),5例行根尖下截骨术矫治(手术组),收集患者治疗前后的头颅侧位X线片进行头影测量分析.结果 两组SNA、SNB角治疗前后变化均有统计学意义,其中正畸组SNA角减少(0.59±0.88)°,SNB角减少(0.45±1.19)°；手术组SNA角减少(3.63±1.22)°,SNB角减少(2.58±1.24)°.反映侧貌突度改善的切牙内收指标U1-Y、L1-Y和上下唇突点内收指标TUL-Y、TLL-Y治疗前后差值均未超过7 mm.治疗前后两组下颌平面角MP-SN的改变均没有统计学意义.结论 在改善双颌前突患者侧貌问题上,与正畸拔牙矫治相比,根尖下截骨术内收切牙的幅度并无太大优势.

Comparison and indication of tooth extraction and subapical osteotomy in bimaxillary protrusion patients

Objective The purpose of this study was to compare the effect of tooth extraction and subapical osteotomy in bimaxillary protrusion patients,and to investigate the indications of these two methods.Methods The samples consisted of 20 adult patients with intractable bimaxillary protrusion were divided into 2 groups,15 applied with tooth extraction orthodontic treatment,and 5 with subapical osteotomy.The hard and soft tissue variables were measured with lateral cephalographic tracings before and after the treatment.Results There was no difference in retraction of the incisors between two treatment groups,and both the retraction was less than the width of the first premolar.The amounts of change in the upper and lower lip projection were greater in subapical osteotomy group.Conclusion The results of this study show that subapical osteotomy provide no superiority in improving profile of bimaxillary protrusion patients.