陈峥 林紫燕 王海燕

[摘要] 目的 观察安氏Ⅱ1错患者接受Twin-Block矫治器治疗前后下颌骨及颞下颌关节区域的三维变化，分析Twin-Block矫治器对下颌骨生长发育以及颞下颌关节的影响。 方法 选取2015年12月～2017年2月间生长发育高峰期安氏Ⅱ1错患者20例，拍摄Twin-Block矫治器矫治前后的CBCT，导入Dolphin软件进行下颌骨三维重建后定点测量，运用SPSS软件统计分析下颌骨以及颞下颌关节的变化。 结果 治疗后双侧下颌升支长、喙突长以及下颌骨综合长度、髁突内外径长、冠状向的髁突宽长度比较，差异有统计学意义（P<0.05），但是其余关于颞下颌关节以及下颌骨的测量项目比较，差异无统计学意义（P>0.05）。 结论 Twin-Block矫治器能刺激安氏Ⅱ1错患者的下颌体长度、升支高度以及下颌综合长度、髁突内外径、冠状位的髁突宽度增长。

[关键词] 安氏Ⅱ1错；下颌骨；颞下颌关节；CBCT

[中图分类号] R783.5 [文献标识码] B [文章编号] 1673-9701（2018）25-0082-04

[Abstract] Objective To observe the three-dimensional changes of mandibular and temporomandibular joint regions before and after treatment of Twin-Block appliance in patients with Angle Class Ⅱ division 1 malocclusion， and to analyze the effect of Twin-Block appliance on mandibular growth and temporomandibular joint. Methods 20 patients with Angle Class Ⅱ division 1 malocclusion during the peak period of growth and development from December 2015 to February 2017 were selected. The CBCT before and after the treatment of the Twin-Block appliance was taken and imported into the Dolphin software for three-dimensional reconstruction of the mandible. The SPSS software was used to statistically analyze changes in the mandible and the temporomandibular joint. Results After treatment， there were significant differences in the length of the mandibular ascending ramus， the length of the coracoid， the comprehensive length of mandible， the length of inner and outer diameter of the condyle， the length of the coronoid condyle width between bilateral mandibles（P<0.05）. While there were no significant differences in rest items related to the measurement of temporomandibular joint and the mandible（P>0.05）. Conclusion The Twin-Block appliance can stimulate the mandibular length， the ascending branch height， the mandibular comprehensive length， the condylar diameter and the coronoid condyle width of the patients with Angle Class Ⅱ division 1 malocclusion.

[Key words] Angle Class Ⅱ division 1 malocclusion； Mandible； Temporomandibular joint； CBCT

安氏Ⅱ1错是临床上一种常见的错畸形，在我国恒牙列初期发病率为19.41%，构成比占错畸形总数的26.62%[1]，其中下颌后缩或下颌发育不足的约占一半以上[2]。国内外很多学者[3-4]认为Twin-Block矫治器对处于生长发育高峰前期和高峰期的患者能产生较好的效果。作为功能矫治器，Twin-Block矫治器在引导下颌前伸、改善磨牙关系方面作用显著。但关于其矫治后下颌骨整体的变化，至今仍存在一定的争议。锥形束CT作为三维影像学检查手段较传统CT，具有高分辨、低辐射量、价格低廉等优点。同时结合Dolphin软件三维重建下颌骨進行定点测量，能对下颌骨以及颞下颌关节中髁突的变化有更直观、清晰的了解。本研究希望通过观察安氏……