张东强 杜星颜 王敏 李春梅 周炼

[摘要]目的：观察分析微型种植钉支抗治疗Ⅲ类错牙合畸形患者疗效及硬组织与软组织侧貌变化。方法：选取2016年5月-2017年5月东莞健力口腔医院正畸科收治的60例Ⅲ类错牙合畸形患者为研究对象，通过数字随机原则将所选择病例分为对照组与实验组，每组30例，其中对照组应用多曲方丝弓技术进行矫治，实验组则行微型种植钉支抗治疗，比较两组患者应用不同矫治方式干预后的临床效果，以及硬组织与软组织侧貌变化。结果：根据两组数据显示，实验组经治疗后软硬组织侧貌有明显变化，其硬组织SNA、ANB、NP-FH、NA-PA较之对照组水平增高，SNB、OP-FH水平则低于对照组，软组织H角、UL-Snpg、LL-Snpg水平增高，Z角、NLA、UL-Eline与LL-Eline水平降低，组间差异有统计学意义（P<0.05）。实验组第一磨牙、侧切牙、中切牙牙根体积相比对照组更高，其吸收率更低，实验组患者在治疗1、3个月后经检测发现，其咬合力与咀嚼效率均更高于对照组，且治疗后不良反应总发生率较对照组明显降低，差异有统计学意义（P<0.05）。结论：针对Ⅲ类错牙合畸形患者在治疗中应用微型种植钉支抗技术，对改善患者牙齿畸形与软硬组织侧貌有显著作用，且能降低牙根吸收率，减少不良反应发生率，值得在临床推广应用。

[关键词]微型种植钉支抗;Ⅲ类错牙合畸形;硬组织侧貌;软组织侧貌

[中图分类号]R783.5    [文献标志码]A    [文章編号]1008-6455（2021）01-0109-04

Clinical Study of Mini-Implant Anchorage in the Treatment of Class ⅢMalocclusion

ZHANG Dong-qiang， DU Xing-yan， WANG Min， LI Chun-mei，ZHOU Lian

（Department of Orthodontics， Jianli Stomatological Hospital， Dongguan 523500，Guangdong，China）

Abstract： Objective  To observe and analyze the changes of hard tissue and soft tissue profile in patients with Class Ⅲ malocclusion treated with micro（mini）-implant nail anchorage. Methods  60 patients with Class Ⅲ malocclusion admitted to our hospital（Dongguan Jianli Stomatological Hospital） from May 2016 to May 2017 were selected as the research objects. The selected cases were divided into control group and experience group according to the principle of digital randomization， 30 cases in each group. The control group was treated with Multiloop edgewise archwire（MEAW） technique， while the experience group was treated with micro-implant nail anchorage. The clinical effects and the changes of hard tissue and soft tissue profile after different orthodontic interventions were compared between the two groups. Results  According to the data of the two groups， there were significant changes in the profile of soft and hard tissues in the experimental group after treatment. The levels of SNA， ANB， NP-FH and NA-PA in the hard tissues were higher than those in the control group， while the levels of SNB and OP-FH were lower than those in the control group. The levels of H angle， UL-Snpg and LL-snpg in the soft tissues were higher， while the levels of Z angle， NLA， UL eline and ll eline were lower in the experimental group （P<0.05）. The root volume of the first molar， lateral incisor and central incisor in the experimental group was higher than that in the control group， and its absorption rate was lower. After 1 or 3 months of treatment， the bite force and chewing efficiency of the experimental group were higher than those in the control group， and the total incidence of adverse reactions after treatment was significantly lower than that in the control group （P<0.05）. Conclusion  In the treatment of Class Ⅲ malocclusion patients， the application of micro-implant  anchorage technology has a significant effect on improving the dental deformity and soft and hard tissue profile of patients， and can reduce root resorption rate， reduce the incidence of adverse reactions. It is worth popularizing in clinical application.

Key words： micro-implant  anchorage; Class Ⅲ  malocclusion; hard tissue profile; soft tissue profile

安氏Ⅲ类错牙合畸形是临床中比较常见的错牙合畸形病症，多表现为前牙反牙合、上颌发育不足及下颌过度发育等症状[1]，若不能及时对其展开有效治疗，则会影响患者颌骨发育，导致反覆盖、反覆牙合越严重，对于患者的颜面部美观与口腔功能均造成一定负面影响。因此，多数学者认为对Ⅲ类错牙合畸形患者展开早期矫治十分必要，通过矫治可改善患者咬合功能，避免硬组织与软组织进一步发生改变，解除骨性不调[2]。以往临床中主要采用口外弓、唇挡、下颌J钩、颌间牵引及多曲方丝弓技术等，但随着医疗技术的不断发展与进步，微型种植钉支抗方式在传统支抗基础上得到改进，因其具备有操作简单、舒适度高、患者依赖度小等优势而得到广泛应用[3]。……