任嘉杰 冯小东 宋铁砾

[摘要]目的：探究安氏Ⅱ1不同拔牙模式矯治前后牙弓、上气道形态及软组织侧貌变化的临床疗效。方法：选择2016年6月-2020年6月来笔者医院就诊的98例安氏Ⅱ1错牙合畸形需拔牙矫治的患者，按照随机数表法分成观察组和对照组，每组49例。观察组拔除上颌2颗第一前磨牙和下颌2颗第二前磨牙，对照组拔除上颌2颗第一前磨牙，之后采用矫正器进行矫正。比较治疗前后两组患者牙弓、上气道形态及软组织侧貌变化。结果：治疗后，两组上、下颌尖牙间宽度及上、下颌第一磨牙间宽度均减小，但观察组均小于对照组（P<0.05）;治疗后，两组SPP-SPPW、U-MPW、P-T、V-LPW均高于治疗前，且观察组均高于对照组（P<0.05）;治疗后，两组SPP-SPPW、U-MPW、P-T、V-LPW的横径较治疗前升高（P<0.05），但两组比较无显著性差异（P>0.05）;治疗后，两组鼻唇角增大，颏唇角增大，上下唇突度减小，但两组间无明显差异（P>0.05）。结论：拔除上颌2颗第一前磨牙和下颌2颗第二前磨牙对安氏Ⅱ1错牙合患者牙弓及上气道形态影响大于拔除上颌2颗第一前磨牙，两种拔牙方式均能改善面部软组组侧貌，但差异无明显区别。

[关键词]安氏Ⅱ1错牙合;拔牙方式;牙弓;上气道形态;软组织侧貌变化

[中图分类号]R783.5    [文献标志码]A    [文章编号]1008-6455（2021）05-0070-05

Clinical Observation on Changes of Dental Arch， Upper Airway Morphology and Soft Tissue Profile Before and After AngleⅡ1 Correction with Different Extraction Modes

REN Jia-jie，FENG Xiao-dong，SONG Tie-li

（Department of Stomatology，Beijing Tongren Hospital，Capital Medical University，Beijing 100730，China）

Abstract：Objective To explore the changes of dental arch， upper airway morphology and soft tissue profile before and after Angle Ⅱ1 correction with different extraction modes. Methods A total of 98 patients with Angle Ⅱ1 malocclusion who were treated for extraction and correction in the hospital from June 2016 to June 2020 were enrolled. They were divided into observation group and control group by random number table method， 49 cases in each group. In the observation group， 2 first premolars in the upper jaw and 2 second premolars in the lower jaw were extracted. In control group， 2 first premolars in the upper jaw were extracted， and then they were corrected with appliances. The changes of dental arch， upper airway morphology and soft tissue profile before and after treatment were compared between the two groups. Results After treatment， the width of adjacent canine teeth at upper and lower jaws and the width of adjacent first molars at upper and lower jaws were decreased in both groups， which were narrower in observation group than control group （P<0.05）. After treatment， SPP-SPPW， U-MPW， P-T and V-LPW were increased in both groups， which were higher in observation group than control group （P<0.05）. After treatment， transverse diameters of SPP-SPPW， U-MPW， P-T and V-LPW were increased in both groups （P<0.05）， without significant differences between the two groups （P>0.05）. After treatment， nasolabial angle was increased， mentolabial angle was increased and the protrusion of the upper and lower lips was decreased in both groups， there was no significant difference between the two groups （P>0.05）. Conclusion The effects of extracting 2 first premolars of the upper jaw and 2 second premolars of lower jaw are greater than those of extracting 2 first premolars of the upper jaw on dental arch and upper airway morphology in patients with Angle Ⅱ1 malocclusion. Both methods can improve facial soft group profile. However， the differences are not significant.

Key words：Angle Ⅱ1 malocclusion; extraction mode; dental arch; upper airway morphology; change of soft tissue profile

安氏Ⅱ1错牙合是常见口腔畸形，患者表现为下颌后缩、上颌前突，影响患者的侧貌及上气道形态，同时对患者口腔功能及心理健康有一定影响[1]。随着大众对美观的要求，通常会进行矫正，对于牙列较为拥挤或过于前突患者采取拔牙治疗，从而解除牙列拥挤，使牙颌面正常发育，改善软组织面型，增进面部美观[2-3]。牙弓的形态关系着矫治后患者的面部美观，有学者[4]认为拔牙矫治后牙弓形态的改变对矫治效果的稳定性有一定影响。有研……