曾红梅 周学军 杨忠良

[摘要]目的：分析比较MBT与Z2直丝弓矫治器在安氏Ⅱ类1分类错牙合畸形患者矫治中的应用效果。方法：回顾性选取2013年1月-2019年12月笔者医院口腔科诊治的80例安氏Ⅱ类1分类错牙合畸形患者为研究对象，按照正畸方法不同分为MBT组（42例）与Z2组（38例），分别予以MBT直丝弓矫治器、Z2直丝弓矫治器进行正畸治疗，评估正畸效果，对比X线头影测量指标、咬合打开时间及排齐整平时间。结果：MBT组、Z2组正畸达标率均>90%，且兩组比较无统计学差异（P>0.05）;正畸前，MBT组、Z2组上齿槽座角（SNA）、下齿槽座角（SNB）、上下齿槽座角（ANB）、上中切牙长轴与前颅底平面夹角（U1-SN）、下中切牙长轴与下颌平面夹角（L1-MP）比较无统计学差异（P>0.05）;正畸结束后，ANB、U1-SN、L1-MP均显著缩小（P<0.05），组间比较无统计学差异（P>0.05）。与Z2组相比，MBT组咬合打开时间与排齐整平时间均明显短（P<0.05）。结论：安氏Ⅱ类1分类错牙合畸形患者正畸过程中应用MBT与Z2直丝弓矫治器均具有确切的矫治效果，有助于改善面部侧面观及整体满意度，但前者能更快速打开咬合，缩短矫治疗程。

[关键词]MBT直丝弓矫治器;Z2直丝弓矫治器;错牙合畸形;支抗;咬合;正畸

[中图分类号]R783.5  [文献标志码]A  [文章编号]1008-6455（2021）04-0143-03

Comparison of the Application Effect between MBT and Z2 Straight Wire Appliance in Orthodontics for Class Ⅱ Division 1 Malocclusion

ZENG Hong-mei1，ZHOU Xue-jun2 ，YANG Zhong-liang3

（1.Department of Stomatology，the Third Affiliated Hospital of Anhui Medical University / the First People's Hospital of Hefei， Hefei 230001， Anhui，China; 2.Department of Stomatology， the First Affiliated Hospital of Anhui Medical University， Hefei 230022，Anhui，China; 3.Department of Materials and Equipment，the Fourth Affiliated Hospital of Anhui Medical University，Hefei 230000，Anhui，China）

Abstract：Objective To comparatively analyze the application effect of MBT and Z2 straight wire appliance in orthodontics of patients with Class Ⅱ Division 1 malocclusion. Methods  80 patients with Class Ⅱ Division 1 malocclusion who had been treated in the Outpatient Department of Stomatology in the hospital between January 2013 and December 2019 were selected retrospectively. They were divided into 42 cases treated with MBT straight wire appliance （MBT group） and 38 cases treated with Z2 straight wire appliance （Z2 group） according to the orthodontic method. The orthodontic effects were evaluated. The X-ray cephalometry indexes， bite opening time， leveling and aligning time were compared. Results The control rates of orthodontics in both MBT group and Z2 group were higher than 90% （P>0.05）. Before orthodontics， there was no statistically significant difference in the sella-nasion-A （SNA）， sella-nasion-B （SNB）， A point-nasion-B （ANB）， upper incisor-sn plane （U1-SN） or lower incisor-mandibular plane （L1-MP） between the two groups （P>0.05）. After orthodontics， the ANB， U1-SN and L1-MP were significantly decreased （P<0.05）， but there was no statistically significant difference between groups （P>0.05）. The bite opening time and leveling and aligning time of MBT group were significantly shorter than those of Z2 group （P<0.05）. Conclusion  Both MBT and Z2 straight wire appliance used in orthodontics of patients with Class Ⅱ Division 1 malocclusion can achieve exact results，which is conductive to improving the facial appearance and overall satisfaction. However， the former can help bite open more quickly and shorten the course of orthodontics.

Key words：MBT straight wire appliance;Z2 straight wire appliance; malocclusion; anchorage; occlusion; orthodontic effect

错牙合畸形是口腔科常见疾病，其发病与肌平衡失调、下颌先天缺牙、口腔不良习惯、替牙障碍、牙合干扰、外伤、牙周病及遗传等因素有关[1]，常采用安氏分类法，以恒定稳固的上第一恒磨牙为基准，根据其与上下牙弓的关系可将错牙合畸形分为三类，临床以安氏Ⅱ类1分类错牙合畸形较为常见，且尤其多发于未成年人群[2]。由于此种畸形严重影响患者面部外观，可对儿童及青少年日常生活、人际交往及心理健康产生系列负面影响，临床通常需经过内收前牙、改善牙槽骨前突及面部软组织异常、建立正常覆牙合覆盖等措施改善面部美观状态[3]。直丝弓矫治……