张雪敏 李玉丛 李星

[摘要]目的：探究自锁托槽非拔牙矫治对牙列拥挤患者牙列形态及面部软硬组织的影响。方法：选择2014年1月-2019年1月于笔者医院口腔科就诊的270例牙列拥挤患者为研究对象，以随机数字表法分为观察组（135例）和对照组（135例），观察组予以自锁托槽非拔牙矫治，对照组予以传统托槽矫治，两组均持续矫治10个月。观察并比较两组矫治10个月时的矫治效果，矫治前后的牙弓宽度及面部软硬组织指标。结果：矫治10个月时，观察组成功率为96.30%，高于对照组的80.74%（P<0.05）。矫治10个月时，两组上下颌第一、第二前磨牙，上下颌第一磨牙弓宽度均较矫治前增加，且观察组高于对照组（P<0.05）;矫治10个月时，两组ULP、N'-Sn-Pg'均较矫治前降低，且观察组低于对照组（P<0.05）;两组SnLs-SiL、Cm-Sn-Ls、Li-E、Ls-E、U1-FH、OP-FH、U1-L1均较矫治前升高，且观察组高于对照组（P<0.05）;两组SNA、SNB、U1-NA、U1-NA距均较矫治前降低，且观察组U1-NA、U1-NA距低于對照组（P<0.05）。结论：自锁托槽非拔牙矫治可有效改善牙列拥挤患者牙弓宽度、面部软硬组织指标水平，有助于促使患者面部软硬组织恢复，并提高矫治效果。

[关键词]牙列拥挤;自锁托槽;非拔牙矫治;牙弓宽度;面部软组织;面部硬组织

[中图分类号]R783.5    [文献标志码]A    [文章编号]1008-6455（2021）07-0135-04

Effects of Non-extraction Orthodontic Correction with Self-Ligating Brackets Correction on Dentition Morphology and Facial Soft and Hard Tissues of Patients with Crowded Dentition

ZHANG Xue-min， LI Yu-cong， LI Xing

（Department of Stomatology， Shijiazhuang Traditional Chinese Medicine Hospital，Shijiazhuang 050000， Hebei， China）

Abstract：Objective To investigate the effects of non-extraction orthodontic correction with self-ligating brackets correction on dentition morphology and facial soft and hard tissues of patients with crowded dentition. Methods From January 2014 to January 2019， 270 patients with dentition crowding were selected and randomly divided into observation group （135 cases） and control group （135 cases）. The observation group was treated with self-ligating brackets without tooth extraction， while the control group was treated with traditional brackets. Both groups were treated continuously for 10 months. The correction effects of the two groups 10 months after correction， and the arch width， facial soft and hard tissue indexes before and 10 months after correction of the two groups were observed and compared. Results 10 months after correction， the success rate in the observation group was 96.30%， which was higher than 80.74% of the control group （P<0.05）. 10 months after correction， the arch widths of the upper and lower first premolars and the upper and lower first molars in the two groups increased compared with those before correction， and the observation group was higher than the control group （P<0.05）. 10 months after correction， ULP， N'-Sn-Pg'in both groups were lower than before correction， and the observation group was lower than the control group （P<0.05）. SnLs-SiL， Cm-Sn-Ls， Li-E， Ls-E， U1-FH， OP-FH， U1-L1 in the two groups were higher than those before correction， and the observation group was higher than the control group （P<0.05）. The distances between SNA， SNB， U1-NA and U1-NA in the two groups were lower than those before correction， and U1-NA and U1-NA in the observation group were lower than those in the control group （P<0.05）. Conclusion Self-ligating brackets can effectively improve the dental arch width， facial soft and hard tissue index level，promote the recovery of facial soft and hard tissue， and improve the treatment effect.

Key words：crowded dentition; self-ligating brackets correction; non-extraction correction; arch width; facial soft tissue; facial hard tissue

牙列拥挤为口腔科常见疾病，属于牙齿畸形的一种，严重影响患者口腔及颜面部发育、口腔卫生健康以及面部美观等[1]。减数拔牙治疗属于临床常用疗法，但其创伤较大，随着医疗技术的不断发展，非拔牙矫治逐渐受到广大患者的青睐[2]。但不同的矫治器在牙列拥挤矫治中的效果不一，传统托槽矫治器存在结扎丝扎嘴、复诊时间较长等不足，且矫治过程中牙齿移动时产生的疼痛程度较大[3]。新型自锁托槽矫治器利用锁帽代替结扎丝或结扎圈固定弓丝，与传统托槽矫治器存在明显区别，理论上可大幅度减少操作时间，降低弓絲与托槽槽沟间的摩擦力，有效提高矫治效果[4]。本研究旨在进一步探究自锁托槽非拔牙矫治对牙列拥挤患者牙列形态及面部软硬组织的影响，为临床应用提供依据，现报道如下。……