沈悦 曾翠敏 刘明辉 李淑婷 邓溪川 吕俊丽

[摘要]目的：探究微型種植体支抗在青年安氏Ⅱ类1分类错牙合畸形治疗中的应用及疗效。方法：选择2017年12月-2018年12月在沧州市人民医院口腔正畸科接受治疗的100例安氏Ⅱ类1分类错牙合畸形青年患者的资料进行回顾性分析，全部患者根据所接受的正畸治疗方案分为对照组和实验组。对照组：52例，使用口外弓支抗;实验组：48例，使用微型种植体支抗。对比两组的治疗时间、治疗效果、锥体束CT指标（尖牙间宽度、上齿槽座角、下齿槽座角、磨牙位移）、咀嚼功能指标（咬合力、咀嚼效率）、龈沟液炎性因子指标[白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）]、并发症情况（不适感、水肿、感染、牙齿松动、牙龈炎）。结果：实验组的治疗时间短于对照组（P<0.05）。治疗后，实验组的尖牙间宽度、上齿槽座角、下齿槽座角、咬合力、咀嚼效率高于对照组，实验组的磨牙位移、IL-1β、TNF-α、IL-6低于对照组（均P<0.05）。实验组的各类并发症比例均低于对照组（均P<0.05）。结论：微型种植体支抗在青年安氏Ⅱ类1分类错牙合畸形的矫治中，可改善治疗效果，缩短治疗时间，改善患者的牙齿美学形态，提升咀嚼能力，降低牙周组织的炎性反应风险，提高治疗的安全性。

[关键词]微型种植体;支抗;安氏Ⅱ类1分类错牙合畸形;口外弓;美观

[中图分类号]R782.1    [文献标志码]A    [文章编号]1008-6455（2021）07-0139-04

Application and Effect of Mini Implant Anchorage in the Treatment of Class Ⅱ Division 1 Malocclusion in Young People

SHEN Yue1，ZENG Cui-min2，LIU Ming-hui2，LI Shu-ting3，DENG Xi-chuan2，LV Jun-li2

（1.Department of Orthodontics; 2. Department of Stomatology; 3. Department of Anesthesiology， Cangzhou Peoples Hospital， Cangzhou 061000，Hebei，China）

Abstract： Objective  To explore the application and effect of Micro Implant Anchorage in the treatment of class II Division 1 malocclusion in young people . Methods  From December 2017-December 2018， 100 adolescent patients with Angle Class II Division 1 malocclusion who were treated in the Department of orthodontics of Cangzhou people's hospital were retrospectively analyzed. All the patients were divided into control group and experimental group according to the orthodontic treatment plan， 52 cases in the control group and 48 cases in the experimental group. The control group was treated with extraoral arch anchorage， and the experimental group was treated with micro implant anchorage. The treatment time， treatment effect， cone beam CT indexes （canine width， upper alveolar angle， lower alveolar angle， molar displacement）， masticatory function indexes （bite force， masticatory efficiency）， gingival crevicular fluid inflammatory factor index  （IL-1 β， TNF - α， IL-6）， complications （discomfort， discomfort， masticatory efficiency） were compared between the two groups Edema， infection， loose teeth， gingivitis）. Results The treatment time of the experimental group was shorter than that of the control group （P<0.05）.After treatment， the width between canines， upper alveolar angle， lower alveolar angle， bite force and masticatory efficiency of the experimental group were higher than those of the control group， while the molar displacement， IL-1 β， TNF - α and IL-6 in the experimental group were lower than those in the control group （all P<0.05）. The proportion of complications in the experimental group was lower than that in the control group （all P<0.05）. Conclusion  Micro implant anchorage in the treatment of class II Division 1 malocclusion in young people can improve the treatment effect， shorten the treatment time， improve the aesthetic shape of teeth， improve the chewing ability， reduce the risk of inflammatory reaction of periodontal tissue， and improve the safety of treatment.

Key words： micro implant; anchorage; deformity; extraoral arch; aesthetic

安氏Ⅱ类1分类错牙合畸形是青年人群中十分常见的牙齿畸形，临床工作中对于该种病变的治疗方法，一般强调以矫正上下颌的相对位置关系，降低前牙覆盖，改善牙齿功能和外貌等为主[1-2]。以往的研究结果表明，支抗可视为口腔正畸治疗过程中最为关键的部分，而支抗同时也是提供矫治力量的基础所在，特别在安氏Ⅱ类1分类错牙合畸形中，支抗的控制在整个矫治过程中，扮演十分关键的角色[3-4]。传统上已经具有较多种类的支抗的策略，如横腭杆或口外弓等，但以往这些方法大多依赖患者自己的配合情况，而且具有十分明显的口腔异物感，同时非常不利于人体口腔保持清洁，长期的治疗过程也影响外在美观程度，在诸多因素的干扰之下，传统的支抗治疗效果十分有限[5]。……