高玉丽　郝学丽

[摘要]目的：探究微種植体支抗治疗对口腔正畸患者牙根吸收状况、咀嚼功能及美观程度的影响。方法：选取2018年1月-2020年1月笔者医院接受正畸治疗的130例口腔错牙合畸形患者为研究对象，根据自愿原则进行分组。对照组：采取传统正畸支抗治疗（n=65）;研究组：接受微种植体支抗治疗（n=65）。对比两组正畸结束后牙根吸收状况、正畸相关指标（磨牙移动等）、美观程度，治疗前、治疗后咀嚼功能（咬合力、咀嚼效率）、上下颌骨测量结果（SNA、ANB、SNB、U1-SN、L1-MP）、生活质量（Oral health related quality of life，OHRQOL）评分及牙周健康指标（GI、PLI、SBI）的差异，并记录治疗期间并发症发生情况。 结果：治疗后，研究组患者牙根吸收量、上中切牙倾角差、上中切牙凸距差及美观程度评分显著大于对照组，而磨牙移动显著小于对照组（均P<0.05）。治疗后，两组患者咬合力、咀嚼效率、OHRQOL评分较治疗前均显著上升（P<0.05），且研究组患者上述指标与同期对照组比较有显著性差异（P<0.05）。治疗后，两组患者SNA、ANB、U1-SN均较治疗前降低，SNB、L1-MP均较治疗前升高（P<0.05），研究组上述指标均优于对照组（P<0.05）。治疗后，研究组患者GI、PLI、SBI与治疗前比较无显著性差异，而对照组较治疗前显著上升（P<0.05），研究组患者上述指标与同期对照组比较有显著差异（P<0.05）。治疗期间，研究组患者并发症发生率显著低于对照组（P<0.05）。 结论：应用微种植体支抗治疗口腔正畸患者效果显著，可有效提升患者咀嚼功能，改善患者美观程度，提升其生活质量，对牙周组织的损伤较小，减少并发症的发生，但牙根吸收量较大而需做好预防措施。

[关键词]口腔正畸;微种植体支抗;牙根吸收;咀嚼功能;美观程度

[中图分类号]R783.5    [文献标志码]A    [文章编号]1008-6455（2021）09-0132-05

Effects of Micro-screw Implant Anchorage on Root Resorption Status， Chewing Function and Aesthetic Degree of Patients with Orthodontics

GAO Yu-li1， HAO Xue-li2

（1.Department of Orthodontics， Affiliated Hospital of Qingdao University， Qingdao 266500，Shandong，China;2.Department of Stomatology， Linshu County People's Hospital of Linyi City， Linyi 276700， Shandong， China）

Abstract： Objective To explore the effects of micro-screw implant anchorage on root resorption status， chewing function and aesthetic degree of patients with orthodontics. Methods  Totally 130 patients with oral malocclusion who received orthodontic treatment in our hospital from January 2018 to January 2020 were selected and grouped according to the voluntary principle. The patients who received traditional orthodontic anchorage therapy were selected as control group （n=65）， and patients who received micro-screw implant anchorage therapy were enrolled as study group （n=65）. The root resorption status， orthodontic related indicators （molar movement， etc.） and aesthetic degree after the end of orthodontics， and chewing function （occlusal force，chewing efficiency）， maxillary-mandibular measurement results （SNA， ANB， SNB， U1-SN， L1-MP）， quality of life [oral health related quality of life （OHRQOL） score] and periodontal health indicators （GI， PLI， SBI） before and after treatment were compared between the two groups， and the occurrence of complications were recorded during treatment. Results  After treatment， the root absorption volume， difference of upper central incisor inclination angle， difference of upper central incisor protruding distance and aesthetic degree score in study group were significantly greater than those in control group while the molar movement was significantly smaller than that in control group （P<0.05）. After treatment， the occlusal force， chewing efficiency and OHRQOL score in the two groups were significantly increased compared with those before treatment （P<0.05）， and the above indicators in study group were significantly different from those in control group during the same period （P<0.05）. After treatment， SNA， ANB and U1-SN in the two groups were decreased compared with those before treatment while SNB and L1-MP were increased compared with those before treatment （P<0.05）， and the above indexes in study group were better than those in control group （P<0.05）. After treatment， there were no differences in the GI， PLI and SBI in study group compared with those before treatment， and the indexes in control group were increased significantly compared with those before treatment （P<0.05）， and the above indexes in study group were significantly different from those in control group during the same period （P<0.05）. During treatment， the incidence rate of complications in study group was significantly lower than that in control group （P<0.05）. Conclusion  Micro-screw implant anchorage has significant effects in the treatment of patients with orthodontics. It can effectively improve the chewing function， enhance the aesthetic degree and promote the quality of life， and it has small damage to periodontal tissues， and can reduce the occurrence of complications， but it has large root absorption and needs preventive measures.

Key words： orthodontics; micro-screw implant anchorage; root resorption; chewing function; aesthetic degree

既往研究发现，错牙合畸形患儿的口腔健康生活质量呈明显偏低状态，临床医师和患儿父母应予以高度重視，积极接受正畸治疗不仅可改善错牙合畸形的牙齿排列和面型美观度，还能显著提高患儿的口腔健康生活质量[1]。临床上常用口外弓、横腭杆及颌间牵引等方式进行治疗，但稳定性、患者舒适性及配合性较差，且口腔感染、牙齿松动等并发症较多，致使正畸效果较差。随着临床医学技术的发展，微种植体支抗作为一种新型的矫正手段，广泛受到临床医师及口腔畸形患者的青睐。微种植体支抗是依靠与骨组织的嵌合力，具有植入操作简单、创伤小、相容性良好等优势，正畸效果较理想[2]。……