[摘要]目的：探讨比较矢状扩弓与横向扩弓矫治乳牙反牙合患儿的临床效果。方法：回顾性分析2021年1月-2022年12月笔者医院收治的108例乳牙反牙合患儿的临床资料，根据资料中治疗方法不同分为A组（54例）和B组（54例）。A组采用横向扩弓矫治器治疗，B组采用矢状扩弓矫治器治疗。对患儿头颅侧位片行测量分析，比较两组治疗前后软硬组织、恒切牙胚位置的变化情况。结果：治疗后，A组上颌骨长度（Ptm-A）、下颌骨体长度（Go-Po）、上乳中切牙突度（D1-NA、D1-SN）、上乳中切牙位置（D1i-X、D1a-X、D1a-Y）、上恒中切牙胚位置（G1i-X、G1i-Y、G1a-X、G1a-Y）、A-X、A-Y较治疗前升高，上下乳中切牙夹角（D1-L1）较治疗前减小（均P＜0.05）；B组上唇突度（Ls-E）、上乳中切牙突度、上恒中切牙胚突角（G1-NA），上恒中切牙胚角（G1-SN）、上乳中切牙位置（D1i-X、D1a-X）、上恒中切牙胚位置（G1i-X、G1i-Y、G1a-X）、A-X较治疗前增加，下唇突度（Li-E）、下乳中切牙突角（L1-NB）、上下乳中切牙夹角、下乳中切牙角（L1-MP）较治疗前减小（均P＜0.05）。其他测量指标治疗前后改变量差异无统计学意义（P＞0.05）。结论：矫治乳牙反牙合中矢状扩弓与横向扩弓对软硬组织的影响相似，而横向扩弓比矢状扩弓更利于上恒中切牙胚向前下移动，即可促进恒切牙建立正常覆牙合、覆盖关系，防止恒牙列反牙合。

[关键词]矢状扩弓；横向扩弓；乳牙反牙合；正畸治疗；回顾性分析；软硬组织；头影测量分析；头颅定位侧位片

[中图分类号]R783.5" " [文献标志码]A" " [文章编号]1008-6455（2025）08-0163-04

Comparison of the Effect of Sagittal Arch Expansion and Transverse Arch Expansion in Orthodontic Treatment for Children with Deciduous Teeth Occlusion

ZHOU Xue

（ Department of Stomatology， Tangshan Hongci Hospital， Tangshan 063000， Hebei， China ）

Abstract： Objective" To explore the orthodontic effect of sagittal and transverse arch expansion on children with deciduous teeth. Methods" Retrospective analysis was performed on the clinical treatment data of 108 children with deciduous teeth （occlusion） treated in the hospital from January 2021 to December 2022， and they were divided into A group （54 cases） and B group （54 cases） according to different treatment methods. Group A was treated with transverse extension appliance， group B was treated with sagittal extension appliance. The lateral cranial radiographs of the children were measured and analyzed， and the changes of soft and hard tissue and permanent incisor embryo position were compared between two groups. Results" After treatment， the length of maxilla （Ptm-A）， length of mandibular body （Go-Po）， protrusion of upper primary central incisor （D1-NA， D1-SN）， position of upper primary central incisor （D1i-X， D1a-X， D1a-Y）， position of upper permanent central incisor （G1i-X， G1i-Y， G1a-X， G1a-Y）， A-X， A-Y were observed in the A group -Y was higher than that before treatment， and the Angle between the upper and lower primary central incisors （D1-L1） was lower than that before treatment（ all P＜0.05）. In the B group， upper lip protrusion （Ls-E）， upper primary central incisor protrusion， upper permanent central incisor Angle （G1-NA）， upper permanent central incisor Angle （G1-SN）， upper primary central incisor position （D1i-X， D1a-X）， upper permanent central incisor position （G1i-X， G1i-Y， G1a-X）， A-X increased after treatment. The lower lip protrusion （Li-E）， lower primary central incisor protrusion Angle （L1-NB）， upper and lower primary central incisor Angle， and lower primary central incisor Angle （L1-MP） were significantly lower than those before treatment （ all P＜0.05 ）. The other measurement indexes were no significant difference between two groups （P＞0.05）. Conclusion" Both sagittal expansion and transverse expansion can be used to correct primary crossbite， and the effects on soft and hard tissues are similar. Horizontal expansion is more conducive to the forward and downward movement of upper permanent central incisor embryo than sagittal expansion， and it can promote the establishment of a normal overbite occlusal coverage relationship between the permanent incisors and prevent permanent dentition crossbite occlusal.

Key words： sagittal arch expansion; transverse arch expansion; deciduous teeth occlusion; orthodontic treatment; retrospective analysis; retrospective analysis; soft and hard organization; cephalometry; cephalometrical film

乳牙反牙合大多数为功能性反牙合，据研究统计，中国大陆地区发生率为12.6%[1]。乳牙反牙合会阻碍颌骨发育，造成牙齿异常磨耗，不利于语言发音学习，不及时治疗会进展为颌骨畸形，影响患儿颜面部美观、口腔健康及心理健康[2]。……