[摘要]目的：评价应用改良肌激动器联合Damon自锁托槽矫治技术治疗下颌后缩性骨性Ⅱ类青少年错牙合畸形的临床效果。方法：收集2019年-2021年以下颌后缩为主的生长发育高峰期前骨性Ⅱ类错牙合畸形患者20例，I期应用改良头帽-肌激动器功能矫治器，Ⅱ期应用Damon自锁托槽矫治技术，并对患者治疗前后的软硬组织及气道的相关变化进行分析。结果：治疗前后的CBCT测量显示，硬组织及牙牙合：SNB角、Po-NB、S-Ar、Co-Gn、ANS-Me、ANS-Gn/N-Gn（%）增加，ANB角、Wits值、NA-PA、U1-SN、U1-L1、U6-Ptm明显减小；软组织：FCA、ULP明显减小，LLP、LLL及EP-UL增加；气道：V总、V鼻咽、V腭咽及相应最小横截面积显著增加。结论：对于生长发育高峰期前的骨性Ⅱ类错牙合畸形采用双期矫治疗效明显，可有效改善下颌后缩、前牙唇倾度及软组织侧貌，上气道通气状况也得以改善，对临床有参考意义。

[关键词]改良肌激动器；Damon自锁托槽；双期矫治；下颌后缩；骨性Ⅱ类错牙合

[中图分类号]R783.5" " [文献标志码]A" " [文章编号]1008-6455（2025）08-0145-05

Clinical Analysis of Two-phase Treatment of Skeletal Class Ⅱ Malocclusion with Modified Activator and Damon Self-ligating Bracket

FENG Haixia1， ZHU Qi1， QIAN Chao2， WANG Hua3， GU Yan3

[ 1.Department of Stomatology， Suzhou Ninth People's Hospital， Suzhou 215200， Jiangsu， China; 2.Department of Stomatology， Liyang People's Hospital， Changzhou 213300， Jiangsu， China; 3.Department of Orthodontics， the Affiliated Stomatological Hospital of Nanjing Medical University， State Key Laboratory Cultivation Base of Research， Prevention and Treatment for Oral Diseases （ Nanjing Medical University ）， Nanjing 210029， Jiangsu， China ]

Abstract： Objective" To evaluate the clinical effects of using a modified activator combined with Damon self-ligating bracket technique in treating skeletal Class Ⅱ malocclusion with mandibular retrusion in adolescents. Methods" Twenty cases of skeletal Class Ⅱ malocclusion patients before the peak growth period with mandibular retrusion were collected from 2019 to 2021." A modified activator appliance was used in Phase I and Damon self-ligating technique was used in Phase Ⅱ. Changes in hard tissue， soft tissue and airway before and after treatment were analyzed. Results" CBCT measurements showed： for hard tissues， SNB， Po-NB， S-Ar， Co-Gn， ANS-Me and ANS-Gn/N-Gn（%） increased， while ANB， Wit， NA-PA， U1-SN， U1-L1 and U6-Ptm significantly decreased; for soft tissues， FCA and ULP significantly decreased， while LLP， LLL and EP-UL increased; for airway， Vtotal， Vnaso and Vpalato" significantly increased. Conclusion" For skeletal Class II malocclusion before the peak growth period， the two-phase orthodontic treatment is effective in improving mandibular retrusion， anterior teeth inclination and the profile; the upper airway patency is also improved， which has clinical reference value.

Key words： modified activator; Damon self-ligating bracket; two-phase treatment; mandibular retrusion; skeletal Class Ⅱ malocclusion

安氏Ⅱ类错牙合是临床常见的错牙合畸形，患者的主诉通常是要求治疗上前牙前突，一般当前牙深覆盖超过6 mm时，常伴随上、下颌骨关系异常，其临床主要表现为下颌后缩[1-2]。临床实践中，单纯通过固定矫治器内收上前牙难以取得理想的矫治效果。因此，对于生长高峰期前及生长高峰期的骨性Ⅱ类错牙合患者，应择期采用双期治疗[3]。即Ⅰ期利用其自身生长潜力，采用功能矫治器纠正颌骨关系异常，缩减牙颌面不调程度，改善上下颌骨关系，降低后续固定矫治难度，Ⅱ期再使用固定矫治器对牙位及咬合关系作精细调整。……