CAJ | 학술논문

目的比较Twin-block和Ⅱ类牵引对青少年安氏Ⅱ类1分类错(牙合)下颌后缩患者髁突形态的影响,探讨二者颞下颌关节改建机制的异同,为此类患者的治疗提供依据.方法选取60例替牙列晚期至恒牙列早期的安氏Ⅱ类1分类错(牙合)下颌后缩患者,利用计算机产生的随机数字随机分为Twin-block组、Ⅱ类牵引组与对照治疗组(采用固定矫治且过程中不采用Ⅱ类牵引或固定功能矫治措施),每组各20例.治疗前后所有患者均拍摄锥形束CT,比较各组髁突形态及关节间隙的治疗前后差异及组间差异.结果治疗后3组髁突短轴与髁突上部高度的总体差异有统计学意义(P＜0.05),Twin-block组[(8.51±1.48)和(7.39±1.42) mm]和Ⅱ类牵引组[(8.44±1.03)和(7.24±0.89)mm]均显著大于对照治疗组[(7.47±1.27)和(6.47±1.56) mm](P＜0.05),而Twin-block组与Ⅱ类牵引组的组间差异均无统计学意义(P＞0.05).治疗后Twin-block组和Ⅱ类牵引组髁突短轴、髁突上部高度显著大于治疗前(P＜0.05).其余各组关于髁突、关节窝形态的测量项目治疗前后差异均无统计学意义(P＞0.05).各组治疗前后关节间隙差异均无统计学意义(P＞0.05),治疗前后关节间隙指数组间差异均无统计学意义(P＞0.05).结论 Twin-block和Ⅱ类牵引均可使安氏Ⅱ类1分类错(牙合)下颌后缩的青少年患者髁突短轴和髁突上部高度增加,但二者对颞下颌关节的改建效果类似,治疗前后髁突与关节的位置关系并无显著变化.
목적 비교Twin-block화Ⅱ류견인대청소년안씨Ⅱ류1분류착(아합)하합후축환자과돌형태적영향,탐토이자섭하합관절개건궤제적이동,위차류환자적치료제공의거.방법 선취60례체아렬만기지항아렬조기적안씨Ⅱ류1분류착(아합)하합후축환자,이용계산궤산생적수궤수자수궤분위Twin-block조、Ⅱ류견인조여대조치료조(채용고정교치차과정중불채용Ⅱ류견인혹고정공능교치조시),매조각20례.치료전후소유환자균박섭추형속CT,비교각조과돌형태급관절간극적치료전후차이급조간차이.결과 치료후3조과돌단축여과돌상부고도적총체차이유통계학의의(P＜0.05),Twin-block조[(8.51±1.48)화(7.39±1.42) mm]화Ⅱ류견인조[(8.44±1.03)화(7.24±0.89)mm]균현저대우대조치료조[(7.47±1.27)화(6.47±1.56) mm](P＜0.05),이Twin-block조여Ⅱ류견인조적조간차이균무통계학의의(P＞0.05).치료후Twin-block조화Ⅱ류견인조과돌단축、과돌상부고도현저대우치료전(P＜0.05).기여각조관우과돌、관절와형태적측량항목치료전후차이균무통계학의의(P＞0.05).각조치료전후관절간극차이균무통계학의의(P＞0.05),치료전후관절간극지수조간차이균무통계학의의(P＞0.05).결론 Twin-block화Ⅱ류견인균가사안씨Ⅱ류1분류착(아합)하합후축적청소년환자과돌단축화과돌상부고도증가,단이자대섭하합관절적개건효과유사,치료전후과돌여관절적위치관계병무현저변화.
Objective To compare the temporomandibular joint changes in adolescent Class Ⅱ division 1 malocclusion patients with mandibular retrusion treated with Twin-block and Class Ⅱ elastics.Methods Sixty Class Ⅱ division 1 malocclusion patients with mandibular retrusion were divided into 3 groups (Twin-block group,Class Ⅱ elastic group and control group,20 patients in each group) randomly.Differences of condylar process morphology were compared using cone-beam CT(CBCT) before and after treatment.Results Condylar largest anteroposterior diameter and upper condylar height increased after treatment in both Twin-block groupand Class Ⅱ elastic group.The condylar largest anteroposterior diameter and upper condylar height were longer in both Twin-block group [(8.51 ± 1.48) and (7.39 ± 1.42) mm] and Class Ⅱ elastic group [(8.44± 1.03) and (7.24±0.89) mm] than those in the control group[(7.47± 1.27) and (6.47 ± 1.56) mm] (P＜0.05).No significant difference was found in other measurements (P＞0.05).Conclusions Condylar largest anteroposterior diameter and upper condylar height in Class Ⅱ division 1 malocclusion patients increased after treatment using Twin-block and Class Ⅱ elastics.There was no significant difference between two groups.