CAJ | 학술논문

目的：利用三维模型测量的手段对比不同支抗控制下上颌前突的矫治结果。方法选择上颌需要拔除双侧第一前磨牙且需要强支抗的上颌前突患者46名，随机分为种植体支抗组、口外弓组和Nance弓组。于正畸治疗前和上颌间隙关闭后制取上颌记存模型，通过三维模型测量手段，测量并对比不同支抗组上颌中切牙和上颌第一磨牙的三维位置改变。结果种植体支抗组、口外弓组和Nance弓组患者上颌中切牙矢状向内收移动，位移分别为（-6.661±1.328）、（-5.939±1.806）、（-5.788±2.009） mm，组间比较差异无统计学意义（P=0.121）。上颌中切牙的垂直向移动，种植体支抗组平均压低（0.129±1.815） mm，而口外弓组和Nance弓组分别伸长了（-2.162±2.026）、（-2.623±1.776） mm。种植体支抗组和其他两组之间比较差异有统计学意义（P<0.05）。种植体支抗组、口外弓组和Nance弓组患者上颌第一磨牙的矢状向移动位移分别为（0.608±1.045）、（1.445±1.462）、（1.503±0.945） mm；上颌第一磨牙的垂直向移动，种植体支抗组平均压低（0.720±0.805） mm，口外弓组轻度压低（0.076±0.986） mm，Nance弓组轻度伸长（-0.072±0.690） mm。种植体支抗组和其他两组之间比较差异有统计学意义（P<0.05）；3组均发生舌向移动，组间比较差异无统计学意义（P>0.05）。结论种植体支抗在上颌前突矫治中对于上颌切牙的垂直向控制以及对上颌磨牙的矢状向、垂直向控制优于传统支抗。
목적：이용삼유모형측량적수단대비불동지항공제하상합전돌적교치결과。방법선택상합수요발제쌍측제일전마아차수요강지항적상합전돌환자46명，수궤분위충식체지항조、구외궁조화Nance궁조。우정기치료전화상합간극관폐후제취상합기존모형，통과삼유모형측량수단，측량병대비불동지항조상합중절아화상합제일마아적삼유위치개변。결과충식체지항조、구외궁조화Nance궁조환자상합중절아시상향내수이동，위이분별위（-6.661±1.328）、（-5.939±1.806）、（-5.788±2.009） mm，조간비교차이무통계학의의（P=0.121）。상합중절아적수직향이동，충식체지항조평균압저（0.129±1.815） mm，이구외궁조화Nance궁조분별신장료（-2.162±2.026）、（-2.623±1.776） mm。충식체지항조화기타량조지간비교차이유통계학의의（P<0.05）。충식체지항조、구외궁조화Nance궁조환자상합제일마아적시상향이동위이분별위（0.608±1.045）、（1.445±1.462）、（1.503±0.945） mm；상합제일마아적수직향이동，충식체지항조평균압저（0.720±0.805） mm，구외궁조경도압저（0.076±0.986） mm，Nance궁조경도신장（-0.072±0.690） mm。충식체지항조화기타량조지간비교차이유통계학의의（P<0.05）；3조균발생설향이동，조간비교차이무통계학의의（P>0.05）。결론충식체지항재상합전돌교치중대우상합절아적수직향공제이급대상합마아적시상향、수직향공제우우전통지항。
Objective This study aims to compare the treatment outcomes in patients with maxillary dentoalveolar pro-trusion by applying different anchorage methods via three-dimensional model measurement. Methods A total of 46 patients with maxillary dentoalveolar protrusion treated with bilateral maxillary first premolar extractions and high anchorage were selected. The subjects were randomly divided into three groups according to the type of anchorage applied, which included implant, extraoral, and Nance arch anchorages. The maxillary dental models were made before treatment and after space closure of maxilla. The movements of the maxillary central incisors and first molars were measured via a three-dimensional model measurement, and the amounts of movement were compared among the three groups. Results The sagittal lingual movements of the maxillary central incisors were (-6.661±1.328), (-5.939±1.806), and (-5.788±2.009) mm for the implant, extraoral, and Nance arch anchorage groups, respectively, with no significant difference among the three groups (P=0.121). The corresponding vertical movements of the maxillary central incisors were (0.129±1.815) mm intrusion, and (-2.162± 2.026), (-2.623±1.776) mm extrusion. Significant difference was found between the implant anchorage group and the other groups (P<0.05). The corresponding sagittal mesial movements of the maxillary first molars were (0.608±1.045), (1.445± 1.462), and (1.503±0.945) mm. The corresponding vertical movements of the maxillary first molars were (0.720±0.805) mm intrusion, (0.076±0.986) mm intrusion, and (-0.072±0.690) mm extrusion. Significant difference was found between the implant anchorage group and the other two groups (P<0.05). In the transverse direction, the first molars all moved lingually with no significant difference among the three groups (P>0.05). Conclusion Implant anchorage may be <br> superior in the vertical control of the maxillary incisors and in the sagittal, as well as in the vertical control of the maxillary molars, compared with the traditional anchorages during the treatment of patients with maxillary dentoalveolar protrusion.