CAJ | 학술논문

目的：应用Coben分析法评价前方牵引治疗上颌发育不足的临床疗效，阐明Coben分析法在骨性安氏Ⅲ类错畸形致病机制的诊断及矫治计划制定中的优势。方法对120例处在生长发育期的由上颌发育不足所致的骨性安氏Ⅲ类错患者行上颌前方牵引治疗，分别对上颌前方牵引矫治前、后的头颅定位侧位片采用Coben分析法和北医大分析法进行头影测量分析。结果上颌前方牵引后，Coben分析法测量结果中，面中1/3深度增加且Ptm-A段的变化有统计学差异，面下1/3深度减小，颜面高度增加（P<0.001）；北医大分析法测量结果中，SNA、ANB、U1/NA、 U1/SN、MP/SN、Y轴角显著增加（P<0.001），SNB、U1/L1显著减小（P<0.001），L1/MP减小（P<0.05）。结论上颌前方牵引疗法对以Coben分析法中Ptm-A段过小为主要机制的生长发育期骨性安氏Ⅲ类错畸形有显著疗效； Coben分析法是一种比较直观、容易理解的头影测量分析方法，在错畸形尤其是骨性安氏Ⅲ类错的诊断中具有临床意义。
목적：응용Coben분석법평개전방견인치료상합발육불족적림상료효，천명Coben분석법재골성안씨Ⅲ류착기형치병궤제적진단급교치계화제정중적우세。방법 대120례처재생장발육기적유상합발육불족소치적골성안씨Ⅲ류착환자행상합전방견인치료，분별대상합전방견인교치전、후적두로정위측위편채용Coben분석법화북의대분석법진행두영측량분석。결과 상합전방견인후，Coben분석법측량결과중，면중1/3심도증가차Ptm-A단적변화유통계학차이，면하1/3심도감소，안면고도증가（P<0.001）；북의대분석법측량결과중，SNA、ANB、U1/NA、 U1/SN、MP/SN、Y축각현저증가（P<0.001），SNB、U1/L1현저감소（P<0.001），L1/MP감소（P<0.05）。결론상합전방견인요법대이Coben분석법중Ptm-A단과소위주요궤제적생장발육기골성안씨Ⅲ류착기형유현저료효； Coben분석법시일충비교직관、용역리해적두영측량분석방법，재착기형우기시골성안씨Ⅲ류착적진단중구유림상의의。
Objective We aims to evaluate the therapeutic effect of maxillary protraction on maxillary maldevelopment using Coben analysis to illustrate the advantages of Coben analysis in identifying pathogenic mechanisms and in designing treatment plans for Class Ⅲ malocclusions. Methods A total of 120 patients were diagnosed to have skeletal Class Ⅲ maloc-clusions with maxillary maldevelopment. These patients were selected as the subjects of the present research. Maxillary protraction was exerted to promote maxilla growth. Cephalometric analysis was conducted by using Coben analysis and angle analyses of Beijing Medical University to collect data before and after maxillary protraction. Results According to Coben analysis measurements, the height of facies cranii increased after maxillary protraction. The depth of lower face decreased, whereas that of mid-face increased and the Ptm-A value increased significantly in the mid-face (P<0.001). In the angle ana-lysis of Beijing Medical University, SNA, ANB, U1/NA, U1/SN, MP/SN, and Y-axis angles increased significantly (P<0.001), whereas SNB, U1/L1 (P<0.001), and L1/MP (P<0.05) decreased. Conclusion Maxillary protraction has a significant effect on growing skeletal Class Ⅲ malocclusions with the chief mechanism of Ptm-A value just diagnosed as minor by Coben analysis. Coben analysis is visual and clear in identifying pathogenic mechanisms of Class Ⅲ malocclusions.