CAJ | 학술논문

背景：安氏Ⅱ类错牙合是临床上常见的错牙合畸形，主要表现为骨性错牙合，其主要因素是下颌后缩，对于此类患者，多进行早期矫治，以纠正骨性畸形，明显改善颜面外观。目的：对比Twin-Block矫治器与直丝弓矫治器配合口外弓及Ⅱ类牵引早期矫治骨性安氏Ⅱ类1分类错牙合的临床效果及生物力学变化。方法：选择处于生长发育高峰期的骨性安氏Ⅱ类1分类错牙合患者30例，按随机数字表法分为两组，每组15例，分别用Twin-Block矫治器及直丝弓矫治器配合口外弓及Ⅱ类牵引治疗。对比及测量两组患者治疗前后头颅侧位片，并作统计学分析。结果与结论：矫治结束后，所有患者磨牙和尖牙均达到或接近中性关系，上下齿槽座角(ANB 角)减少至正常范围。Twin-Block矫治器的骨效应明显大于直丝弓矫治器，使用Twin-Block矫治器，患儿下颌骨体长度及下面高增加更显著。提示Twin-Block矫治器对尚处于生长发育期的早期骨性Ⅱ类错牙合患者疗效显著，可在生物力学的作用下，改变不协调的颌骨关系，实现组织重建，获得理想软组织侧貌。对于下颌后缩显著，上切牙较为唇倾，下切牙较为直立的病例侧貌改善效果更佳。
배경：안씨Ⅱ류착아합시림상상상견적착아합기형，주요표현위골성착아합，기주요인소시하합후축，대우차류환자，다진행조기교치，이규정골성기형，명현개선안면외관。목적：대비Twin-Block교치기여직사궁교치기배합구외궁급Ⅱ류견인조기교치골성안씨Ⅱ류1분류착아합적림상효과급생물역학변화。방법：선택처우생장발육고봉기적골성안씨Ⅱ류1분류착아합환자30례，안수궤수자표법분위량조，매조15례，분별용Twin-Block교치기급직사궁교치기배합구외궁급Ⅱ류견인치료。대비급측량량조환자치료전후두로측위편，병작통계학분석。결과여결론：교치결속후，소유환자마아화첨아균체도혹접근중성관계，상하치조좌각(ANB 각)감소지정상범위。Twin-Block교치기적골효응명현대우직사궁교치기，사용Twin-Block교치기，환인하합골체장도급하면고증가경현저。제시Twin-Block교치기대상처우생장발육기적조기골성Ⅱ류착아합환자료효현저，가재생물역학적작용하，개변불협조적합골관계，실현조직중건，획득이상연조직측모。대우하합후축현저，상절아교위진경，하절아교위직립적병례측모개선효과경가。
BACKGROUND:Class II malocclusion is commonly observed in clinics, with the main manifestation of skeletal malocclusion, and mandibular retrusion is the main reason. Class II malocclusion should be treated early to correct skeletal malformation and improve facial appearance. OBJECTIVE:To compare the biomechanics change in early treatment of Class II division 1 malocclusion with Twin-Block appliance and straight wire appliance combined with face-bow and Class II drawing. METHODS: Thirty patients with malocclusion who were at peak velocity on the growth curve were randomly divided into two groups, with 15 cases in each group. Patients in each group were treated with Twin-Block appliance and straight wire appliance combined face-bow and Class II drawing, respectively. The cephalometric records of al patients were examined before and after the treatments. The acquired data were processed by statistical analysis. RESULTS AND CONCLUSION:After treatment, al molars and cuspid teeth achieved or reached Class I, and ANB angle decreased to normal range. The bone effect of Twin-Block appliance was more significant than straight wire appliance. Using Twin-Block appliance, the length of mandible body and lower face height increased significantly. Experimental findings indicate that, Twin-Block appliance has significant therapeutic effects in treatment of early skeletal Class II division 1 malocclusion patients, who are at peak velocity on the growth curve. With the biomechanical effects, this treatment corrects asymmetrical jaw relation, reconstructs the tissue, and obtains satisfactory lateral facial profile of soft tissues. The therapeutic effect is more obvious for patients with obvious mandibular retrusion, flared upper incisors and upright lower incisors.