CAJ | 학술논문

目的探讨亚历山大矫治技术下两种不同拔牙模式治疗后下颌牙列变化的差异.方法选取采用亚历山大技术矫治完成的拔牙病例52例,分为拔除上下第一前磨牙组(A组)和拔除上颌第一前磨牙及下颌第二前磨牙组(B组),测量矫治前后下颌数字模型的牙弓宽度、长度、Spee曲深度及前牙不齐指数,并通过头影测量获取下切牙唇倾度.采用配对及成组f检验分别对测量项目进行统计分析.结果矫治后两组病例的尖牙间宽度稍增大,第一磨牙间宽度、牙弓长度、Spee曲深度、IRR均减小,差异有统计学意义(P＜0.05).治疗后A组下前牙唇倾度显著减小(P＜0.05),B组变化不显著(P＞0.05).B组治疗前后第一磨牙间宽度、Spee曲深度减小量均比A组大,下前牙倾斜度减少量较A组小(P＜0.05).两组尖牙间宽度、牙弓长度及IRR等变化量间无显著差异(P＞0.05).结论亚历山大矫治技术有利于维持原有牙弓宽度的大小.下颌减数第一前磨牙有利于维持磨牙间宽度及回收下前牙;减数下颌第二前磨牙则更有利于磨牙前移调整磨牙关系并维持下切牙唇倾度.
목적 탐토아력산대교치기술하량충불동발아모식치료후하합아렬변화적차이.방법 선취채용아력산대기술교치완성적발아병례52례,분위발제상하제일전마아조(A조)화발제상합제일전마아급하합제이전마아조(B조),측량교치전후하합수자모형적아궁관도、장도、Spee곡심도급전아불제지수,병통과두영측량획취하절아진경도.채용배대급성조f검험분별대측량항목진행통계분석.결과 교치후량조병례적첨아간관도초증대,제일마아간관도、아궁장도、Spee곡심도、IRR균감소,차이유통계학의의(P＜0.05).치료후A조하전아진경도현저감소(P＜0.05),B조변화불현저(P＞0.05).B조치료전후제일마아간관도、Spee곡심도감소량균비A조대,하전아경사도감소량교A조소(P＜0.05).량조첨아간관도、아궁장도급IRR등변화량간무현저차이(P＞0.05).결론 아력산대교치기술유리우유지원유아궁관도적대소.하합감수제일전마아유리우유지마아간관도급회수하전아;감수하합제이전마아칙경유리우마아전이조정마아관계병유지하절아진경도.
Objective To investigate the differences of alterations of lower arch between two different extraction patterns treated with Alexander Discipline.Methods 52 extraction cases treated with Alexander Discipline were divided into group A (extraction of first premolars) and group B (extraction of upper first and lower second premolars).Arch widths,lengths,curve of Spee and irregularity index (IRR) were measured in digital mandibular casts before and after treatment.IMPA was also measured in cephalograms.Paired t-test and group t-test were used for statistical analysis.Results The lower inter-canine width increased slightly,while lower inter-molar width,depth of curve of Spee and IRR decreased after treatment (P＜0.05).After treatment,IMPA decreased in group A (P＜0.05),but remained unchanged in group B (P＞0.05).The decrease of inter-molar width and depth of curve of Spee were larger in group B,but IMPA was smaller than group A (P＜ 0.05).There were no significant differences of changes of lower inter-canine width and arch length as well as IRR between two groups after treatment (P＞0.05).Conclusions Alexander Discipline is prevailing in maintaining the lower arch width.Extraction of the lower first premolars has advantages in maintaining lower inter-molar width as well as retracting lower incisors.Extraction of lower second premolars might be more appropriate in correcting the distal molar relationship and maintaining the angulation of lower incisors.