目的探讨正畸矫治成人骨性反(牙合)伴下颌偏斜的临床疗效,以期为临床提供参考。方法选择成年骨性反(牙合)伴下颌偏斜的安氏Ⅲ类错(牙合)畸形患者18例,男性5例,女性13例。矫治初期上颌使用直丝弓矫治器;下颌配戴附拉钩的全牙列活动性垫,解除前牙反(牙合),排齐整平上前牙,并通过垫上的拉钩进行斜牵引,纠正下颌偏斜。矫治前后拍摄头颅侧位X线片,采用配对t检验分析各头影测量项目的矫治前后差异。结果总疗程(18.0±3.5)个月,18例患者前牙反(牙合)及下颌偏斜均得到纠正,前牙建立正常覆覆盖关系。上颌前牙显著前移, U1-NA 角由矫治前的(26.25±3.89)°增加至矫治后的(38.25±1.77)°,U1-SN角由矫治前的(104.75±2.48)°增加至矫治后的(117.50±2.12)°,矫治前后差异均有统计学意义(P〈0.01)。结论正畸治疗可成功矫治成人骨性反伴下颌偏斜的安氏Ⅲ类错(牙合)畸形;矫治初期下颌配戴附拉钩的全牙列活动性垫,可明显改善患者正侧貌。
Objective To investigate the effects of orthodontic treatment of skeletal crossbite adults with mandibular deviation. Methods Eighteen skeletal Class Ⅲ adult patients with borderline skeletal crossbite and mandibular deviation were selected (5 males,13 females). The mean age was 25 years. All cases were treated with straight-wire appliance in upper arch and occlusal plate in the lower arch. Elastics were applied to correct mandibular deviation. Cephalometric analysis was carried out before and after treatment. Paired t-test was performed. Results After treatment, the anterior crossbite was corrected and Class Ⅰ molar and canine relationships were achieved. The inclination of upper incisors was increased significantly. Conclusions Straight-wire appliance combined with occlusal plate was effective on correcting adult patients with mild, moderate skeletal crossbite and mandibular deviation.