新型交叉颊面管对第二前磨牙拔除后的支抗效果评估

doi:10.11958/20240487

天津医药 ›› 2024, Vol. 52 ›› Issue (9): 977-981.doi: 10.11958/20240487

新型交叉颊面管对第二前磨牙拔除后的支抗效果评估

张馨匀¹(), 韩易辰¹, 江浩², 张明灿¹^,^△()

1 天津市滨海新区塘沽口腔医院正畸科（邮编300450）
2 天津市第五中心医院口腔科

收稿日期:2024-04-18 修回日期:2024-05-19 出版日期:2024-09-15 发布日期:2024-09-06
通讯作者: ^△E-mail：zmcfirst@126.com
作者简介:张馨匀（1992），女，医师，主要从事口腔正畸诊疗相关研究。E-mail：1558936732@qq.com
基金资助:
天津市滨海新区卫生健康委科技项目(2022BWKQ031)

Evaluation of the anchorage effect of a new cross buccal tube in the treatment of second premolar extraction

ZHANG Xinyun¹(), HAN Yichen¹, JIANG Hao², ZHANG Mingcan¹^,^△()

1 Department of Orthodontics, Binhai New Area Tanggu Stomatology Hospital, Tianjin 300450, China
2 Department of Stomatology, Tianjin Fifth Central Hospital

Received:2024-04-18 Revised:2024-05-19 Published:2024-09-15 Online:2024-09-06
Contact: ^△E-mail：zmcfirst@126.com

张馨匀, 韩易辰, 江浩, 张明灿. 新型交叉颊面管对第二前磨牙拔除后的支抗效果评估[J]. 天津医药, 2024, 52(9): 977-981.

ZHANG Xinyun, HAN Yichen, JIANG Hao, ZHANG Mingcan. Evaluation of the anchorage effect of a new cross buccal tube in the treatment of second premolar extraction[J]. Tianjin Medical Journal, 2024, 52(9): 977-981.

摘要/Abstract

摘要：

目的评价新型交叉颊面管（XBT）关闭上颌第二前磨牙拔牙间隙支抗控制的临床效果。方法选取15例牙列中重度拥挤、骨性Ⅰ类、上颌第二前磨牙缺失或临床检查难以保留的青少年患者，应用生理性支抗技术，减数上颌第二前磨牙，解除拥挤、内收前牙。治疗前后拍摄头颅侧位片并进行头影测量，观察与磨牙支抗和前牙内收相关的骨性、牙性指标变化。结果所有患者治疗结束后牙齿排列整齐，咬合关系良好，侧貌改善。治疗前后，骨性指标∠SNA、∠SNB、∠ANB和垂直向高度∠MP-SN变化差异无统计学意义（P>0.05）。牙性指标上下颌中切牙角度∠U1-SN、∠U1-NA、∠L1-MP、∠L1-NB减小，∠U1-L1增大（P<0.05）；上切牙切缘点远中移动（P<0.05），上切牙根尖点和上颌磨牙位置无明显改变。结论应用新型交叉颊面管有利于青少年患者关闭上颌第二前磨牙拔牙间隙的支抗控制。

关键词: 正畸支抗, 青少年, 新型交叉颊面管, 第二前磨牙拔除

Abstract:

Objective To evaluate the clinical effect of using a new cross buccal tube (XBT) to close the extraction gap of the maxillary second premolar and control the anchorage. Methods Fifteen adolescent patients with moderate to severe crowding, skeletal Class Ⅰ, missing maxillary second premolars or difficult to retain during clinical examination were selected. PASS orthodontic technique was used to reduce the number of maxillary second premolars to relieve crowding and retract the anterior teeth. Before and after treatment, head lateral images were taken and cephalometric measurements were taken. Changes of bone and dental indexes related to molar anchorage and anterior adduction were observed. Results After treatment, teeth of all patients were arranged neatly, the occlusion relationship was good and the profile was improved. Before and after treatment, there were no significant changes in bone indicators such as ∠SNA, ∠SNB and ∠ANB (P>0.05). There was no significant change in vertical height ∠MP-SN (P>0.05). The angle of the upper and lower central incisors, ∠U1-SN, ∠U1-NA, ∠ L1-MP and ∠L1-NB decreased significantly, while ∠U1-L1 increased significantly (P<0.05). The upper incisor margin point moving towards the distal (P<0.05), and there was no significant change in the position of the upper incisor root apex and first molar (P>0.05). Conclusion The application of the new cross buccal tube is beneficial for adolescent patients to control the occlusion of the extraction gap of the maxillary second premolar.

Key words: orthodontic anchorage procedures, adolescent, new cross buccal tube, second premolar extraction

中图分类号:

R783.5

图/表 6

图1 部分标志点以及测量指标示意图 S：蝶鞍中心点；N：鼻根点；A：上牙槽座点；B：下牙槽座点；MP：下颌平面；1：U1A-RL距；2：UM-RL距；3：U1E-RL距。

Fig.1 Landmarks and mearsurement indicators

表1 患者骨性和牙性测量指标治疗前后变化（n=15，$\bar{x}±s$）

Tab.1 Changes in various indicators before and after treatment in patients

测量指标	治疗前	治疗后	差值	t
骨性测量指标
∠SNA/°	82.51±1.68	81.17±2.37	1.34±2.94	1.765
∠SNB/°	79.98±1.91	79.64±2.55	0.34±1.68	0.777
∠ANB/°	3.42±0.42	3.34±0.49	0.08±0.45	0.715
∠MP-SN/°	37.04±1.87	37.51±1.89	-0.48±1.65	1.126
牙性测量指标
∠U1-L1/°	113.31±5.85	126.78±4.68	-13.47±3.58	14.581^＊＊
∠U1-SN/°	110.99±3.32	105.67±5.03	5.32±5.64	3.658^＊＊
∠U1-NA/°	27.39±2.56	21.09±2.56	6.31±1.63	14.948^＊＊
∠L1-MP/°	97.70±4.21	94.31±3.62	3.39±4.59	2.859^＊
∠L1-NB/°	34.30±3.86	28.35±4.28	5.95±2.06	11.167^＊＊
UM-RL距/mm	21.42±1.40	22.19±2.59	-0.77±2.00	1.497
U1E-RL距/mm	48.71±5.26	43.97±4.40	4.75±5.16	3.566^＊＊
U1A-RL距/mm	35.71±1.93	35.38±2.38	0.34±1.49	0.880

图2 矫治前面像、口内像及X线片 a—c：患者突面型，颜面左右不对称，颏部左偏2 mm，口周肌紧张；d—e：X线可见上颌第二前磨牙先天缺失，上颌第二乳磨牙滞留，前牙唇倾；f—g：恒牙列，氟斑牙，上颌第二前磨牙先天缺失，上颌第二乳磨牙滞留，双侧磨牙关系中性，上下牙列均存在中重度拥挤；下牙列中线左偏1.5 mm。

Fig.2 Orthodontic anterior image, intraoral image and X-ray image

图3 矫治9个月口内像患者拔牙间隙基本关闭，牙齿排列整齐，前牙突度改善，中线对正。

Fig.3 Orthodontic treatment for 9 months intraoral image

图4 矫治结束后面像、口内像及X线片 a—c：治疗后口周肌放松，面型改善明显；d、e：前牙突度改善；f、g：治疗后上下颌牙齿排列整齐，覆??覆盖正常，双侧磨牙及尖牙关系均为中性，中线对正。

Fig.4 Facial image, intraoral image and X-ray after orthodontic treatment

图5 矫治前后头影测量及头影测量重叠图 a、b：矫治前后患者头颅侧位片；c：重叠图显示患者上下颌前下方生长，磨牙少量近中移动，前牙内收（黑色为治疗前，红色为治疗后）。

Fig.5 Cephalometry and cephalometric overlapping diagram before and after orthodontic treatment

参考文献 18

[1]	ALSAGGAF D H, AFIFY A R, ZAWAWI K H, et al. Factors influencing the orthodontic treatment plan in Class II malocclusion[J]. Am J Orthod Dentofacial Orthop, 2022, 161(6):829-837.e1. doi:10.1016/j.ajodo.2021.01.034.
[2]	BUCUR S M, VAIDA L L, OLTEANU C D, et al. A brief review on micro-implants and their use in orthodontics and dentofacial orthopaedics[J]. Appl Sci, 2021, 11(22):10719.doi:10.3390/app112210719.
[3]	ZHU G, ZHANG B, YAO K, et al. Finite element analysis of the biomechanical effect of clear aligners in extraction space closure under different anchorage controls[J]. Am J Orthod Dentofacial Orthop, 2023, 163(5):628-644.e11. doi:10.1016/j.ajodo.2022.02.018.
[4]	AL-ANI M H, MAGEET A O. Extraction planning in orthodontics[J]. J Contemp Dent Pract, 2018, 19(5):619-623. doi:10.5005/jp-journals-10024-2307.
[5]	许天民, 刘妍, 黄微, 等. 临界病例拔牙与不拔牙矫治对颅颌面软组织形态的影响[J]. 北京大学学报(医学版), 2004, 36(6):650-654.
	XU T M, LIU Y, HUANG W, et al. Cephalometric comparison of soft-tissue morphology between extraction and non-extraction orthodontic treatment in borderline cases[J]. Journal of Peking University (Health Sciences), 2004, 36(6):650-654. doi:10.3321/j.issn:1671-167X.2004.06.022.
[6]	ARAÚJO T M, CALDAS L D. Tooth extractions in orthodontics:first or second premolars?[J]. Dental Press J Orthod, 2019, 24(3):88-98. doi:10.1590/2177-6709.24.3.088-098.bbo.
[7]	OMAR Z, SHORT L, BANTING D W, et al. Profile changes following extraction orthodontic treatment:acomparison of first versus second premolar extraction[J]. Int Orthod, 2018, 16(1):91-104. doi:10.1016/j.ortho.2018.01.017.
[8]	CHEN H, HAN B, JIANG R, et al. PASS versus MBT^TM for evaluation of anchorage control in three-dimensional measurements:a randomized controlled trial[J]. Eur J Orthod, 2021, 43(1):113-119. doi:10.1093/ejo/cjaa021.
[9]	YUAN J, ZHUANG Z, NIU L, et al. A comparative study on anterior teeth retraction-related hard and soft tissue changes with physiologic anchorage control technique[J]. Eur J Med Res, 2024, 29(1):110. doi:10.1186/s40001-024-01670-5.
[10]	邢嘉豪, 陈华, 陈敏, 等. 减数拔牙后正畸治疗中断情况下牙齿漂移的研究[J]. 口腔疾病防治, 2023, 31(10):727-732.
	XING J H, CHEN H, CHEN M, et al. Study of tooth drifts after orthodontic extractions in cases of interruption[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2023, 31(10):727-732. doi:10.12016/j.issn.2096-1456.2023.10.006.
[11]	TENG F, DU F Y, CHEN H Z, et al. Three-dimensional analysis of the physiologic drift of adjacent teeth following maxillary first premolar extractions[J]. Sci Rep, 2019, 9(1):14549. doi:10.1038/s41598-019-51057-4.
[12]	PAPAGEORGIOUSS N, ANTONOGLOU G N, MICHELOGIANNAKIS D, et al. Effect of periodontal-orthodontic treatment of teeth with pathological tooth flaring,drifting,and elongation in patients with severe periodontitis:a systematic review with meta-analysis[J]. J Clin Periodontol, 2022, 49:102-120. doi:10.1111/jcpe.13529.
[13]	ALEXANDER R G. The vari-simplex discipline. Part 1. Concept and appliance design[J]. J Clin Orthod, 1983, 17(6):380-392.
[14]	ALHAJERI K, PREMJANI P, ISMAIL A, et al. Changes in vertical dimension:extraction versus non-extraction[J]. Orthodontic Journal of Nepal, 2019, 9(1):19-27. doi:10.3126/ojn.v9i1.25685.
[15]	RITCHIE C, MCGREGOR S, BEARN D R. Temporary anchorage devices and the forces and effects on the dentition and surrounding structures during orthodontic treatment:a scoping review[J]. Eur J Orthod, 2023, 45(3):324-337. doi:10.1093/ejo/cjac072.
[16]	田炳欣, 孙立婷, 冯哲, 等. 生理性支抗Spee氏弓矫治器联合微种植支抗在垂直方向上对上颌前突患者颌平面角及颏部形态的影响[J]. 中国组织工程研究, 2022, 26(27):4330-4334.
	TIAN B X, SUN L T, FENG Z, et al. Effect of Physiological Anchorage Spee’s Wire System combined with micro-implant anchorage on jaw plane angle and chin shape in patients with maxillary protrusion in the vertical direction[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(27):4330-4334. doi:10.1166/jbn.2022.3373.
[17]	SU H, XU K, HAN B, et al. A retrospective study of factors contributing to anchorage loss in upper premolar extraction cases[J]. Niger J Clin Pract, 2022, 25(5):664-669. doi:10.4103/njcp.njcp_1791_21.
[18]	FENG Z, MA T, TIAN B, et al. Effects of titanium implant combined with nano-indentation in the vertical control of physiological anchorage spee’s wire system corrective technology[J]. J Biomed Nanotechnol, 2022, 18(6):1668-1675. doi:10.1166/jbn.2022.3373.

新型交叉颊面管对第二前磨牙拔除后的支抗效果评估

Evaluation of the anchorage effect of a new cross buccal tube in the treatment of second premolar extraction

引用本文

RichHTML

PDF (PC)

可视化

摘要/Abstract

使用本文

图/表 6

参考文献 18

相关文章 8

编辑推荐

Metrics

本文评价

[1]	刘伟涛, 孙佳, 戚琳, 邹冰爽, 周绍楠, 周彦恒. 隐形矫治器结合种植体支抗治疗拔牙患者的垂直向变化研究[J]. 天津医药, 2022, 50(7): 726-733.
[2]	刘洋, 李宁, 杨文杰, 樊盼英, 聂玉刚, 薛秀娟, 张国龙, 赵东阳△. 河南省2010—2019年新报告的青年学生HIV感染者流行病学特征及首次随访检测分析#br# #br#[J]. 天津医药, 2021, 49(5): 539-544.
[3]	张姝贤，张缨，杨晓艳，李丽华△. Toric设计角膜塑形镜矫正青少年近视合并中高度散光的近期疗效[J]. 天津医药, 2018, 46(11): 1217-1221.
[4]	孙晓雷, 马信龙, 薛惠予, 杨倩, 刘学庆, 陆静. 天津市 221 例青少年双能 X 线骨密度分析[J]. 天津医药, 2017, 45(7): 715-718.
[5]	李孝英1 ,彭诚1 ,郭奕2 ,孙维娥1 ,陈晓英1 ,王东3 . 腭侧微螺钉型种植体支抗治疗上颌前突的临床应用研究[J]. , 2014, 42(5): 487-489 .
[6]	颜丹,王建国,张锡忠. 直径对微种植体和颌骨表面影响的三维有限元分析[J]. , 2013, 41(1): 22-25 .
[7]	曾宪帆1 ,邢丹2 ,王威2 ,宋东辉2 . 显微内窥镜下腰椎间盘摘除术治疗青少年腰椎间盘突出症[J]. , 2012, 40(2): 176-176 .
[8]	冯学民1 ,秦岚2 . 青少年Graves病131I治疗前后TRAb变化与预后的关系[J]. , 2010, 38(12): 1099-1100 .