Dentoalveolar compensation in skeletal Class Ⅲ patients treated with orthognathic surgery

目的 分析骨性Ⅲ类错(牙合)手术患者上下颌前牙的代偿特征,以期为临床提供患者术前牙颌代偿的数据参考.方法 选取2011年11月至2015年1月于北京大学口腔医学院·口腔医院进行正畸-正颌联合治疗的54例成年骨性Ⅲ类错(牙合)患者,取治疗前头颅侧位X线片,进行头影测量,并与北京大学口腔医学院·口腔医院建立的中国汉族正常(牙合)相应数据进行单样本t检验;对患者骨性测量项目与牙性测量项目进行Pearson相关性分析;根据颌骨矢状向和垂直向关系将患者分成4组,A组:ANB角＜-4°,SN-MP角≤37.7°,11例;B组:ANB角≥-4°,SN-MP角≤37.7°,16例;C组:ANB角＜-4°,SN-MP角＞37.7°,14例;D组:ANB角≥-4°,SN-MP角＞37.7°,13例.对4组牙颌测量项目进行单因素方差分析和SNK法多重比较.结果 骨性Ⅲ类错(牙合)上前牙较正常(牙合)更唇倾(P＜0.01),下前牙较正常(牙合)更舌倾(P＜0.01).矢状向和垂直向骨型均与上下前牙位置有一定相关性(P＜0.05).4组患者上切牙倾斜度及突度代偿差异均无统计学意义(P＞0.05);A组下切牙舌倾及舌向移位代偿最明显[L1-NB角、L1-NB距分别为(14.2°±5.9°)和(2.2±1.9) mm],而D组代偿最轻[L1-NB角、L1-NB距分别为(23.7°±7.5°)和(6.3±2.6)mm].结论 骨性Ⅲ类错(牙合)上前牙唇倾代偿,下前牙舌倾代偿;不同骨面型上下前牙的代偿特征各有不同,去代偿时应区别处理.Objective To investigate the compensation of the upper and lower incisors in skeletal Class Ⅲ patients treated with orthodontic-surgical approach.Methods The samples consisted of 54 skeletal Class Ⅲ patients treated with orthodontic-surgical approach from November 2011 to January 2015.Lateral cephalograms were taken before treatment.The differences between the samples and the norms from Peking University normal occlusion sample library were assessed using independent-sample t test.Correlation analyses were performed to find associations between skeletal and dental parameters.According to skeletal anteroposterior discrepancy/vertical type (ANB/SN-MP), the samples were allocated into group A (ANB＜-4°, SN-MP≤37.7°, n=1 1), group B (ANB≥-4°, SN-MP≤37.7°, n=16), group C (ANB＜-4°, SN-MP＞ 37.7°, n=14), and group D(ANB≥-4°, SN-MP＞37.7°, n=13).After measurement of variables, one-way ANOVA with SNK multiple comparison test were performed.Results The maxillary incisors were more proclined and the mandibular incisors more retroclined in skeletal Class Ⅲ patients compared with norm values(P＜0.01).Both skeletal anteroposterior discrepancy and vertical type were correlated with the position of upper and lower incisors(P＜0.01).According to skeletal anteroposterior discrepancy/vertical type, no significant differences were found in the upper incisors' inclination among the four groups, while patients in group A and group D exhibited significant difference in lower incisor compensation.Conclusions Different skeletal anteroposterior discrepancy/vertical type resulted in varied incisors' compensation.Therefore,decompensation should be treated differently.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)11656-6605