中国实用口腔科杂志

中国实用口腔科杂志

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PAR指数与头影测量对拔除下颌第一磨牙矫治效果临床评价

王庆琳，何永坚，周少云，马明玉，李荣霞   

  1. 广州医科大学附属第二医院口腔正畸科，广东  广州  510260
  • 出版日期:2017-11-15 发布日期:2017-12-14

  • Online:2017-11-15 Published:2017-12-14

摘要：

目的    分析下颌第一磨牙拔除的错牙合畸形患者的正畸治疗效果。方法    选取2007—2016年广州医科大学附属第二医院口腔正畸科就诊的因龋病或根尖周病变拔除下颌第一磨牙患者19例。所有病例均采用MBT直丝弓矫治器矫治，滑动法关闭间隙并配合颌间牵引完成矫治，对比正畸前后PAR指数和头影测量值。结果    19例患者平均疗程（33.47±7.93）个月，治疗前后PAR加权总分及各项PAR分值差异均有统计学意义（P＜0.05）。PAR疗效分析显示极大改善13例（68.42%），改善6例（31.58%），无治疗后变差或无改变病例。治疗前后U1-SN角、U1-NA、U1-NA角减少值差异均有统计学意义（P＜0.05），其余指标差异均无统计学意义（P＞0.05）。结果显示拔牙间隙关闭，牙牙合关系良好；上切牙内收，软组织侧貌协调。结论    拔除下颌第一磨牙病例只要严格把握适应证，合理设计，严谨操作，可以获得满意的临床矫治效果。

关键词: PAR指数, 头影测量, 下颌第一磨牙拔除, 疗效评价

Abstract:

Objective    To access the clinical effect of orthodontic treatment for patients undergoing extraction of mandibular first molar. Methods    Nineteen patients（three male and sixteen female）undergoing extraction of mandibular first molar because of caries or periapical disease were collected，who were treated in the Second Hospital Affiliated to Guangzhou Medical University from 2007 to 2016. All the patients were treated with orthodontic space closure using MBT preadjusted appliance and sliding mechanics and class Ⅱ or class Ⅲ elastics. Cephalometric films and casts that were taken before and after orthodontic treatment were measured and analysed. Results    The average treatment time was（33.47±7.93）months. Thirteen cases（68.42%）were evaluated as greatly improved，six cases（31.58%）as improved，and no cases were evaluated as worse or no difference after treatment；the difference in weighted PAR score and each of the PAR score were statistically significant （P < 0.05）. There were significant changes in U1-NA，U1-NA and U1-SN （P < 0.05），but not in the rest of the values （P > 0.05）. Extraction spaces of mandibular first molars were closed. Good occlusal relationships and soft tissue profiles were achieved in all cases. Conclusion    The first molar extraction could achieve satisfactory results under strict planning，appropriate control and careful clinical operation.

Key words: PAR index, cephalometrics, mandibular first molar extraction, effect evaluation