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目的应用固定式平面导板配合种植钉牵引,采用非减数方法矫治安氏Ⅱ类深覆牙合,探讨其临床要点。方法 2009—2012年在广州市荔湾区口腔医院就诊的安氏Ⅱ类错牙合伴有轻度上颌前突或下颌轻度后缩患者41例,其中安氏Ⅱ~1错牙合患者21例,Ⅱ~2错牙合患者20例。采用上颌选择性拔除第三恒磨牙,下颌不拔牙或拔除第三磨牙,矫正器采用Smart-clip系列自锁托槽直丝弓矫治器,选用A1自攻型不锈钢微种植钉,在颧牙槽嵴区第一磨牙和第二磨牙交界区植入;制作固定式平面导板打开咬合,排齐整平后利用种植钉整体内收前牙,竖直磨牙或推磨牙向后,调整覆牙合覆盖及尖、磨牙关系至正常。结果 41例患者除2例种植体松动脱落,其余患者第一磨牙在前后向和垂直向均未发生显著性移动,患者颜面侧貌得到了明显改善,取得了较为满意的治疗效果。与矫治前相比,矫治后安氏Ⅱ~1患者SNA角、U6-Y距、覆牙合及覆盖明显减小,差异均有统计学意义(P<0.05);安氏Ⅱ~2患者U1-Y距、U1-X距及覆牙合明显减少,覆盖明显增加,差异均有统计学意义(P<0.05)。结论平面导板配合种植钉能够有效治疗安氏Ⅱ1和Ⅱ2错牙合患者,并达到竖直磨牙或推磨牙向后效果;对安氏Ⅱ类错牙合伴有轻度上颌前突或下颌轻度后缩患者,可选择非减数矫治。
Objective To investigate the clinical features of Angle Ⅱ deep overbite occlusion by non-reduction method with fixed flat guide plate and implanting nail traction. Methods From 2009 to 2012, 41 cases of Class Ⅱ malocclusion accompanied by mild maxillary protrusion or mild retrusion in Liwan District Stomatological Hospital of Guangzhou City were involved. Among them, 21 cases were malocclusion Ⅱ ~ 1 malocclusion, , Ⅱ ~ 2 malocclusion patients in 20 cases. Using the maxillary selective removal of the third permanent molars, mandibular extraction or removal of the third molars, straighteners using Smart-clip series of self-ligating brackets straight wire appliance, the selection of A1 self-tapping stainless steel micro planting pin, in the zygomatic alveolar Ridges of the first molars and the second molars at the junction of the implants; production of fixed flat guide plate open bite, aligning and leveling the use of planting spikes adduction of the entire front teeth, vertical molars or molars to adjust the coverage of overbite and Sharp, molar relationship to normal. Results Except for 2 cases, the rest of the first molar did not move in the anterior, posterior, and vertical directions. The facial appearance of the patients was significantly improved and the satisfactory results were obtained. Compared with those before treatment, the SNA angle, U6-Y distance, occlusal coverage and coverage in Angle Ⅱ ~ 1 patients after treatment were significantly decreased (P <0.05); Angle Ⅱ ~ 2 patients U1 -Y distance, U1-X distance and overbite significantly decreased, covering significantly increased, the difference was statistically significant (P <0.05). Conclusion Plane guide plate with implant nail can effectively treat Angle Ⅱ 1 and Ⅱ 2 malocclusion patients and reach the vertical molar or molars backward effect; Class Ⅱ malocclusion accompanied by mild maxillary protrusion or mandibular mild Retarded patients, may choose non-subtraction correction.