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目的 探讨青春期下颌后缩伴关节盘前移关节紊乱患者、使用Herbst治疗下颌后缩的疗效.方法 选择43例10～15岁安氏Ⅱ类伴下颌后缩患者,26例是关节盘髁关系正常的患者(G1组),17例是伴有可复性关节盘前移位的患者(G2组);对治疗前后的头颅侧位片进行数据测量,研究上下颌骨、牙及牙槽关系在治疗前后的改变,以探讨Herbst矫治器前伸下颌后,下颌、牙及牙槽的生长改建.结果 采用配对t检验、分析两组治疗前后头影测量值的改变,U1-SN(G1组:-2.55±5.93,G2组:-8.62±7.45)、ANB值(G1组:-1.39±1.83,G2组:-1.48±1.58)、OJ值(G1组:-4.88±3.09,G2组:-5.08±2.88)均显著减小,Go-Co值(G1组:3.93±2.65,G2组:3.41±2.86)增加,颏前点位置均发生前移.采用独立样本f检验统计学分析,G2组较G1组U1SN值减小(P＜0.006)、U1-L1角度的增加(P＜0.003)均有显著性差异.其余指标无统计学差异.结论 Herbst矫治Ⅱ类下颌后缩,关节盘正常的患者下颌骨前移效果更为明显.“,”Objective To investigate the effects of anterior disc displacement on Herbst in the treatment of mandibular retraction by using cephalometric.Methods Forty-three cases of 10-15 years old Class Ⅱ malocclusion with mandibular retrusion patients were chosed.Among them,26 cases with normal articular disc condyle relationship were included in group G1,and 17 cases with disc anterior displacement were included in group G2.By cephalometric analysis,we studied the changes of sagittal relationship between maxilla and mandible,teeth and alveolar relationship,and to investigate the growth modification in mandible,teeth and alveolar.after mandibular functional protrusion using the Herbst appliance.Results By cephalometric analysis using paired t test before and after treatment in the two groups,U1-SN(G1 group:-2.55±5.93,G2 group:-8.62±7.45)、ANB(G1group:-1.39 ± 1.85,G2 group:-1.48± 1.58) 、OJ(G1 group:-4.88±3.09,G2 group:-5.08 ± 2.88),the values after treatment were significantly reduced.Go-Co value was increased after treatment (G1grouPp:3.93± 2.65,G2 group:3.41 ± 2.86),pogonion position were moved forward.After statistical analysis using Independent-Samples t Test,the U1-SN value of G2 group was reduce significantly lower than G1 group (P＜0.006),and U1-L1 value increase more than G1 group (P＜0.003).There was no significant difference in other indexes.Conclusions The patients with Angle class Ⅱmalocclusion and mandibular retrusion with normal disc positions showed greater degree of mandibular advancement by treatment with Herbst.