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目的:应用Tweed-Merrifield分析法,观察不同Z角标准对正畸矫治难度指数分布情况的影响。方法:对156例安氏II类错进行Tweed-Merrifield鉴别诊断分析,所有病例进行两次难度指数计算,第一次完全按Tweed-Merrifield标准进行计算,为Tweed-Merrifield标准组,第二次将其中的Z角标准值按傅民魁标准计算,为傅民魁标准组。比较两组在治疗难度指数分布上的差异。结果:Tweed-Merrifield标准组中,治疗难度指数轻度22例(14.10%);中度72例(46.16%);重度62例(39.74%)。傅民魁标准组中,治疗难度指数轻度33例(21.15%);中度81例(51.92%),而重度42例(26.92%)。x2检验提示二者有显著的统计学差异(P<0.05)。Tweed-Merrifield标准下,样本的Z角难度指数均值为19.01±11.49;傅民魁标准下,样本Z角难度指数均值为11.71±12.63,二者有显著的统计学差异(P<0.01)。按两种不同标准值计算得出的Z角治疗难度指数均随治疗难度的增加而增加。结论:由于人种的差异,头影测量指标的正常值范围不同,得出的治疗难度也会不同,治疗追求的目标也不完全一致。在应用Tweed-Merrifield鉴别诊断系统进行诊断分析时,总难度指数分值应与各观察单因素相结合,从而客观、准确地反映患者的颅面和牙列特征。
Objective: To observe the influence of different Z-angle standards on the distribution of difficulty index of orthodontic treatment by Tweed-Merrifield analysis. Methods: 156 cases of Class II malocclusion were analyzed by Tweed-Merrifield differential diagnosis. The difficulty index was calculated twice in all cases. The first time was completely calculated according to Tweed-Merrifield standard, which was Tweed-Merrifield standard group. The second time Among them, the standard value of Z angle is calculated according to the standard of Fu Minkui and is the standard group of Fu Minkui. Differences in the distribution of treatment difficulty index were compared between the two groups. Results: In the Tweed-Merrifield standard group, the treatment difficulty index was mild in 22 cases (14.10%), moderate in 72 cases (46.16%) and severe in 62 cases (39.74%). Fu Minkui standard group, the treatment index of mild degree of 33 cases (21.15%); moderate in 81 cases (51.92%), and severe in 42 cases (26.92%). x2 test showed a significant difference between the two (P <0.05). Under the Tweed-Merrifield criterion, the average Z-angle difficulty index of samples was 19.01 ± 11.49. The mean Z angle difficulty index of samples was 11.71 ± 12.63 at Fu Min-kui standard, with significant statistical difference (P <0.01). According to two different standard values calculated Z angle of treatment difficulty index increased with the difficulty of treatment increased. CONCLUSION: Because of the differences in race, the normal range of cephalometric measures varies from treatment to treatment, and the goals of treatment are not exactly the same. When using the Tweed-Merrifield differential diagnosis system for diagnostic analysis, the total difficulty index score should be combined with each observation single factor to objectively and accurately reflect the craniofacial and dentition features of patients.