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目的通过分析改良Twin-block矫治器治疗安氏I 类1分类错牙合的临床效果,探讨增加Twin-block矫正器的骨效应,减少牙效应的有效方法.方法随机选择26例手腕骨片为FG-G期的安氏I 类1分类下颌后缩儿童分为两组,其中T1组13例(男6例,女7例),平均年龄11.5岁,采用传统Twin-block矫正器治疗;T2组13例(男5例,女8例),平均年龄11.7岁,采用增加了高位牵引头帽及下颌切牙帽,并去除上颌唇弓的改良式Twin-block矫正器治疗,对两组治疗前后头颅X线侧位片进行Pancherz测量分析,评价矫治效果.结果与T1相比较,T2组SNA角、ANB角、A-FHp、MP/SN、U6-CFH、L1L1’/MP的变化均有统计学意义(P<0.05).结论增加口外弓高位牵引,可明显抑制上颌矢状生长及上颌磨牙萌出,稳定下颌平面角度,去除上颌唇弓并增加下切牙帽可减少切牙倾斜,下颌前移量也得到增加.此种改良对提高改善I 类错牙合的骨骼效应,减少牙效应十分有效.,Objective To investigate the treatment effect of class II division 1 malocclusion produced by the modified Twin-block appliance, finding the effective methods to maximize the skeletal effect and minimize the dentoalveolar effect. Method The study consisted of 26 children with class II division 1 malocclusion and retrognathic mandible. T1 group(6 boys 7 girls, average 11.5years old)treated with traditional Twin-block appliance,T2 group(5 boys 8 girls, average 11.7 years old)treated with modified Twin-block appliance. Cephalometric data were collected at the start and the end of the study and statistical analysis were applied. Results Compared with the T1 group, SNA、ANB、A-FHp、MP/SN、U6-CFH 、L1L1’/MP were statistically significant(P<0.05)in T2 group. Conclusion The addition of Headgear to the appliance resulted in effective control of the maxillary in sagittal direction and the upper molar in vertical direction. Adding lower incisors cap and dislodging the upper labial bow could prevent upper incisors retroclined and lower incisors proclined excessively. These modifications could control the mandible plane, enhance the mandible protruion and maximize the Class II skeletal correction effect.