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目的:探讨已行双颌手术的骨性安氏Ⅲ类错患者治疗前、正颌手术前正畸后和治疗完成后拔与不拔上颌第一前磨牙的上、下颌骨硬组织结构差异。方法:研究对象为均已行上颌骨Le Fort I型前移和下颌骨矢状劈开后退术的骨性安氏Ⅲ类错畸形伴上颌骨发育不足和下颌骨发育过度的患者。研究对象被分成两组:术前正畸拔除上颌第一前磨牙组15例,未拔牙组16例。摄取治疗前(T1)、正颌手术前正畸后(T2)、治疗完成后(T3)的头颅侧位定位片分析测量9个指标值,采用SAS 8.02软件包对数据进行团体t检验。结果:治疗前(T1)拔牙与非拔牙组上牙槽角(SD-SN)有显著差异(P<0.05)。正颌手术前正畸后(T2)下中切牙角(L1-MP)和覆盖有显著差异(P<0.05)。治疗后(T3)下中切牙角(L1-MP)有显著差异(P<0.05)。其他各测量项目均无统计学差异,P>0.05。结论:拔牙组在治疗前骨组织的结构形态上上牙槽骨较非拔牙组更前突,通过术前拔牙正畸内收上前牙长轴后得以改善。正颌手术前正畸后拔牙组下前牙去代偿较非拔牙组更明显,下前牙更直立。
OBJECTIVE: To investigate the difference of hard tissue between mandibular first premolar and mandibular first premolar before and after orthodontic treatment and post-treatment orthognathic surgery . Methods: The subjects were all patients with skeletal Class Ⅲ malocclusion associated with maxillary Le Fort Ⅰ advancement and mandibular sagittal split kyphosis with underdeveloped maxilla and mandibular overgrowth. Subjects were divided into two groups: preoperative orthodontic removal of maxillary first premolar group 15 cases, 16 cases of non-extraction group. Nine indexes were measured before treatment (T1), orthodontics after orthognathic surgery (T2), and after the treatment was completed (T3). SAS 8.02 software package was used for group t test. Results: Before treatment (T1) there was a significant difference in SD-SN between the two groups (P <0.05). There was a significant difference (P <0.05) between L1-MP and coverage after orthodontics (T2) before orthognathic surgery. After treatment (T3), the median incisor angle (L1-MP) was significantly different (P <0.05). Other measurement items were no significant difference, P> 0.05. Conclusion: In the tooth extraction group, the shape of the upper alveolar bone is more anterior than that in the non-extracavitary group before treatment, which can be improved by adducing the long axis of anterior tooth in preoperative extraction orthodontics. Orthodontics before orthognathic surgery after extraction of the lower anterior teeth group to compensate more than the non-extracavitary group more obvious, the lower anterior teeth more upright.