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目的探讨铸造夹板式Herbst矫治器和方丝弓矫治器双期矫治AngleⅡ2类错的机制和效果。方法选取30例FG-G期恒牙列AngleⅡ2类错患者,平均分为Herbst治疗组和对照组,两组患者均采用非拔牙矫治。其中,Herbst组15例,采用铸造夹板式Herbst矫治器和方丝弓矫治器双期矫治;对照组15例,采用方丝弓矫治器辅以头帽口外弓后推磨牙治疗。Herbst组和对照组的所有患者均在治疗前、后拍摄头颅定位侧位片,进行矫治前后、颌、面矢状向和垂直向上的头影测量分析,并做统计学处理。结果两组患者均达到了磨牙中性关系,前牙达到正常的覆盖、覆关系,但是治疗组的疗程明显的短于对照组。结论方丝弓矫治器固定矫治法和Herbst矫治器、方丝弓矫治器双期矫治法均能有效地矫治AngleⅡ2类错;但前者主要通过牙齿的变化发挥矫治效能,而后者则主要通过Herbst矫治器刺激下颌骨生长、促进下颌骨前移等骨性变化发挥矫治效能、并且有利于患者面型的改善。
Objective To investigate the mechanism and effect of casting distracting Class Ⅱb malocclusion by cast splint Herbst appliance and square arch appliance. Methods Thirty patients with Angle Ⅱ class Ⅱ malocclusion of FG-G permanent dentition were divided equally into Herbst treatment group and control group. Both groups were treated by non-extraction treatment. Among them, Herbst group of 15 cases, the use of cast plywood Herbst orthodontic appliance and square wire appliance double treatment; control group of 15 patients, the use of silk wire appliance supplemented with head and hatch outside the bow after molars. All the patients in the Herbst group and the control group were taken cephalometric radiographs before and after treatment, and the cephalometric analysis was performed before, after, and after sagittal, sagittal, sagittal and vertical. Results The two groups of patients reached the molars neutral relationship, and the anterior teeth reached the normal coverage and rectal relationship, but the course of treatment in the treatment group was obviously shorter than that in the control group. Conclusion Square wire appliance fixation and Herbst appliance and square wire appliance double appliance can effectively correct AngleⅡ2 malocclusion. However, the former is mainly used to correct orthodontic effect through the change of teeth, while the latter is mainly through Herbst The appliance stimulates the growth of the mandible and promotes the orthognathic and skeletal changes such as the mandibular advancement. It also helps to improve the patient's face shape.