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目的探讨正颌外科治疗骨性Ⅲ类错的临床效果。方法以南昌大学附属口腔医院颌面外科2007年1月~2013年1月收治的32例骨性Ⅲ类错患者为研究对象,采用X线头颅定位片头影测量方法分析所有接受正颌外科治疗患者的前后软、硬组织变化情况。结果与治疗前比较,治疗后患者的SNA角、■-NA距、ī-NB距、ī-NB角、ī-1角、OP-SN角、GoGn-SN角、IMPA、FMA变化不明显,差异无统计学意义(P>0.05);SNB角、SND角、ANB角、■-NA角、Pg-NB角、SE角、SL角、FMIA均有显著变化,差异有统计学意义(P<0.05),且SNB角、SE角、SL角恢复至正常值(P>0.05)。患者的S-N′-Sn和Z角无明显变化,差异无统计学意义(P>0.05),S-N′-Si角、Ls-SnPn角、N′-Sn-Pg′角、N′-Sn距、Ls-E距、S-N′-Pg′角显著减小且Sn-N′-Si角、N′-Me′距、Sn-Me′距、Li-E距显著增加,差异有统计学意义(P<0.05)。结论骨性Ⅲ类错中ANB角在-4°~-6°的患者采取下颌骨矢状劈开截骨术疗效显著,患者颜面部形态恢复良好,值得临床推广应用。
Objective To investigate the clinical effect of orthognathic surgery in the treatment of skeletal class Ⅲ malocclusion. Methods 32 cases of skeletal Class Ⅲ malocclusion treated by Department of Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanchang University from January 2007 to January 2013 were selected as the study subjects. X-ray skull positioning cephalometry was used to analyze the clinical data of all patients undergoing orthognathic surgery Before and after the soft and hard tissue changes. Results Compared with those before treatment, the SNA angle, the -NA distance, ī-NB distance, ī-NB angle, ī-1 angle, OP-SN angle, GoGn-SN angle, IMPA and FMA were not significantly changed after treatment. (P> 0.05). SNB angle, SND angle, ANB angle, ■ -NA angle, Pg-NB angle, SE angle, SL angle and FMIA all had significant differences (P < 0.05), and SNB angle, SE angle, SL angle returned to normal (P> 0.05). There was no significant difference in SN’-Sn and Z angle between the two groups (P> 0.05), SN’-Si angle, Ls-SnPn angle, N’-Sn- Ls-E distance and SN’-Pg ’angle were significantly decreased and the Sn-N’-Si angle, N’-Me’-spacing, Sn-Me’-spacing and Li-E spacing were significantly increased, with significant difference (P <0.05). Conclusions In patients with skeletal Class Ⅲ malocclusion, the sagittal split osteotomy in ANB angle from -4 ° to -6 ° has a significant effect. The facial shape of the patients recovered well and is worthy of clinical application.