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目的探讨拔除下颌第二磨牙治疗轻中度骨性Ⅲ类错畸形之临床效果及术后稳定性。方法选择轻度或中度骨性Ⅲ类错畸形患者8例,性别不限,年龄>12周岁,ANB角为0°~4°;磨牙和(或)尖牙为近中关系;上颌骨发育基本正常,拥挤度<3 mm,第三磨牙形态及位置无明显异常。全部患者采取拔除37、47结合直丝弓矫治技术治疗,治疗前、后,分析常规头颅侧位片。结果治疗后,前牙取得正常覆覆盖关系,下中切牙角减少1.65°,差异无统计学意义(P=0.142)。ANB增加1.35°,差异有统计学意义(P<0.05)。磨牙及尖牙均建立中性关系,后继第三磨牙基本达正常位置,取代第二磨牙并与对颌建立咬。结论对于轻中度Ⅲ类错合患者,与传统拔除四个第一前磨牙的设计相比,拔除37、47结合直丝弓矫治技术治疗可达到满意疗效。
Objective To investigate the clinical effect and postoperative stability of mandibular second molars in the treatment of mild to moderate skeletal class Ⅲ malocclusion. Methods Eight patients with mild or moderate skeletal class Ⅲ malocclusion were enrolled in this study. Their gender, age> 12 years, ANB angle was 0 ° ~ 4 °. The molar and / or canine were close to each other. The maxillary Development was normal, the degree of congestion <3 mm, the third molars morphology and location no significant abnormalities. All patients with removal of 37,47 combined with straight wire appliance treatment, before and after treatment, analysis of conventional cephalometric films. Results After treatment, the anastomosis of the anterior teeth achieved normal coverage, and the lower incisor angle was decreased by 1.65 °, with no significant difference (P = 0.142). ANB increased 1.35 °, the difference was statistically significant (P <0.05). Molar and canine are to establish a neutral relationship, followed by the third molar basically up to replace the second molar and the jaw to establish bite. Conclusions For patients with mild to moderate class III malocclusion, compared with the traditional design of removing the four first premolar teeth, the removal of 37,47 combined with straight wire arch correction treatment can achieve satisfactory results.