微种植体支抗联合自制式滑动杆单侧推磨牙向后的临床应用

微种植体支抗联合自制式滑动杆单侧推磨牙向后的临床应

用

［摘要 ］目的：探讨运用微种植体支抗联合自制式滑动 杆单侧推磨牙向后的应用要点。方法：选择安氏□类亚类错 牙合7例（男2例，女5例），年龄15?30岁，平均18.7岁 轻中度拥挤，拥挤度平均 4?5mm，或伴上中线偏移，或侧 貌较突者。采用单侧植入微种植体支抗钉联合自制式滑动杆 推磨牙向后，恢复上下磨牙的中性关系，保持上颌磨牙两侧 对称，推力250g。疗程3?5个月，平均4个月。通过临床 评价和矫治前后的照片和模型分析其治疗的有效性。结果：

7 例患者有效地应用微种植体支抗联合自制式滑动杆单侧推 磨牙向后，矫正了单侧磨牙H类远中关系、轻中度拥挤、中 线偏移或恢复上颌磨牙两侧对称，取得较好的临床疗效。远 移侧上颌第一磨牙远中平均移动 4.2mm，平均移动速度 1.05mm/月。结论：微种植体支抗联合自制式滑动杆单侧推 磨牙向后，发挥了绝对强支抗作用，有效地远中移动上颌磨 牙，容易取得患者配合，取材容易制作简便，有临床推广价 值。

［关键词 ］微种植体支抗；滑动杆；磨牙远中移动；安氏

□类错牙合

[中图分类号 ]R783.5 [ 文献标志码 ]A [文章编 号］1008-6455 ( 2015) 14-0057-04

Abstract ： Objective To evaluate the clinical application of unilateral distalization of maxillary molars in class II malocclusion with micro- implant anchorage joint sliding jig. Methods 7 Class II , subdivision malocclusion patients with I - n° Crowding or midline shifting or profile protrusion (5 females and 2 males)were selected as the subjects， aged from 15 to 30 years old ( 18.7 on average)， All the patients were treated by distalizing the unilateral upper molar with micro- implant anchorage joint sliding jig.The micro-implant was embedded in buccal alveolar bone between maxillary second premolar and first molar.The duration for distalization of upper molars was from 3 to 5 months( about 4 months on average).This study had measured pre-and-post treatment changes in velocity， distance and position of the maxillary first molar through casts and photos. Results All the 7 cases were corrected the midline and Class II malocclusion ， aligned the teeth.The maxillary molars were bodily distalized by 4.2

mm ， 1.05/M. Conclusion The results of this study have shown that the micro?Cimplant placed in the alveolar bone joint sliding jig provided a absolute anchorage for distalization of maxillary molars.It is an effective

and reliable method for distalizing maxillary molars without the loss of anchorage.This method requires minimal patient compliance and also shortens the whole treatment period and is easy to insert and remove.

Key words ：micro-implant ；sliding jig ；molar distalization ； Angle ' s class II malocclusion

Angle H类错牙合畸形是临床上较为常见的错牙合畸形， 有的是属于临界病例，可以采用拔牙或不拔牙的方法矫治。 随着矫治理念的转变和矫治技术的不断提高，许多病例推磨 牙向远中的方法来获得间隙 [1] ，取得较为满意的矫治效果。 推磨牙向后是难题之一，单侧不对称的远中移动上颌磨牙更 难。对于单侧磨牙H类关系，一侧轻中度拥挤、中线偏移或 上颌牙弓不对称等情况，不得不采用单侧推上颌磨牙向远中 的方法矫治。传统的推磨牙向远中的方法有钟摆矫治器、 Jones Jig 矫治器和头帽口外弓等 [2]，但这些治疗方法对患者 的依从性要求高、副作用大，限制了其临床应用 [3] 。本研究 介绍一种微种植体支抗联合自制式滑动杆的结构、组成与制 作，探索一种更为优越有效的单侧不对称推磨牙向后的方