摘要目的 评价上颌快速扩弓(rapid maxillary expansion,RME)联合多曲方丝技术(multiloop edgewise arch wire,MEAW)矫治年轻成人骨性反(牙合)伴下颌偏斜畸形的临床疗效.方法 选择成年安氏Ⅲ类骨性错(牙合)伴下颌偏斜患者9例,年龄16.2～18.8岁,采用上颌快速扩弓纠正单侧后牙反(牙合),多曲方丝技术配合颌问牵引调整咬合关系,纠正下颌及中线偏斜.矫治前后拍摄头颅侧位片和正位片,并进行X线头影测量分析.结果 (1)矢状方向上,SNA增大(1.4±1.7)°,SNB减少(0.7±0.9)°,ANB增加(2.1±0.9)°,颌骨前后向不协调减轻;U1-SN,L1-MP矫治前后分别增加(2.7±3.7)°和减少(5.4±2.9)°,前牙覆盖减少(3.8±1.0)mm.(2)垂直方向上,MP-SN和MP-FH分别增加(1.9±2.0)°和(1.1±2.6)°,矫治前后差异均无统计学意义.(3)矫治前后Maz-Maz'增加(2.6±2.8)mm,Um-Um'增加(6.2±5.9)mm,后者矫治前后差异具有统计学意义.(4)矫治前后,△Cd-Me和△Cd-Go分别减少(3.7±2.1)mm和(2.8±1.6)mm;ManDP-MSL和Me-MSL分别减少(3.8±2.3)mm和(3.6±2.5)mm,矫治前后差异均具有统计学意义.结论 上颌快速扩弓联合多曲方丝技术可以有效地矫治年轻成人轻、中度骨性反(牙合)伴下颌偏斜畸形,纠正异常咬合关系,改善颜面部不对称畸形.

abstractsObjective To evaluate the effects of multiloop edgewise arch wire(MEAW)technique combined with rapid maxillary expansion(RME)in correcting skeletal crossbite young adults with mandibular deviation.Methods 9 young adults with skeletal class Ⅲ malocclusion and mandibular deviation were selected(4 males,5 females,aged from 16.2-18.8 years).They were all corrected with RME and MEAW techniques.Cephalometric radiographs were taken and analyzed at the pretreatment(T1)and post-treatment(T2).Students't-test was used to determine if there were significant differences between the 2 time periods.Results SNA increased by(1.4+1.7)°,SNB decreased by(0.7+0.9)°,and ANB increased by(2.1+0.9)°;U1-SN increased by(2.7+3.7)°and L1-MP decreased by(5.4+2.9)°.MP-SN and Mp-FH increased by(1.9+2.0)°and(1.1+2.6)°respectively,neither of which had significant difference.Maz-Maz' increased by(2.6+2.8)mm,while Um-Um'increased by(6.2+5.9)mm.The latter had significant difference.△Cd-Me and △Cd-Go decreased by (3.7+2.1)mm and(2.8+1.6)mm respectively;while ManDP-MSL and Me-MSL decreased by (3.8+2.3)mmand(3.6+2.5)mm,respectively.All of them had significant differences.Conclusion MEAW technique combined with RME is a clinically effective method for correcting adults with mild and moderate skeletal crossbite and mandibular deviation.