【摘要】：目的：自鎖托槽是近年來(lái)較為流行的一種固定矯治器。與傳統(tǒng)托槽相比，自鎖托槽在臨床使用中有諸多的優(yōu)勢(shì)，如摩擦力較小，椅旁時(shí)間較短，舒適度好等。但關(guān)于自鎖托槽是否能夠擴(kuò)大牙弓，減少拔牙，又不致使切牙過(guò)度唇傾，國(guó)內(nèi)外研究均有很大爭(zhēng)議。本研究旨在評(píng)價(jià)自鎖托槽對(duì)非拔牙患者正畸治療前后牙弓形態(tài)及顱面部軟硬組織的變化，以探討自鎖托槽對(duì)牙列及顱面形態(tài)的影響，為自鎖托槽在臨床中更好的應(yīng)用提供依據(jù)。 方法:選取40例非拔牙矯治病例，其中20例使用傳統(tǒng)直絲弓托槽，20例使用3B自鎖托槽進(jìn)行矯治。制作正畸治療前后的患者上、下頜模型，拍攝患者頭顱側(cè)位片。對(duì)模型和頭顱側(cè)位片的標(biāo)志點(diǎn)進(jìn)行多項(xiàng)測(cè)量：①測(cè)量治療前上下牙弓擁擠度；○2測(cè)量治療前后上頜的牙弓寬度（包括：牙弓尖牙牙尖寬度、第一前磨牙頰尖寬度、第一前磨牙中央窩寬度、第二前磨牙頰尖寬度、第二前磨牙中央窩寬度、第一磨牙近中頰尖寬度、第一磨牙中央窩寬度）；○3治療前后牙弓長(zhǎng)度（包括牙弓前、中、全段長(zhǎng)度）�！�4治療前后頭顱側(cè)位片能反應(yīng)骨面型和上下切牙唇傾度和凸度的共13個(gè)項(xiàng)目（∠SNA、∠SNB、∠ANB、Yaxis、∠U1-L1、U1-NA、∠U1-NA、L1-NB、∠L1-NB、UL-EP、LL-EP、Z角、N’-Sn-Pg）。測(cè)量結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果： 1)治療前兩組患者的上、下牙弓擁擠度無(wú)明顯差異（P0.05），均為輕～中度擁擠，兩組樣本特征相似，具有可比性。 2)治療后兩組患者的上頜牙弓寬度均較治療前增加，尤其是上頜前磨牙區(qū)寬度增加明顯（P0.05）。自鎖托槽組雙尖牙區(qū)寬度的增加較傳統(tǒng)組明顯，但兩者的差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。 3)治療后兩組患者的上、下頜牙弓長(zhǎng)度均較治療前增加（P0.05）。自鎖托槽組牙弓前段長(zhǎng)度的增加較傳統(tǒng)組明顯，而傳統(tǒng)組牙弓中段長(zhǎng)度的增加較明顯，但兩者的差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。4)治療后兩組患者的上、下牙弓周長(zhǎng)均較治療前增加（P0.05）。自鎖 托槽組上下牙弓周長(zhǎng)的增加較傳統(tǒng)組明顯，但兩者的差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。5)頭影測(cè)量結(jié)果顯示：自鎖組患者出現(xiàn)下前牙唇傾，唇部形態(tài)無(wú)前突。 兩組托槽的差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。結(jié)論：對(duì)于牙列擁擠的非拔牙矯治，無(wú)論采用自鎖托槽還是傳統(tǒng)直絲 托槽，都具有增加牙弓寬度、牙弓長(zhǎng)度及牙弓周長(zhǎng)的作用，自鎖托槽對(duì)雙尖牙區(qū)寬度的增加較為明顯，但兩者之間的差異無(wú)統(tǒng)計(jì)學(xué)意義。自鎖托槽仍會(huì)引起前牙唇傾及側(cè)貌改變。與傳統(tǒng)直絲托槽相比，自鎖托槽并不能顯著擴(kuò)大牙弓，減少拔牙。
[Abstract]:Objective: self-locking bracket is a popular fixed appliance in recent years. Compared with the traditional bracket, the self-locking bracket has many advantages in clinical use, such as less friction, shorter chair time, good comfort and so on. However, there is a lot of controversy at home and abroad about whether the self-locking bracket can expand the dental arch, reduce the extraction of teeth, and do not lead to excessive lip inclination of incisors. The purpose of this study was to evaluate the changes of dental arch morphology and craniofacial soft and hard tissue before and after orthodontic treatment in patients with non-extraction, so as to explore the effect of self-locking bracket on dentition and craniofacial morphology, and to provide evidence for better clinical application of self-locking bracket. Methods: 40 cases of non-extraction orthodontic treatment were selected, of which 20 cases were treated with traditional straight wire arch bracket and 20 cases with 3B self-locking bracket. The upper and lower jaw models were made before and after orthodontic treatment, and lateral cephalometric films were taken. The marking points of the model and lateral cephalometric radiography were measured as follows: (1) the congestion of upper and lower dental arch was measured before treatment; 02 the width of maxillary arch was measured before and after treatment (including: cusp width of dental arch, buccal tip width of first premolar, width of central fossa of first premolar, width of buccal tip of second premolar, width of central fossa of first premolar, width of central fossa of second premolar, The width of the first molar near the middle buccal tip and the width of the central fossa of the first molar); 03 the length of dental arch before and after treatment (including the length of anterior, middle and full segment of dental arch). 04 the lateral cephalic film before and after treatment can reflect the bone surface type and upper and lower incisor lip inclination and convexity of 13 items (鈮，

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