摘 要 目的：探讨滑动法直丝弓矫治技术矫治A ngle氏Ⅰ类错畸形的机理及矫治结果。方法：应用前颅基底结构重叠法对19例Angle氏Ⅰ 类错拔牙病例戴用滑动法国产Roth直丝弓矫治器，矫治前后的头颅定位侧位X光片的21项 测量数 据进行配对研究。结果：对21项数据进行统计学处理(t检验)显示：①代表牙因素的测量 项目除磨牙垂直向移动(U6PP距、L6GoGn距)、磨牙前后关系以及平面旋转方面无显著性不 同外，其它各项数据矫治前后均有显著性统计学差异。②代表颌骨因素的测量项目除了前面 高(AFH)和后面高(PFH)外，其余项目矫治前后均没有显著性差异。结论：说明了应用滑动机 理的国产Roth直丝弓矫治器矫治Angle氏Ⅰ类错畸形病例，特别是牙源性错畸形的矫治 效果十分显著，而对颌骨难以产生矫形作用。
关键词 直丝弓矫治器 滑动机制 Ⅰ类错 拔牙病例 评价
Evaluation and clinical application of Chinese Roth straight
\=wire appliance with sliding mechanics for class I malocclusion cases
LIN Xinping, NI Zengyu, HU Rongdang, at al.
(Department of Orthodontics,Faculty of Stomatology, Wenzhou Medical College, Wen zhou 325027)
Abstract: Objective:To evaluate the treatment effects of ho memade Roth straight wire appliance + sliding mechanics on extraction cases wi th Class Ⅰ malocclusion.Methods:Cephalometric images of anterior cranial base w ere superimposed for the pretreatment and posttreatment lateral cephalograms o f 19 subjects. Traces and 16 points of landmarks were made. 21 parameters were t o quantify the amount and kind of skeletodental changes during treatment. Pair edsamples t test was carried out.Results:(1)There were no significant statisti cal differences between pretreatment and posttreatment for the parameters, whi ch represent the dental movements,except for the vertical and anteroposterior relation of molars and occlusal plane.(2)Skeletal changes during treatment showe d no significant differences except for the anterior facial height (AFH) and pos terior facial height (PFH).Conclusion:There were significant clinical effets of Chinese Roth straight wire appliance + sliding mechanics on Class Ⅰ malocc1usio n cases, particularly on dental Class Ⅰ malocclusion cases. However, this strai ght wire appliance had no discernable influences on the skeletal or orthopedic c hanges during treatment.
Key Words: straight wire appliance; sliding mechanics; clas s Ⅰ malocclusion
直丝弓矫治器是70年代由L.F.Andrews医生分析了120付正 常牙模型的基础上，由方丝弓矫治器发展而来。在其托槽及带环上融进了消除三个序列 弯曲的一系列数据，与方丝弓矫治器相比，大大简化了操作程序，矫治效果更佳［1］ 。笔者自94年迄今，应用该矫治术对19例Angle氏Ⅰ类错拔牙病例矫治前后头影测量值 的比较分析，以探讨其临床应用效果，同时对MBT滑动法直丝弓矫治器的特点及临床应用注 意事项加以阐明及讨论。
1 临床资料
本组19例，男8例，女11例，年龄11～23岁，平均15.4±3.7岁，全部患者均作减数拔牙，根 据临床需要及患者意见分析拔除全部第一双尖牙或第二双尖牙。矫治时间为9～21月，平均1 5.6±3.5月。Roth直丝弓矫治器选用杭州奥索公司生产的产品，滑动法直丝弓矫治技术的基 本矫治步骤如下：①第一阶段：排齐整平，0.014″NiTi/0.16″NiTi加以摇椅型，尖牙向后 结扎(Lacebacks)和弓丝末端打钩(bendbacks)(第一根弓丝)。0.018″NiTi/0.016″ ss/0.0 19″×0.025″NiTi加以Lacebacks和bendbacks及摇椅形(第二根弓丝)。②第二阶段：关闭 拔牙间隙及调整，0.019″×0.025″ss，结扎丝被动结扎1个月，再换用NiTi拉簧，牵引 圈或弹性链加以主动力(第三根弓丝)，必要时加以夜间Ⅱ类牵引。③第三阶段：完成阶段即 调整咬关系。颌间垂直牵引及个别牙位调整。用片段弓或换用NiTi圆丝(第四根弓丝)。
