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摘 要：本研究利用三维坐标测量仪，开发了正畸牙移动的上颌测量系统，并采用前瞻性配对设计，对16例拔除四个第一双尖牙、使用国产Roth数据直丝弓矫治器矫治的病例，分两组分别进行一步滑动法和两步滑动法关闭间隙。测量研究的结果显示：两步法在节省支抗上要稍优于一步法，但临床上不显著，一步法在时间上要明显短于两步法，两者在维持覆、维持前牙转矩方面无显著差别。本研究认为，一步滑动法在直丝弓临床用于中更易被接受。
分类号：R783.5 文献标识码：A
文章编号：1003-1634(2000)01-0029-03
Comparison of One-step and Two-step Sliding Technique using Straight Wire Appliance
Zeng Xianglong
(Department of Orthodontics,School of Stomatology,Beijing Medical University)
Yang Xinhai
Abstract：SWA(straight wire appliance) technique for extraction cases developed significantly in recent years,such as sliding technique in the space-closure stage.Space closure with sliding technique can be done by one or two steps.Different opinions have been formed about their difference,and the experimental studies are in need.We chose 16 first premolar extraction cases,which had been planned for prospective paired t-test.All cases were treated by SWA of Roth set-up.The measurements of dental models and cephalogram were taken using our new measuring methods.The conclusions of our study were as follows: Two-step sliding technique was slightly better than one-step technique in anchorage control,but used much more time.There Were no significant difference in the changes of overbite and incisor torque between these two techniques.So we prefer one-step sliding technique to two-step sliding technique when using SWA.
Key words：straight wire appliance sliding technique one-step method two-step method anchorage▲
直丝弓矫治器关闭拔牙间隙有两种方法：一步法和两步法。对于它们的优缺点，特别是两者的支抗需求，存在着不同的看法〔1～3〕。本研究的目的是通过临床配对实验，比较一步法和两步法，不仅比较两者支抗上的差异,而且对前牙牙轴和垂直方向的控制也进行研究，为临床应用提供参考。
材料和方法
1.样本
16名安氏Ⅰ类双颌前突或安氏Ⅱ类Ⅰ分类错牙合患者，拔除四个第一双尖牙，使用国产的Roth数据直丝弓托槽和颊面管进行矫治。
2.临床设计
根据性别、年龄、下颌平面角、ANB角配对成8对(表1)。上颌分两组，分别用一步滑动法和两步滑动法关闭间隙。上第一磨牙加TPA。整个间隙关闭过程不用口外力和Ⅱ类牵引。
表1 样本配对设计情况
| 序 号 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
| 组 别 |
A |
B |
A |
B |
A |
B |
A |
B |
A |
B |
A |
B |
A |
B |
A |
B |
| 性 别
年 龄
SN-MP角
ANB角 |
女
12
3
2 |
女
12
3
2 |
女
12
2
1 |
女
12
2
2 |
女
13
1
1 |
女
13
1
1 |
女
12
2
1 |
女
13
2
1 |
女
24
2
2 |
女
22
2
2 |
男
13
1
3 |
男
15
1
3 |
男
12
3
2 |
男
12
3
1 |
男
13
2
3 |
男
12
2
3 |
注：SN-MP角：1表示30°，2表示30°～38°，3表示38°。
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