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J Zhejiang Univ (Med Sci)  2021, Vol. 50 Issue (2): 195-204    DOI: 10.3724/zdxbyxb-2021-0123
    
Clinical efficacy of counterclockwise rotating the functional occlusal plane using micro-implant anchorage
ZHANG Chenxing(),XU Liqi,LIN Jun()
Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Abstract  

Objective:To evaluate the therapeutic effect of using micro-implant anchorage (MIA) to rotate the functional occlusal plane (FOP) counterclockwise. Methods:Forty skeletal class Ⅱ high-angle patients who had completed orthodontic treatment were enrolled, including 20 patients treated with MIA orthodontic system (MIA group) and the other 20 patients treated with traditional sliding straight wire appliance (control group). Cephalometric measurements on the lateral cranial radiographs before and after treatment were performed, all acquired data were statistically analyzed with SPSS 26.0. Results:At the end of treatment, MIA group obtained better effect of FOP and mandibular plane counter-clockwise rotation than the control group. In the MIA group, the average change of FOP-frankfort horizontal plane (FH), FOP-SN and mandibular plane angle (MP-FH) angle was –4.5(–7.3, –3.7)°, (–4.6±3.3)° and –1.7(–3.0, –0.9)°, respectively. In the control group, the average change of FOP-FH, FOP-SN and MP-FH angle was –0.1(–4.1, 3.0)°, (–0.1±5.1)° and –0.4(–2.4, 0.7)°, respectively. There was significant difference between the change of the two groups (all P<0.05).Conclusion: Compared with the traditional sliding straight wire appliance, counterclockwise rotation of FOP can be more effectively reversed by using MIA orthodontic system, and the MP-FH can be reduced as well.



Key wordsOrthodontics      Functional occlusal plane      Micro-implant anchorage      Counter-clockwise rotation      Efficacy     
Received: 11 November 2020      Published: 18 June 2021
CLC:  R783.5  
Corresponding Authors: LIN Jun     E-mail: 842932137@qq.com;linjun2@zju.edu.cn
Cite this article:

ZHANG Chenxing,XU Liqi,LIN Jun. Clinical efficacy of counterclockwise rotating the functional occlusal plane using micro-implant anchorage. J Zhejiang Univ (Med Sci), 2021, 50(2): 195-204.

URL:

http://www.zjujournals.com/med/10.3724/zdxbyxb-2021-0123     OR     http://www.zjujournals.com/med/Y2021/V50/I2/195


微型种植体支抗逆时针旋转功能性牙合平面的疗效研究

目的:分析使用微型种植体支抗(MIA)逆时针旋转功能性牙合平面(FOP)的矫治效果,并与传统滑动直丝弓技术进行比较。方法:筛选骨性Ⅱ类高角正畸结束患者 40 例,其中 20 例使用 MIA 矫治系统(MIA 组),20 例使用传统滑动直丝弓矫治技术(对照组),对患者治疗前后的头颅侧位片进行头影测量,使用 SPSS 26.0 软件对获取的数据进行统计学分析。结果:治疗结束后,MIA 组患者相较于对照组获得了更好的 FOP 及下颌平面的逆旋效果,表现为 MIA 组患者治疗后 FOP-眶耳平面(FH)角平均变化–4.5(–7.3,–3.7)°,FOP-前颅底平面(SN)角平均变化(–4.6±3.3)°,下颌平面角(MP-FH)平均变化–1.7(–3.0,–0.9)°,而对照组患者治疗后 FOP-FH 角平均变化–0.1(–4.1,3.0)°,FOP-SN 角平均变化(–0.1±5.1)°,MP-FH 角平均变化–0.4(–2.4,0.7)°,两组治疗变化差异均有统计学意义(均P<0.05)。结论:相较于传统滑动直丝弓矫治技术,MIA 矫治系统可更有效地逆旋 FOP,同时减小MP-FH。


关键词: 口腔正畸学,  功能性牙合平面,  微型种植体支抗,  逆时针旋转,  疗效 
Figure1 Diagram of main mark points and reference planes of lateral cephalogram measurement

组别

n

FOP-FH角(°)

FOP-SN角(°)

BOP-FH角(°)

BOP-SN角(°)

U1-APo 距(mm)

U1-APo 角(°)

L1-APo 距(mm)

MIA 组

20

–4.5(–7.3, –3.7)**

–4.6±3.3**

–1.1±3.6

–0.5±3.0

–3.0±2.5**

–7.1±9.0**

–1.6±1.9**

对照组

20

–0.1(–4.1, 3.0)

–0.1±5.1

–0.1±3.7

0.3±3.9

–2.7±1.9**

–8.3±7.2**

–0.5±1.2

t/u

331.5

–3.321

–0.872

–0.748

–0.483

0.462

–2.257

P

<0.01

<0.01

>0.05

>0.05

>0.05

>0.05

<0.05

组别

n

L1-APo 角(°)

U1-L1角(°)

U6-PP距(mm)

L6-MP距(mm)

U1-PP距(mm)

L1-MP距(mm)

?

MIA 组

20

–0.1±7.3

7.2±1.2**

1.9(0.4, 2.8)**

2.1±1.7**

–0.1±2.2

–0.5±2.1

?

对照组

20

2.6±5.6

5.7±9.4*

2.1(1.0, 4.2)**

4.0±1.5**

–0.4±2.2

–1.1±2.2*

?

t

–1.292

0.486

242.0

–3.619

–0.692

–2.399

?

P

>0.05

>0.05

>0.05

<0.01

>0.05

<0.05

?

Table 1 Comparison of dental related parameter changes after treatment between the MIA group and the control group

组别

n

SNA 角(°)

SNB 角(°)

ANB 角(°)

Wits值(mm)

MP-FH角(°)

SN-GoGn角(°)

A-NPo距(mm)

MIA 组

20

–1.3±3.1

0.9±2.5

–2.1±2.2**

0.2±3.5

–1.7(–3.0, –0.9)**

–1.3±3.1

–2.7±2.2**

对照组

20

–1.8±3.0*

0.2±2.6

–2.0±1.9**

–2.3±3.4**

–0.4(–2.4, 0.7)

–0.1±3.1

–2.9±2.3**

t/u

0.569

0.892

–0.240

2.325

278.5

–1.196

0.275

P

>0.05

>0.05

>0.05

<0.05

<0.05

>0.05

>0.05

组别

n

FH-NA角(°)

NA-APo角(°)

Na-GnGo角(°)

FH-NPo角(°)

SGn-FH角(°)

Gn-Go距(mm)

MIA 组

20

–0.7±2.2

–6.0±4.6**

–0.1±2.1

2.2(0.9, 3.1)**

–1.3±1.7**

2.7(1.9, 4.9)**

?

对照组

20

–1.4±2.0**

–6.5±5.1**

–1.0±1.4**

1.1(–0.4, 3.1)**

–0.4±1.6

2.6(1.4, 5.1)**

t/u

1.085

0.313

1.629

151.5

–1.880

191.0

?

P

>0.05

>0.05

>0.05

>0.05

>0.05

>0.05

组别

n

Ar-Go距(mm)

Na-Me距(mm)

S-Go距(mm)

S-Go/Na-Me(%)

ANS-Me距(mm)

ANS-Me/Na-Me(%)

?

MIA 组

20

2.5(1.0, 4.3)**

4.1±3.9**

4.6(1.1, 5.9)**

1.3±2.3*

1.4±2.1**

–1.0(–2.5, 0.1)

?

对照组

20

3.6(1.6, 6.1)**

6.5±5.3**

3.9(2.0, 6.7)**

0.7±2.2

3.5±3.1**

0.1(–0.7, 0.8)

?

t/u

243.5

–1.609

204.5

0.968

285.5

262.5

?

P

>0.05

>0.05

>0.05

>0.05

<0.05

>0.05

?

Table 2 Comparison of the bone related parameter changes after treatment between the MIA group and the control group

组别

n

Ulip-E

Llip-E

Stm-FOP

MIA€组

20

–2.2±2.0**

–2.3±2.1**

–1.7±2.0**

对照组

20

–2.5±1.7**

–3.3±2.0**

–1.0±3.1

t

0.438

1.554

–0.792

P

0.644

0.129

0.433

Table 3 Comparison of the soft tissue related parameter changes after treatment between the MIA group and the control group
Figure 2 Facial and oral photos during treatment of the typical case
Figure 3 Curved tomographic X-rays and lateral X-rays of the typical case before and after treatment
Figure 4 Overall superimposition of before (black color) and after (red color) treatment cephalometric radiographs of the typical case (based on SN plane, S point)

测量项目

治疗前

治疗后

治疗后变化

SNA 角(°)

83.7

81.9

–1.8

SNB 角(°)

78.1

79.5

1.4

ANB 角(°)

5.6

2.3

–3.3

Wits 值(mm)

–4.0

–2.9

1.1

MP-FH角(°)

33.2

27.0

–6.2

U1-APo 角(°)

41.9

34.6

–7.3

U1-APo 距(mm)

10.8

6.5

–4.3

L1-APo 角(°)

31.5

32.4

0.9

L1-APo 距(mm)

9.3

4.5

–4.8

U1-L1角(°)

106.6

113.0

6.4

FOP-FH角(°)

18.9

9.0

–9.9

BOP-FH角(°)

14.8

13.4

–1.4

S-Go/Na-Me(%)

64.1

66.7

2.6

ANS-Me/Na-Me(%)

58.2

54.0

–4.2

Ulip-E(mm)

2.3

–3.3

–5.6

Llip-E(mm)

5.8

1.6

–4.2

U6-PP(mm)

19.6

19.9

0.3

L6-MP(mm)

28.8

28.2

–0.6

U1-PP(mm)

27.3

25.5

–1.8

L1-MP(mm)

37.1

32.6

–4.5

Table 4 Comparison of cephalometric measurements before and after treatment of the typical case
Figure 5 Biomechanics of closing loop technique, traditional sliding technique and micro-implant anchorage
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