玻璃离子或树脂垫治疗乳牙期及混合牙列早期前牙反的效果比较

杨小如，李旭艳，庄福涛，彭　静



杨小如1，李旭艳2，庄福涛1，彭静1

1.100039北京，武警总医院口腔科；2.101200，北京平谷区妇幼保健院口腔科

【摘要】目的比较玻璃离子或树脂垫与传统垫舌簧矫治器在治疗乳牙期和混合牙列早期前牙反时的效果。方法选取10位能熟练运用这两种方法治疗前牙反的医师，设计21个调查项目进行问卷调查，对调查结果进行问卷打分，以评价这两种方法的效果。结果玻璃离子或树脂垫与传统垫舌簧矫治器在21项比较内容中，在矫治疗程问卷评分分别为3.90±1.88和3.80±2.10，两者比较无统计学意义；在口腔印模制取、矫治器制作简单性、综合评价等其余20项评价指标，两种治疗方法的评分比较均有统计学差异(P<0.05)。结论在治疗乳牙期及混合牙列早期的前牙反时，玻璃离子或树脂垫的疗效优于传统的垫舌簧矫治器，值得临床推广。

【关键词】玻璃离子或树脂垫；垫舌簧矫治器；乳牙期；混合牙列前期；前牙反

1对象与方法

1.1对象选取武警总医院和北京市平谷区妇幼保健院口腔科共10位医师，他们能熟练采用玻璃离子或树脂垫矫治乳牙期和混合牙列早期前牙反，同时也能熟练应用垫舌簧矫治器治疗前牙反。

1.2调查方法调查项目共计21项，即口内取印模、矫治器制作简单性、佩戴初期舒适度、矫治器适应期长短、矫治器佩戴时间、矫治器钢丝折断、矫治器钢丝划伤牙龈或黏膜、治疗中前牙松动、治疗中牙齿疼痛、复诊间隔时间、口腔卫生情况、矫治疗程长短、医疗成本、对下前牙矫治作用、尖窝关系密合程度、咀嚼效率、发音、美观、患儿配合程度、监护人接受程度、综合评价。

1.3评定标准在评定前，对医师评定标准进行校准，然后对这21个调查项目进行问卷打分。每个调查项目设6个等级的感受，采用5分制：不能接受(0分)，一般(1分，2分)，良好(3分，4分)，满意(5分)。

1.4统计学处理使用SPSS17.0，将10位医师对这两种方法评价的21个指标的感受分数使用成组t检验进行统计学比较，P<0.05为差异有统计学意义。

2结果

两种矫治方法在矫治疗程长短上无统计学差异，其余项目评分两种方法比较均有统计学差异，玻璃或树脂垫的疗效优于传统的垫舌簧矫治器(P<0.05，表1)。

表1　医师对两种矫治方法项目调查分值比较　(n=10；±s)

3讨论

6～12岁孪生子遗传与环境作用的研究发现，下颌前后位置关系最容易受环境因素的影响，而面部高度受强遗传因素的控制，特别是面前部的高度[7,8]。这增加了本研究利用玻璃离子垫矫治混合牙列早期及乳牙期前牙反的信心。

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(2016-02-20收稿2016-03-20修回)

(责任编辑尤伟杰)

基金项目：北京市优秀人才培养资助项目(2008ID0900900299)

作者简介：杨小如，硕士研究生，主治医师。 通讯作者：彭静，E-mail：pengjing008@sina.com

【中国图书分类号】R783.5

An investigating study of correcting anterior crossbite of deciduous and early mixed dentitions with occlusal guidance of glass ionomer cement or resin

YANG Xiaoru1, LI Xuyan2，ZHUANG Futao1，and PENG Jing1.

1.Department of Stomatology, General Hospital of People’s Armed Police Force, Beijing 100039，China；2. Department of Stomatology, Pinggu Maternal and Child Health Hospital，Beijing 101200，China

【Abstract】ObjectiveTo compare the advantage and disadvantage of occlusal guidance of glass ionomer cement or resin with traditional splint and lingual spring in clinical through the questionair for doctor.Methods21 research items were investigated by 10 clinical doctors who can accomplish the therapy with those two methods to correct anterior crossbite skillfully. And the research items were: whether the oral impression, making appliance simplicity, early period comfort when wearing appliance, the length of appliance adaptation, appliance wearing time, wire broken of appliance, appliance wire scratching gingival mucosa, anterior tooth loose in the treatment, dental pain in the treatment, follow-up interval, oral hygiene, treatment duration, medical cost, the lower anterior teeth correction, cusp and fossa relationship close together, masticatory efficiency, pronunciation, appearance, children with the degree, the acceptance of guardian, comprehensive evaluation.ResultsComparing the two treatment methods of 21 research items,the occlusal guidance of glass ionomer cement or resin and the traditional splint lingual spring in the course of orthodontic treatment, the questionnaire scores were 3.90±1.88 and 3.80±2.10, there was no statistically significant difference (P>0.05). However, for the oral impression, making appliance simplicity, comprehensive evaluation and other 20 evaluation items: the scores of the two treatment methods had highly significant difference (P<0.05).ConclusionCompared with the traditional splint and lingual spring to correct anterior crossbite, the occlusal guidance of glass ionomer cement or resin is a fixed functional appliance, which can be easily operated in clinic and has many advantages. This technology is worthy of extensive promotion.

【Key words】occluusal guidance of glass ionomer cement or resin; splint and lingual spring; deciduous dentition; early mixed dentition; anterior crossbite