目的：探讨锥形束CT（Cone Beam Computed Tomography，CBCT）在青少年反牙合（骨性Ⅲ类错牙合畸形）正畸治疗中的应用价值。方法收集66例12~18岁进行掩饰治疗的骨性Ⅲ类错牙合畸形患者，使用自锁托槽种植钉支抗，按垂直骨面型进行分类，选取左侧下中切牙进行测量，运用CBCT比较不同垂直骨面型患者的下颌前牙可移动骨量，对测量结果进行统计分析。结果患者前牙区唇侧牙槽骨理论可移动骨量高角较均角及低角小（P<0.01）；舌侧牙槽骨理论可移动骨量低角>均角（P<0.01），均角>高角（P<0.01）；总牙槽骨理论可移动骨量低角>均角>高角（P<0.01）。不同垂直骨面型患者唇侧牙槽骨理论可移动骨量<舌侧牙槽骨理论可移动骨量（P<0.01）。结论青少年骨性Ⅲ类错牙合患者前牙区唇侧牙槽骨理论可移动骨量较舌侧少，使用CBCT测量下颌前牙可移动骨量在骨性Ⅲ类错牙合患者掩饰性治疗中可减少下颌前牙内收过程中的医源性风险。%Objective To study the clinical value of cone beam CT (CBCT) in the orthodontic treatment of adolescent patients with malocclusion (Skeletal Class III malocclusion).Methods 66 cases of Skeletal Class III from patients ranging from 12 years old to 18 years old were collected. The self-locking braces with MBT planting nail resistance was used. The collected cases were divided into 3 divisions respectively according to different vertical facial types. The mandibular left central incisor of each subject was chosen for measurement. CBCT was used to compare different vertical facial type of skeletal Class III in patients with anterior tooth mobile bone mass, results of the measurement were analyzed statistically.Results The high-angle Class III malocclusion was less than that of average-angle (P<0.01) and low-angle (P<0.01) ones; the average-angle Class III malocclusion was less than that of low-angleones (P<0.01) and more than that of high-angle ones (P<0.01); the low-angle Class III malocclusion was more than that of average-angleones (P<0.01), which was more than that of high-angle ones (P<0.01).Conclusion In adolescent patients with skeletal Class III, the movable bone mass of the lip side was relatively less than the bone mass on the lingual side. It is necessary to measure the movable bone mass by using the CBCT for adolescent with skeletal Class III patients in orthodontic treatment, which can reduce the iatrogenic risk in the process of adduction of the mandible anterior teeth.
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