Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy
Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy
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DOI：
10.1016/j.ajodo.2003.06.010
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发表时间：
2004-07-01
影响因子：
3
通讯作者：
McNamara, JA
中科院分区：
文献类型：
--
作者：
Baccetti, T;Franchi, L;McNamara, JA
本研究的目的是选择一个头影测量变量模型来预测早期治疗Ⅲ类错牙合畸形的结果，包括快速上颌扩张和面罩治疗，然后采用固定矫治器进行综合治疗。在治疗开始时对 42 名 III 类错牙合患者（20 名男孩，22 名女孩）的头颅侧位片进行了分析（平均年龄 8 岁 6 个月+/- 2 岁，处于颈椎成熟的 I 阶段）。所有患者均在平均 6 年零 6 个月（颈椎成熟的 IV 期或 V 期）后接受重新评估，其中包括积极治疗加保留。此时，根据咬合标准将样本分为2组：成功组（30名患者）和不成功组（12名患者）。应用判别分析来选择长期治疗结果的治疗前预测变量。第一次观察时头影测量测量的逐步变量选择确定了 3 个预测变量。当患者治疗前头影测量记录显示下颌升支较长（即面部后部高度增加）、颅底角锐利和下颌平面角陡峭时，从长远来看，III 类错牙合畸形的矫形治疗可能是不利的。根据多变量统计方法生成的方程，可以预测每位新的Ⅲ类错牙合患者的截断性矫形治疗的结果，概率误差为16.7%。
The aim of this study was to select a model of cephalometric variables to predict the results of early treatment of Class III malocclusion with rapid maxillary expansion and facemask therapy followed by comprehensive treatment with fixed appliances. Lateral cephalograms of 42 patients (20 boys, 22 girls) with Class III malocclusion were analyzed at the start of treatment (mean age 8 years 6 months +/- 2 years, at stage I in cervical vertebral maturation). All patients were reevaluated after a mean period of 6 years 6 months (at stage IV or V in cervical vertebral maturation) that included active treatment plus retention. At this time, the sample was divided into 2 groups according to occlusal criteria: a successful group (30 patients) and an unsuccessful group (12 patients). Discriminant analysis was applied to select pretreatment predictive variables of long-term treatment outcome. Stepwise variable selection of the cephalometric measurements at the first observation identified 3 predictive variables. Orthopedic treatment of Class III malocclusion might be unfavorable over the long term when a patient's pretreatment cephalometric records exhibit a long mandibular ramus (ie, increased posterior facial height), an acute cranial base angle, and a steep mandibular plane angle. On the basis of the equation generated by the multivariate statistical method, the outcome of interceptive orthopedic treatment for each new patient with Class III malocclusion can be predicted with a probability error of 16.7%.