Comparison of posttreatment stability after total mandibular arch distalization with mini-implants and mandibular setback surgery.

Yoon-Ah Kook, Tae-Hyun Choi, Jae Hyun Park, So-Hyun Kim, Nam-Ki Lee
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Abstract

Objectives: To compare posttreatment stability in skeletal Class III patients between those treated by total mandibular arch distalization (TMAD) with buccal mini-implants and those by mandibular setback surgery (MSS).

Materials and methods: The samples included 40 Class III adults, 20 treated by TMAD using buccal interradicular mini-implants and 20 treated with MSS. Lateral cephalograms were taken at pretreatment, posttreatment, and at least 1-year follow-up, and 24 variables were compared using statistical analysis.

Results: Mandibular first molars moved distally 1.9 mm with intrusion of 1.1 mm after treatment in the TMAD group. The mandibular incisors moved distally by 2.3 mm. The MSS group exhibited a significant skeletal change of the mandible, whereas the TMAD group did not. During retention, there were no skeletal or dental changes other than 0.6 mm labial movement of the mandibular incisors (P < .05) in the MSS group. There was 1.4° of mesial tipping (P < .01) and 0.4 mm of mesial movement of the mandibular molars and 1.9° of labial tipping (P < .001) and 0.8 mm of mesial movement of the mandibular incisors in the TMAD group. These dental changes were not significantly different between the two groups.

Conclusions: The TMAD group showed a slightly decreased overjet with labial tipping of the mandibular incisors and mesial tipping of the first molars during retention. Posttreatment stability of the mandibular dentition was not significantly different between the groups. It can be useful to plan camouflage treatment by TMAD with mini-implants in mild-to-moderate Class III patients.

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下颌全弓远端植入微型植入体和下颌后移手术治疗后稳定性的比较。
目的:比较下颌骨全弓远端截骨术(TMAD)和下颌骨后移手术(MSS)治疗后骨骼III级患者的稳定性:样本包括 40 名 III 类成人,其中 20 人接受了使用颊面骨间微型植入物的全下颌牙弓远端矫治术,20 人接受了下颌后缩手术。分别在治疗前、治疗后和至少 1 年的随访期间拍摄侧方头影,并通过统计分析对 24 个变量进行比较:结果:TMAD组治疗后,下颌第一磨牙向远端移动了1.9毫米,内陷1.1毫米。下颌切牙向远端移动了 2.3 毫米。MSS 组的下颌骨出现了明显的骨骼变化,而 TMAD 组则没有。在固位期间,MSS 组除了下颌门牙向唇侧移动 0.6 mm 外(P < .05),没有其他骨骼或牙齿变化。TMAD组的下颌臼齿有1.4°的中侧倾倒(P < .01)和0.4毫米的中侧移动,下颌切牙有1.9°的唇侧倾倒(P < .001)和0.8毫米的中侧移动。这些牙齿变化在两组之间没有明显差异:结论:TMAD组的过咬合略有减少,下颌切牙在保持期间向唇侧倾斜,第一磨牙向中侧倾斜。治疗后下颌牙列的稳定性在两组间无明显差异。对于轻度至中度的 III 类患者,用微型种植体进行 TMAD 伪装治疗是非常有用的。
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