Influence of Implant Anchorage Loading Methods on Craniomaxillary Soft Tissue and Hard Tissue after Closing the Extraction Space in Patients with Maxillary Protrusion
Objective To explore the influence of implant anchorage loading methods on the craniomaxillary soft tissue and hard tissue in patients with maxillary protrusion after closing the extraction space.Methods 156 patients with maxillary protrusion who were admitted to department of Oral Surgery and Craniomaxillofacial of the author's hospital were selected as the research subjects from April 2020 to June 2023.All patients needed to extract the maxillary bilateral first premolars and use implant anchorage to adduct the upper anterior teeth,and they were classified into group A(short traction hook and direct anchorage method,n=52),group B(long traction hook and direct anchorage method,n=52)and group C(short traction hook and indirect anchorage method,n=52)by adopting the random number table method.The changes of craniomaxillary soft and hard tissues were compared among the three groups before and after treatment.Results Before closing the space,there were no significant differences in craniomaxillary soft tissue and hard tissue indicators among the three groups(P＞0.05),but the upper coronal seat point-nose root point-lower alveolar seat angle(ANB)in group B was larger than that in groups A and C(P＜0.05).The anterior skull base plane-upper sulcus seat angle(SNA),the anterior skull base plane-lower sulcus seat angle(SNB),sella nasion-to-mandibular plane angle(SN-MP),upper incisor inclination(U1-SN),nasolabial angle,crown lingual movement(U1c-Sv),overjet,intrusion of the maxillary first molar on the mesial buccal cusp and mesial root apex(U6c-H,U6r-H)revealed no obvious differences among the three groups of patients after closing the space(P＞0.05),but there were statistical differences in ANB,angle between plane and anterior skull base plane(SN-OP),retraction amount of maxillary first molar(U6-SN),lingual root movement amount(U1r-Sv),incisal edge point of upper central incisor,root apex intrusion amount(U1c-H,U1r-H),mesial buccal cusp of maxillary first molar,distance between mesial apical point and Sv(U6c-Sv,U6r-Sv),maxillary first molar mesial buccal apex and mesial apical tip(U6c-H,U6r-H)and overbite change(P＜0.05).The changes of ANB and Ls-E line in group B were greater than those in group C(P＜0.05),and the changes of SN-OP,U6-SN and U1c-Sv were greater in group A than those in group C(P＜0.05).The changes of U1r-Sv and U1c-H were greater in group B than those in group A and group C(P＜0.05),and the two indicators in group C were greater than those in group A(P＜0.05).The change of U1r-H was greater in group B than that in group A and group C(P＜0.05),and was greater in group A than that in group C(P＜0.05).The change of U6c-Sv in group C was greater than that in group B(P＜0.05).The changes of U6c-H and U6r-H were greater in group A than those in group B(P＜0.05).The change of overbite in group B was greater than that in group A and group C(P＜0.05).Conclusion Three different implant anchorage loading methods have a good anchorage effect on patients with maxillary protrusion,and they can improve the morphology of maxillary hard tissue and cause corresponding soft tissue changes.Among them,short traction hook combined with direct anchorage method can significantly lower the molars,tilt the crown distally,and rotate the occlusal plane clockwise,and long traction hook combined with direct anchorage method can obtain good root control movement and intrusion effect of the anterior teeth,and good vertical change effect of the upper anterior teeth,and it is beneficial to the overbite control.Both long traction hook and short traction hook combined with indirect anchorage method can obtain good sliding adduction force and stabilize the occlusal plane.
maxillary protrusionimplant anchorage therapyloading methodssoft and hard tissuesextraction space
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