Preliminary Study On The Clinical Effect Of Physiological Anchorage Spee''s-wire System Combined With Intrusive Auxiliary Arch To Open Bite

Objective: To observe the clinical effect of physiologic anchorage Spee's-wire system combined with intrusive auxiliary arch in the treatment of adolescents with vertical growth and deep overbite.Methods: A total of 14 adolescents with high angle and deep overbite were enrolled in the Department of Orthodontics,The First Affiliated Hospital of Dalian Medical University from September 2016 to November 2018.All patients were classified as Class I or Class II malocclusion.The clinical manifestations are dentition crowding and/or maxillary protrusion with deep overbite(including cases where the initial anterior teeth are not deep and there is a deepening of the ridge during treatment).All the subjects used a reduction of 4 first premolars to solve the problem of crowding or prominence combined with deep overbite,The application of physiological anchorage Spee's-wire system combined with the reduction of the auxiliary arch was used to correct the malocclusion.The patient was subjected to the measurement of the X-ray skull positioning lateral slice before the occlusion was opened,and the X-ray skull positioning lateral slice before the occlusion was closed,The changes of the anterior teeth of the patient before and after these two stages and the force displacement of the relevant teeth were analyzed.Results: The average time to open the anterior teeth with a intrusive auxiliary arch was9-16 months in 14 patients without any additional anchorage measures.1?The anterior overbite(OB)changed from 5.36(mm)to 3.13(mm),and the anterior teeth changed from deep ridge to normal coverage.The difference was statisticallysignificant(P<0.05);U1r(U1r is Upper central incisor impedance center)-PP(mm): The distance from the impedance center of the upper central incisor to the maxillary condyle plane was changed from 17.11±2.99(mm)to 15.28±2.57(mm),and the difference was statistically significant(P <0.05),the compression into the ankle is achieved;L1r(the impedance center of the central incisor under L1r)-MP(mm): the distance from the impedance center of the lower central incisor to the mandibular plane is changed from 28.20 ± 1.81(mm)25.43±3.55(mm),the difference between the front and the back was statistically significant(P<0.05),and the indentation was achieved;2?There was no significant difference between the upper and middle incisors and the PP plane before and after the treatment.The difference was not statistically significant(P>0.05).The lower incisor and the mandibular plane were slightly changed before and after the correction.The analysis showed no significant difference between the two groups(P>0.05),indicating that there was no obvious lip tilt in the lower anterior teeth.The curved tomogram showed no obvious absorption of the anterior teeth;3?As the first molar of the anchorage,although there was slight elongation after the correction,the difference between the two was not statistically significant(P>0.05).When the anterior teeth were depressed,the anti-wear teeth were subjected to the moment of tilting to the far side,but the molars before and after the correction The angle did not change significantly.The statistical results showed that the difference was not statistically significant(P>0.05).When the lower anterior teeth pressure is applied by lowering the auxiliary arch,the anti-wearing teeth will be subjected to the moment of the distal direction and the elongation,so the anti-wearing teeth will be inclined backward and slightly elongated.However,during the application of the lower auxiliary arch,we can counteract the elongation and orientation of a part of the anti-wearing teeth by increasing the number of anti-jamming teeth(incorporating the second molar,and the first molar as the anti-tooth)and the patient's own bite force.Tilting torque in the far middle;FH-MP(°),SN-MP(°)and Y-axis(°)increased slightly before and after depression,but the difference before and after depression was not statistically significant(P>0.05);there was no change before and after PFH/AFH treatment.Ar-Go(mm)and Go-Po(mm)were significantly increased compared with those before treatment,and the difference was statistically significant(P<0.05).Conclusion: The physiological anchorage Spee's-wire system combined with theintrusive auxiliary arch to open the anterior occlusion of adolescent patients with high angle and deep overbite,it is effective in solving the problem of deep bite and can effectively reduce the bite of the anterior teeth,the slight extension of the posterior teeth and the inclination to the far side are very small compared with the pressure of the anterior teeth,and can store the anchorage for the late anterior teeth;it will not increase the mandibular plane angle of adolescents with deep bite,and the mandibular plane will not be smooth,and the facial shape will not continue to deteriorate.The anterior teeth do not have obvious lip tilt and root resorption,and the anti-friction teeth are slightly inclined to the far side,and the reserve of the anterior teeth is retained after the alignment.