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目的:对比个性化钛板及传统前方牵引治疗生长发育期骨性Ⅲ类错 的临床疗效，为临床提供参考。 方法:前瞻性纳入2018年8月至2021年7月于首都医科大学口腔医学院正畸科就诊的生长发育期上颌发育不足的骨性Ⅲ类错 患者，分别采用个性化钛板（个性化钛板组）和传统方法（传统前牵组）进行前方牵引治疗。收集两组治疗前后头颅侧位X线片进行头影测量分析，包括SNA角（上牙槽座角）、ANB角（上牙槽座点-鼻根点-下牙槽座点角）、FH-MP角（下颌平面角）、Y轴角、U1-L1角（上下中切牙角）、U1-SN角（上中切牙与颅底平面角）、前面下高、上颌长等；并以颅底线为基准平面，测量上下颌骨各参考点［ANS点（前鼻棘点）、A点（上牙槽座点）、Prn点（鼻尖点）、Sn点（鼻下点）、UL点（上唇最突点）等］至VerT线（过蝶鞍影像前壁与前床突下缘交点的颅底线垂线）的距离。对每组患者治疗前后头影测量项目进行配对 t检验，对两组前方牵引治疗前后变化量进行两独立样本 t检验，分析两种前方牵引方法的疗效差异。 结果:个性化钛板组纳入患者20例，年龄（10.8±1.3）岁，男性9例，女性11例；传统前牵组纳入患者20例，年龄（10.5±1.1）岁，男性8例，女性12例。两组前方牵引治疗后SNA角、ANB角、FH-MP角、Y轴角、前面下高、上颌长、ANS-VerT距、A-VerT距、Prn-VerT距、Sn-VerT距、UL-VerT距均显著大于治疗前（ P<0.05）。个性化钛板组SNA角、ANB角、A-VerT距治疗前后变化量［分别为3.15°±2.28°、4.64°±1.40°，（4.41±3.43）mm］均显著大于传统前牵组［分别为2.13°±2.69°、2.81°±1.10°，（3.13±4.76）mm］（ P<0.05），U1-L1角、U1-SN角治疗前后变化量（分别为-0.76°±7.42°、1.74°±6.38°）均显著小于对照组（分别为-5.14°±6.62°、4.57°±5.24°）（ P<0.05）。 结论:前方牵引治疗可有效改善生长发育期骨性Ⅲ类错 患者的上下颌骨位置关系。使用个性化钛板前方牵引治疗骨性Ⅲ类错 的疗效明确，牙性作用较小。

Objective:To compare the clinical efficacy of customized titanium plate and conventional maxillary protraction treatment in patients with skeletal class Ⅲ malocclusion during growth spurt.Methods:During growth spurt, skeletal class Ⅲ patients with maxillary hypoplasia who were treated in the Department of Orthodontics, Capital Medical University School of Stomatology from August 2018 to July 2021 were prospectively enrolled. They were treated with maxillary protraction using customized titanium plates (customized titanium plate group) and conventional methods (conventional protraction group), respectively. Lateral cephalometric radiographs were collected before and after treatment for conventional cephalometric analysis, including SNA angle (angle between Sella, Nasion and A point), ANB angle (angle between A point, Nasion, and B point), FH-MP angle (mandibular plane angle), Y-axis angle, U1-L1 angle (upper to lower central incisor angle), U1-SN angle (upper incisor to SN plane angle), anterior and lower height, maxillary length, etc. The stable basicranial line (SBL) was used as the reference line to measure the distance from each reference point (ANS point, A point, Prn point, Sn point, UL point etc.) to the stable basicranial vertical line (VerT, the perpendicular line of the skull base line at the intersection point of the anterior wall of the sella image and the inferior edge of the anterior bed process). Paired t-tests were performed on the cephalometric data before and after maxillary protraction treatment in the two groups, and two independent samples t-tests were performed to compare the differences in the efficacy of the two maxillary protraction methods. Results:A total of 20 patients (9 males and 11 females), aged (10.8±1.3) years, were included in the personalized titanium plate group. A total of 20 patients (8 males and 12 females), aged (10.5±1.1) years, were included in the conventional protraction group. The SNA angle, ANB angle, FH-MP angle, Y-axis angle, anterior lower height, maxillary length, ANS-VerT distance, A-VerT distance, Prn-VerT distance, Sn-VerT distance, and UL-VerT distance were significantly higher than those before treatment in the two groups ( P<0.05). The changes of SNA angle, ANB angle and A-VerT before and after treatment in the personalized titanium plate group [3.15°±2.28°, 4.64°±1.40°, (4.41±3.43) mm, respectively] were significantly higher than those in the traditional group [2.13°±2.69°, 2.81°±1.10°, (3.13±4.76) mm, respectively]( P<0.05), and the changes of U1-L1 angle and U1-SN angle before and after treatment (-0.76°±7.42° and 1.74°±6.38°, respectively) was significantly lower than that of the control group (-5.14°±6.62° and 4.57°±5.24°, respectively, P<0.05). Conclusion:Maxillary protraction can effectively improve skeletal class Ⅲ relationships in growing patients. The linear measurements using the SBL line as a reference plane visualize the sagittal improvement in sagittal relationship after maxillary protraction. The customized titanium plate maxillary protraction treatment has a clear therapeutic effect on patients with skeletal class Ⅲ deformities, and its dental effect is relatively small.