改良Nance弓矫治后牙锁(牙合)伴前牙深覆(牙合)的临床效果

目的探讨改良Nance弓矫治上颌第二磨牙正锁伴前牙深覆病例的临床效果。方法应用改良Nance弓矫治40例上颌第二磨牙正锁伴前牙深覆患者,对矫治前后X线头影进行测量分析和测量临床牙冠高度,并设空白对照组24例作对照。结果治疗组经过3~4个月的矫治,上颌第二磨牙正锁解除,前面高平均增加(2.63±0.57)mm,后面高平均增加(1.66±0.26)mm,覆平均减少(2.59±1.28)mm,上下前磨牙临床牙冠高度均有显著增加,下颌多于上颌。下磨牙临床牙冠高度亦明显增加,上磨牙不明显。结论改良Nance弓是一种简单有效的矫治上颌第二磨牙正锁的口内装置,并能快速打开咬合,尤其适用于深覆低角型患者。     

改良Nance弓的临床应用

目的　介绍改良Nance弓在深覆合患者的临床应用。原理　结合Nance弓与平导的特点应用于临床。结果　对于配合欠佳的深覆合患者效果显著。结论　改良Nance弓是一种简单有效的打开咬合与加强支抗的口内装置     

方丝弓结合上颌前牙平面导板治疗深覆的临床观察

在正畸治疗中,深覆的矫治是一个难点,在治疗过程中耗费时间较长,能否打开咬合是治疗成功的一个关键。在方丝弓技术中打开咬合的方法很多,但这些方法各有优缺点,对部分病人缺乏理想的效果。作者采用方丝弓矫治器结合上颌前牙平面导板矫治21例深覆患者,取得较好的效果,现报道     

上前牙舌侧粘着式固定平导矫治深覆（牙合）的新探索

目的 探讨固定矫治器配合上切牙舌侧粘着式固定平导矫治深覆（牙合）患者的临床效果.方法 选择均角或低角Ⅲ度深覆（牙合）患者12例作为实验组,男6例,女6例,年龄12～30岁,平均17岁,拔牙9例,非拔牙3例.采用直丝弓固定矫正器治疗,配合制作上前牙舌侧粘着式固定平导辅助打开咬合.选择与实验组相匹配的12例患者作为对照组,对照组患者单纯使用固定矫正器治疗.当覆（牙合）打开后,制取模型,进行治疗前及咬合打开后模型测量分析,分析咬合打开量及所需时间.结果 模型测量结果显示：上颌舌侧固定平导辅助打开咬合效果明显,覆（牙合）平均减小3.37 mm,覆（牙合）打开的平均时间为3.75个月,明显短于对照组.结论 上切牙舌侧粘着式固定平导对于深覆（牙合）患者的矫治非常有效,而且制作简单,有利于口腔卫生,正畸治疗整个过程均不受影响,值得临床推广.     

后牙锁伴前牙Ⅲ°深覆的正畸治疗

本文通过对8例后牙锁伴前牙深覆的患者，以平导结合固定矫治器代替传统的垫式矫治器进行治疗，意在寻求一种有效、快速的矫治后牙锁的方法。结果表明：解除锁平均时间为2．6月，前牙咬合打开为3．4月，完成矫治为14．6月。本文认为平导结合固定矫治器能使锁解除、前牙压低及后牙升高、建同步进行而缩短疗程。     

上颌平面导板在方丝弓矫治器打开咬合中的临床应用

目的探讨上颌平面导板在打开咬合中的作用。方法选择20例前牙深覆达Ⅲ度及以上的正畸患者,在矫治中配戴前牙平面导板,协助打开咬合,并作X线头影测量分析。结果上颌平面导板能有效地打开深覆,使上下颌磨牙升高,改善面下1/3高度,利于前牙内收。结论上颌平面导板应用于方丝弓矫治深覆,能快速有效地打开咬合,调节面部比例,改善面型。     

平导和多曲方丝弓治疗前牙深覆[牙合]的效果比较

目的比较平导、多曲方丝弓治疗深覆[牙合]的效果。方法随机选择深覆[牙合]Ⅱ度以上儿童患者30例,年龄12～17岁,随机分为2组,采用方丝弓矫治技术,分别使用平导和多曲方丝弓打开咬合,在矫治前后拍摄头颅定侧位片,并进行头影测量分析和统计学分析。结果 2组均能有效打开咬合,平导组以磨牙升高为主,多曲方丝弓组以压低前牙为主,而对于2组磨牙升高或前牙压低量的比较,其差别有显著性,P〈0.05。结论平导和多曲方丝弓均能有效治疗深覆[牙合],但作用机制不同,临床上可选择合适的病例使用。     

上颌小平导在固定矫治技术中打开咬合的作用体会

目的 总结活动式上颌小平面导板(简称小平导)在固定矫治中打开咬合的效果。方法 本组31例内倾型和前突型深覆病例在固定矫治中采用小平导打开咬合。结果 31例患者全部打开咬合,为后续治疗(如内倾型深覆的下牙列排齐,前突型深覆的上前牙内收)创造了条件。打开咬合时间平均在4个月左右。结论 上颌小平导可用Ⅱ~Ⅲ度深覆的咬合打开,对高角型病例应当避免使用。     

平导和反SPEE曲弓丝治疗前牙深覆[牙合]的效果比较

目的比较平导、弓丝上加反SPEE曲治疗深覆[牙合]的效果。方法选择深覆[牙合]均在Ⅱ度以上患者27名，平导组14名，反SPEE曲组13名，年龄11—28岁，咬合打开前后拍头颅侧位片进行X线头影测量分析。结果戴用平导可以使下颌骨向下旋转，下面高及全面高增加，打开咬合主要靠磨牙的增高；反SPEE曲可以使下面高及全面高增加，但增加的效果不如平导作用大，差别有显著性，打开咬合主要靠切牙的压低和磨牙的少量增高，磨牙增高的量较平导组的小，差别有显著性。结论两种方法打开咬合的机制不同，临床适应征不同。     

改良Nance弓打开咬合增加磨牙支抗的应用

正畸临床中上颌前突、下颌后缩同时伴有深覆牙合的安氏II类I分类患者比较常见。这一类患者往往上颌需要强支抗，同时也较常应用平导来打开咬合。我们采用改良Nance弓[1]，既加强了上颌支抗，同时也较容易地将咬合打开。1临床制作及其特点1.1制作上颌第一磨牙带环腭侧焊1.0mm不锈钢丝，弓丝离开组织面0.5mm，延伸到前牙基托内。前牙基托的范围为上颌两侧侧切牙之间的区域。腭侧前部导板厚度约2mm，以上下后牙离开2～3mm为宜。导板平面与下切牙长轴垂直。特点：（1）可以起到同Nance弓一样的作用，增加了后牙支抗，避免了口外力的应用，从而…     

Bite-bumper配合固定矫治器矫治内倾型深覆的临床研究

目的探讨Bite-bumper配合固定矫治器矫治内倾型深覆打开咬合的机制及临床使用要点。方法对14名生长发育期的内倾型深覆患者,采用Bite-bumper配合固定矫正技术打开咬合,观察其临床疗效,并通过X线头影测量比较治疗前和咬合打开后有关硬组织的变化。结果1）14例患者打开咬合的时间平均为28 d;2）咬合打开后,颌骨矢状向（SNA、SNB、ANB）的变化无统计学差异,前后面高（S-Go、ANS-Me）增加,前后面高比值（S-Go/N-Me）、下颌平面角（SN-MP）、Y轴（Y axis）的变化无统计学差异,上下前牙唇倾（U1-SN、L1-MP）、切牙间角（U1-L1）减小,后牙（U6-PP,L6-MP）伸高,上切牙（U1-PP）压低,覆（overbite）减小。结论Bite-bumper配合固定矫正技术矫治内倾型深覆可快速打开咬合,并可改善内倾型深覆患者的短面型。     

固定修复重建改善重度成人前牙深覆的研究

目的：总结重建改善成人重度深覆修复方法的综合应用和临床体会。方法：对9例重度前牙深覆伴不同程度牙体牙列缺损的患者,综合应用固定义齿修复,通过适度增高垂直距离的重建方式改善患者的咬合关系。结果：重建以后全部患者牙列形态良好,咬合稳定,咀嚼功能及前牙美观均得到明显改善,经过半年至1年观察,无患者出现颞下颌关节不适主诉。结论：在患者已存在牙体牙列缺损需要修复时,采取适当增加垂直高度的修复性重建方法,可在修复牙体牙列缺损的同时,有效改善成年重度前牙深覆患者的咬合关系、咀嚼功能和美观,是一种较理想的选择。     

Increased overbite and craniomandibular disorders--a clinical approach

This study investigated the effect of a maxillary fixed lingual arch with anterior bite plane on adult patients with craniomandibular disorders (CMD) and increased overbite. The sample comprised 11 patients with an increased overbite (greater than 5 mm) and a normal or Class II molar relationship. The main CMD symptoms were daily tension headache in the region of anterior temporal muscles and/or pain or clicking in the temporomandibular joint. Previous treatment with stabilization splints, removal bite plates, or occlusal grinding had not given satisfactory results. When the maxillary lingual arch with anterior bite plane was fitted, molar separation was approximately 4 mm, and occlusal contact occurred only between the acrylic bite plane and the lower six anterior teeth. The permanent appliance could be removed only by the orthodontist. All patients reported relief of CMD symptoms 1 to 2 weeks after initiation of treatment. After a mean time of 3 months, a flatter curve of Spee, molar contact, and reduced overbite could be seen in all cases. The excessive overbite had decreased approximately 3.4 mm. Subsequent treatment involved orthodontic or prosthetic therapy to normalize and stabilize the sagittal and vertical dimensions. After an average posttreatment observation period of 2 years, all patients remained free of CMD pain.     

斜面导板配合后牙垂直牵引对面高的影响

目的 分析斜面导板配合后牙垂直牵引矫治低角型深覆(牙合)对面部高度的影响.方法 选择20例低角型深覆(牙合)患者,分为试验组及对照组.试验组10例采用HX直丝弓矫治技术,使用斜面导板配合后牙垂直牵引治疗;对照组10例采用HX直丝弓矫治技术,使用斜面导板治疗.两组治疗前后进行X线头影测量,使用SPSS11.0软件进行统计学分析.结果 两组患者矫治后齿槽高度和下面高均增加,差异有统计学意义(P＜0.05).试验组和对照组矫治后的下面高分别为(65.20±1.80) mm和(65.35±1.92) mm,组间差异没有统计学意义(P＞0.05).试验组和对照组打开前牙咬合的平均时间分别为8周和12周.结论 斜面导板配合后牙垂直牵引能有效增加后牙齿槽高度,增加下面高.     

Changes in alveolar morphology during open bite treatment and prediction of treatment result

It has been postulated that dentoalveolar height is enlarged by a compensation mechanism in long face subjects. In this study, dentoalveolar composition was studied in 83 open bite patients. It was found that increases in overbite during treatment coincided with vertical lengthening of the symphysis, which exceeded increments in lower face height. This vertical growth coincided mainly with an increase in the area of the symphysis. Furthermore, a retrusion of the maxillary incisors enhanced bite deepening. Stability of the overbite during the retention period was studied in a subset of 22 patients. It was found that retrusion of the maxillary incisors during treatment led to a more stable overbite during the retention period. Vertical lengthening of the symphysis relative to the increase in lower face height seemed to enhance bite opening during retention. Prediction of the overbite may be reliable, if a re-evaluation of the patients takes place during active treatment. The angle NTGoGn had a substantial predictive value (multiple R = 0.46) for post-treatment overbite. It is concluded that in open bite patients, a dentoalveolar compensation mechanism results in a stable overbite at the end of treatment by enlarging symphysial height through a moderate increase in symphysial volume. In addition, retrusion of the maxillary incisors contributes to overbite reduction. However, an excessive increase in vertical height of the symphysis relative to lower face height may relapse after active treatment. For prediction of the post-treatment overbite, the angle NTGoGn may be used, although a re-evaluation during treatment is recommended.     

改良平面导板治疗青少年磨牙症伴深覆的临床观察

目的观察改良平面导板治疗青少年夜磨牙伴有深覆牙合的效果。方法制作上颌平面导板,下颌两侧尖牙与其接触,后牙抬高。分昼夜戴用导板及夜间戴用导板2组,定期复查观察疗效。结果夜磨牙总治愈率为82.26%;深覆牙合总正常率为67.74%,其中昼夜戴用改良平面导板组的深覆牙合治愈率为100%。结论改良平面导板制作简单,效果明显。     

改良平面导板治疗青少年磨牙症伴深覆(牙合)的临床观察

目的 观察改良平面导板治疗青少年夜磨牙伴有深覆殆的效果。方法 制作上颌平面导板,下颌两侧尖牙与其接触,后牙抬高。分昼夜戴用导板及夜间戴用导板2组,定期复查观察疗效。结果 夜磨牙总治愈率为82．26％;深覆（牙合）总正常率为67．74％,其中昼夜戴用改良平面导板组的深覆（牙合）治愈率为100％。结论 改良平面导板制作简单,效果明显。     

Anchorage provided during intra-arch distal molar movement: a comparison between the Nance appliance and a fixed frontal bite plane

The aim of this retrospective study was to evaluate and compare the anchorage provided with the Nance appliance (NA) and the fixed frontal bite plane (FBP) during intra-arch distal molar movement. After a sample size calculation, 20 patients were recruited and randomly selected for each group from patients who fulfilled the following criteria: use of an intra-arch Ni-Ti coil appliance with either NA or FBP to provide anchorage during a six-month molar distalization period, no orthodontic treatment before molar distalization, and first and second maxillary molars in occlusion. The outcome measures assessed were anchorage loss, ie, anterior movement of maxillary central incisors, distal movement of maxillary molars, and bite opening effect. The mean age in the NA group was 14.7 years (SD 1.09) and in the FBP group 15.0 years (SD 0.99). The data revealed that the maxillary central incisors moved anteriorly 1.4 mm in the NA group and 1.9 mm in the FBP group. The difference in anchorage loss was not significant. The mean amount of molar distalization within the maxilla was 1.7 mm in the NA group and 1.8 mm in the FBP group. In both groups, the overbite was significantly reduced and the overbite was decreased significantly more in the FBP group. Because neither the NA nor FBP provided stable anchorage, a second treatment phase is recommended to reverse the anchorage loss after distal molar movement. If molar distalization is planned in deep bite cases, the FBP is the anchorage system of choice.