种植体型功能矫治器矫治过程中Beagle犬咬肌肌纤维类型的变化

目的:观察种植体型功能矫治器引导Beagle犬下颌骨前移治疗过程中咬肌MyHC-Ⅰ表达量的变化,探讨种植体型功能矫治器矫治过程中咀嚼肌的适应性改建,为矫形治疗提供理论依据.方法:8只7个月龄雄性Beagle犬分别在安装矫治器治疗后4、8、12周及拆除矫治器后4周(即16周)处死,取咬肌浅层中部组织做切片,用SABC法检测MyHC-Ⅰ在Beagle犬咬肌中的表达,采用SPSS 11.5软件包对数据进行统计学分析.结果:MyHC-Ⅰ在对照组咬肌中的阳性表达率为7.61％,在4周实验组咬肌中的阳性表达率为20.43％(P＜0.01),8周时达到最大,而后逐渐减少.拆除矫治器后,咬肌中MyHC-Ⅰ的表达逐渐减少,直至与对照组水平接近.结论:种植体型功能矫治器前移下颌过程中咬肌MyHC-Ⅰ的表达出现明显变化,种植体型功能矫治器能明显促进咀嚼肌的适应性改建.     

推杆式下颌前移矫治器的研制与临床应用

目的 :评估推杆式下颌前移矫治器治疗生长期下颌后缩患者的颌骨和牙列变化。方法 :经方丝弓矫治器排齐上、下牙列后 ,用国产推杆式下颌前移矫治器对 8例生长发育期安氏II1下颌后缩儿童进行矫治 ,拍摄治疗前后头颅定位侧位片 ,进行测量和分析。结果 :推杆式下颌前移矫治器治疗 5 -7个月后 (平均 6个月 ) ,II类磨牙关系矫治为I类关系 ,深覆盖减少了 6.9mm ,下颌骨的变化最为显著 ,SNB增加了 2 .5° ,下颌升支高度 (Co -Go)下颌总长度 (Co -Pg) ,下颌体长度 (Go -Pg)以及Pg到OLp平面的距离分别增加了 3 .8mm、6.5mm和 3 .8mm。上颌骨的生长受到一定抑制 ,SNA由 82 .4°减少到 81.0°。ANB减少了 3 .7° ,Wits值减少了 1.7mm。结论 :经国产推杆式下颌前移矫治器治疗 ,促进了下颌骨生长 ,抑制了上颌骨生长 ,使下颌骨长度得以增加 ,再加上上颌牙列远中移动 ,下颌牙列近中移动 ,实现了II类错牙合的根本改正     

Herbst矫治器治疗安氏Ⅱ1下颌后缩儿童的头影测量研究

目的 :量化评估经Herbst矫治器治疗的生长期患者的颌骨和牙列的矢状和垂直方向变化。方法 :采用国产Herbst矫治器对 17例生长发育期安氏Ⅱ1下颌后缩儿童进行临床矫治 ,并以 10例未经治疗的生长发育期安氏Ⅱ1下颌后缩儿童作为对照。结果 :Herbst矫治器治疗 6～ 8个月 (平均 7个月 )后 ,Ⅱ类磨牙关系矫治为Ⅰ类关系 ,覆盖减少了 7.2mm ,SNB角、下颌升支高度 (Co Go)、下颌总长度 (Co Pg)、下颌体长度 (Go Pg)以及Pg到OLP平面的距离均显著增加。上颌骨生长受到明显抑制 ,SNA角、A到OLP平面的距离均显著减少。在垂直方向上 ,前全面高 (N Me)、前下面高 (ANS Me)、后全面高 (S Go)、后下面高 (Ar Go)治疗后均明显增加。结论 :Herbst矫治器治疗促进下颌骨生长 ,抑制上颌骨生长 ,下颌骨长度增加 ;上颌牙列远中移动 ,下颌牙列近中移动 ,Ⅱ类错牙合得以矫治。     

应用磁力矫治器对青春期恒河猴进行Ⅲ类功能牵引的组织形态学观察

目的应用Ⅲ类磁力矫治器建立青春期恒河猴动物模型,观察其对颅面部形态学及颅面骨缝的组织学影响,并探讨其机制。方法选用生长发育期雄性恒河猴6只,实验组45、90 d各2只,对照组45、90 d各1只。实验组配戴铸造式磁力矫治器,对照组不戴用矫治器。采用头颅侧位片测量分析其颅颌面的形态学变化。选用颅面部6条骨缝作为观察对象,应用活体荧光染色及苏木精-伊红染色观察其组织学变化。结果所有实验动物颌位均出现明显近远中移位,90 d组的变化较45 d组更为明显,对照组无明显变化。荧光染色及苏木精-伊红染色观察显示：实验组各骨缝均表现为明显的骨沉积,尤其是颧颌缝、腭横缝、翼腭缝、颧颞缝最为明显。结论Ⅲ类磁力矫治器可以引起上下颌骨以及牙齿位置的变化,并可使颅面骨缝内纤维结缔组织排列方向发生变化,导致骨缝两侧新骨的大量沉积。     

一例功能性III类错畸形患儿的早期矫治

目的：本文报道1例替牙列期功能性III类错畸形患者的早期矫治过程。方法：该患者使用FRIII型功能矫治器进行治疗。评价指标包括对26个月主动功能矫治阶段前后及2年效果维持后的头影测量分析及模型分析。结果：FRIII型功能矫治器治疗替牙列期功能性III类错畸形时,上颌骨向前生长量有所增加,并且矫治器解除颊肌张力对牙弓宽度的影响,恢复上颌牙弓宽度的自然生长,抑制下颌的生长,治疗后纠正反覆反覆盖。结论：功能性III类错畸形早期纠正下颌前伸、协调口周肌肉功能、恢复引导上下颌骨生长能得到良好的错畸形矫治结果。     

Forsus推杆矫治器矫治安氏Ⅱ类错(牙合)的牙颌结构变化

目的:探讨Forsus推杆矫治器治疗安氏Ⅱ 类错(牙合)引起的牙颌面结构变化.方法:采用Forsus推杆矫治器对21 例11～16岁安氏Ⅱ 类错(牙合)患者进行治疗,并对术前术后X线片进行头影测量分析.结果:经过6～9 个月治疗,下颌向前生长(2.73±1.13) mm,而上前牙舌倾(1.87±2.26) mm,下前牙唇倾(4.74±1.47) mm,覆盖减小(6.61±1.77) mm,其中上下颌骨生长所致占35.1%,牙齿移动占64.9%,磨牙关系改正中骨性因素占51.6%,牙性因素占48.4%.结论:Forsus推杆矫治器是一种简便可行的固定功能矫治器,对安氏Ⅱ 类错(牙合)能产生较显著的生长改良作用.     

包括TMJ上下颌骨及牙列的MBT直丝弓矫治器三维有限元模型的建立

目的 建立带有MBT直丝弓矫治器的颞下颌关节(TMJ)、上下颌骨及牙列的三维有限元模型,研究MBT直丝弓矫治器的力学行为.方法 2007年3月至12月于吉林大学口腔医学院通过多层螺旋CT扫描,获得TMJ、上下颌骨及牙列数据,采用Mimics、Ansys多种软件相结合的方法,建立包括TMJ、上下颌骨及牙列的MBT直丝弓矫治器的三维有限元模型.结果 建立了左侧TMJ、上下颌骨及牙列的MBT直丝弓矫治器的三维有限元模型,还可根据不同研究目的添加和删除组织及部件.结论 所建立的三维有限元模型为进一步分析临床中MBT直丝弓矫治器的力学行为提供了一个良好的平台,进而为临床操作提供理论依据.     

应用磁力矫治器对青春期恒河猴进行Ⅲ类功能牵引的组织形态学观察

目的 应用Ⅲ类磁力矫治器建立青春期恒河猴动物模型,观察其对颅面部形态学及颅面骨缝的组织学影响,并探讨其机制.方法 选用生长发育期雄性恒河猴6只,实验组45、90d各2只,对照组45、90d各1只.实验组配戴铸造式磁力矫治器,对照组不戴用矫治器.采用头颅侧位片测量分析其颅颌面的形态学变化.选用颅面部6条骨缝作为观察对象,...     

MBT直丝弓矫治器与SUS^2下颌前伸矫治器治疗安氏Ⅱ类下颌后缩错[牙合]12例报告

目的：采用MBT直丝弓矫治器与SUS^2下颌前伸矫治器治疗安氏Ⅱ类下颌后缩错[牙合]畸形,观察其临床疗效。方法：对12例安氏Ⅱ类下颌后缩错胎病例应用MBT直丝弓矫治器常规排齐整平上下牙列,再装配SUS^2下颌前伸矫治器进行矫治,对治疗前后面[牙合]像及头颅侧位定位片进行分析。结果：SNB增加2．2°,ANB减少2．5°,SNA无明显变化,前牙覆盖减小4．4ram,MP-FH增加1．2°,NP-FH增加1．6°。结论：用MBT直丝弓矫治器与SUS^2下颌前伸矫治器治疗安氏Ⅱ类下颌后缩错[牙合]畸形可以有效地利用下颌骨向前生长的潜力,刺激下颌骨的生长,抑制上颌骨的生长,同时可以使上颌磨牙远中移动,下颌磨牙近中移动,改善骨性及牙性矢状关系不调,从而达到矫治Ⅱ类错[牙合]的目的,取得明显的骨骼和侧貌改变。     

SUS2矫治器联合直丝弓技术治疗恒牙早期安氏Ⅱ类错(牙合)

目的 观察SUS2下颌前伸矫治器联合直丝弓矫治器对生长期安氏Ⅱ类错(牙合)的治疗效果.方法 选择11例安氏Ⅱ类错(牙合)的患者,其中男3例,女8例,均为恒牙早期.X线头影测量显示为下颌后缩及轻微上颌前突,颈椎分析显示为生长发育高峰期或高峰前期,所有病人用SUS2下颌前伸矫治器联合直丝弓矫治器进行治疗,然后应用头影测量进行效果评估,分析该矫治器的疗效.结果 平均疗程18.4个月,矫正后下切牙唇倾,下颌磨牙近中移动,磨牙关系均达Ⅰ类或接近Ⅰ类,下颌骨的长度增加,下磨牙前移升高,前后牙垂直方向变化导致上下(牙合)平面顺时针旋转,软组织侧貌明显改善.结论 SUS2下颌前伸矫治器与直丝弓矫治器联合使用,装配简便,对生长期安氏Ⅱ类错(牙合)的患者既可刺激下颌骨的生长同时又可抑制上颌骨的生长,从而产生一定的生长改良作用,通过对牙、颌作用而取得比较明显的骨骼以及侧貌的改变.     

The repositioning Nance appliance: a fixed functional appliance and case report

Functional appliances are primarily orthopaedic tools used to influence the facial skeleton in a growing child. These appliances may be fixed or removable. A fixed functional appliance referred to as the Repositioning Nance Appliance (RNA) was developed and a case report is presented. The RNA is a fixed functional appliance consisting of bands on the upper first molars joined together with a 0.036-inch stainless steel wire that is bent around the anterior contour of the palate. Just lingual to the upper incisors the wire is complemented with an acrylic Nance button, which is modified with a downward and backward incline projection. The labial aspect of this projection is smooth and when the lower incisors come into contact with it, they are directed into an edge-to-edge relation with the upper incisors, brought about by forward positioning of the mandible. This has the net effect of relocating the mandible into a Class I relation. A 14-year-old boy in his late mixed dentition stage of dental development presented with mild crowding, a horizontal growth pattern and a skeletal Class II jaw relation caused by an underdevelopment of the mandible. Treatment was initiated using the RNA and continued for a period of 18 months. This was followed by full fixed appliances for another 12 months and resulted in Class I skeletal and dental relations, a reduced overjet and an improved facial profile. The RNA, if applied correctly is a simple fixed functional appliance that can be used with confidence, comfort and economy to both the patient and orthodontic practitioner.     

Correction of a severe skeletal Class II occlusion with a fixed functional appliance anchored on mini-implants: a patient report

This report describes the treatment of a patient with a severe skeletal Angle Class II occlusion with a 14-mm overjet, crowding, and protrusion of the mandibular anterior teeth. The Class II relationship was caused mainly by a short corpus of the mandible. A fixed functional appliance was directly anchored on mini-implants, which were inserted in the mandible. A significant amount of mandibular advancement was achieved, with no protrusion of the mandibular anterior teeth. Facial esthetics improved considerably. This is the first patient report to demonstrate that mini-implants can be applied to anchor fixed functional appliances. The rationale to use mini-implants with fixed functional appliances and the potential benefits of this procedure are discussed.     

Pancherz分析法评价两种功能矫治器治疗安氏Ⅱ^1类错殆患者的效果

目的应用Pancherz分析法评价Dynamax、固定斜面导板治疗生长发育期Ⅱ1类错袷的临床效果．方法应用Dynamax矫治器（D组）、固定斜面导板（G组）联合固定矫治器分别对15例安氏Ⅱ1类错袷患者进行功能性矫治8一12个月,治疗前后摄头颅侧位片,应用Pancherz法进行头影测量分析,两组结果比较采用t检验。结果两组下颌骨均显著生长,治疗前后Pg/OLP、ii／OLP、mi／OLP、is／OLP．ii／OLP、ms／OLP—mi／OLP均有明显改变。前牙覆盖明显减小,D组骨性因素占52．3％,牙性因素占47．7％。G组骨性因素占34．9％,牙性因素占65．1％。磨牙关系明显改善,D组骨性因素占93．9％,牙性因素占6．1％。G组骨性因素占74．4％,牙性因素占25．6％。结论两种功能矫治器矫治Ⅱ1类错袷均可促进下颌骨生长,改善覆盖和磨牙关系。应用Pancherz法分析前牙覆盖及磨牙关系,Dynamax矫治器表现出相对较多的骨性变化。     

Orthodontic and orthopaedic approach in the treatment of skeletal open bite.

The aim of this study was to make a detailed evaluation of the changes in the dentofacial structures that could be effective in the elimination of skeletal open bite. The study was performed on 32 skeletal open bite cases which were treated with Begg technique, Edgewise technique, and functional appliances and findings were analysed by multivariate statistical methods. Open bite was significantly reduced in all of the treatment groups. Apart from minor differences, similar changes were observed with Begg and Edgewise technique treatments. During fixed appliance therapy marked increases in the upper and lower posterior dentoalveolar height were observed, and the mandible rotated backwards. On the other hand, with the functional appliances vertical growth of the posterior upper and lower dentoalveolar region was depressed, and the mandible was rotated forwards and upwards with the centre at the premolars. These findings were confirmed by regression analysis: rotational changes in the maxillary and mandibular bases explained 46 per cent of variance of the reduction of open bite in the functional group, while 28 and 16 per cent of variance was explained in the Edgewise and Begg groups, respectively.     

Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis

OBJECTIVE: To evaluate the anteroposterior short-term skeletal and dental effects on Class II malocclusion in growing patients following treatment with functional appliances (activators or twin block), extraoral traction, or combination appliances (appliances with both functional and extraoral traction components), based on published data. MATERIALS AND METHODS: A literature search was carried out identifying a total of nine prospective clinical trials. The data provided in the publications underwent meta-analysis using the random effects model with regard to SNA, SNB, ANB, and overjet. RESULTS: All appliance groups showed an improvement in sagittal intermaxillary relationships (decrease in ANB) when compared to untreated subjects. Activators and twin block appliances accomplish this mainly by acting on the mandible (increases in SNB) while twin block appliances also seem to act on the maxilla (decrease in SNA). Extraoral traction appliances achieve this by acting on the maxilla (decreases in SNA). Combination appliances mainly act on the mandible (increase in SNB). Activators, twin block, and combination appliances also reveal a decrease in overjet, which is not the case in the singular use of extraoral traction. CONCLUSIONS: Intermaxillary changes being present in all appliance groups, anteroposterior treatment response following the use of functional appliances and/or extraoral traction in growing class II malocclusion patients is most evident in one of the two jaws (mandible for activators and combination appliances and maxilla for extraoral traction) except for the twin block group, which shows changes on both jaws.     

A comparison of the Herbst and Fr?nkel appliances in the treatment of Class II malocclusion

This study investigated the treatment effects produced by two types of functional appliance, one primarily tooth-borne (the Herbst appliance) and one primarily tissue-borne (the FR-2 of Fr?nkel). Serial cephalometric radiographs from 45 patients who had been treated with the acrylic splint Herbst appliance and from 41 patients who had been treated with the FR-2 appliance were compared with serial radiographs of 21 untreated persons with Class II malocclusions. Treatment effects were identified through the use of a conventional cephalometric analysis. The results of this study indicated that both appliances had influenced the growth of the craniofacial complex in treated persons. Significant skeletal changes were noted in both treatment groups, with both groups showing an increase in mandibular length and in lower facial height, as compared with controls. Greater dentoalveolar treatment effects were noted in the group wearing the tooth-borne functional appliance than in those wearing the tissue-borne appliance.     

Activator versus cervical headgear: superimpositional cephalometric comparison.

Clinical trials comparing activator and headgear treatment have shown comparable effectiveness in the total result achieved, but the mechanism of correction is still uncertain. Most studies have used conventional cephalometric methods to evaluate treatment effects, and this might be a factor for the inconclusive results. The aim of this retrospective investigation was to compare the effects of activator and cervical headgear treatment with a superimpositional cephalometric method that could discern between vertical and horizontal effects as well as skeletal, dental, and rotational treatment results. The sample consisted of 2 groups of Class II Division 1 patients, treated without extraction by the same clinician (22 patients were treated with a modified activator-type functional appliance, and 30 patients were treated with a combination of cervical headgear and fixed edgewise appliances). Lateral cephalometric radiographs taken at the beginning of treatment and after Class II molar correction were evaluated conventionally and with a superimpositional method. Regarding the conventional cephalometric measurements, the only difference in the anteroposterior dimension between the 2 treatment modalities was the significantly reduced SNA angle in the headgear group. Both appliances appeared to produce minimal changes in FMA and GoGn-SN angles, and there were no statistically significant differences between the treatment groups. Regional superimpositions showed differences in the movement of molars: the maxillary molar was found to move more posteriorly and inferiorly in the headgear group. Conversely, the mandibular molar was found to move toward the occlusal plane more in the activator group. Assessment of mandibular skeletal changes showed that the mandible moved anteriorly by approximately 1 mm more in the activator than in the headgear group. The overall effect of the 2 appliances was found to be clinically comparable. However, the individual components of change showed differences characteristic of each appliance.     

Study of mandibular growth in patients treated with Fr?nkel′s functional regulator (1b)

Objectives: The purpose of this study was to assess mandibular growth in patients with Class II division 1 malocclusions when treated with Fränkel´s functional regulator 1b. Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n:28), and pubescent (n:15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n:19), and a pubescent group (n:21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movements of the mandible. A two-way ANOVA with interaction was done to compare the changes between the control group and the treatment group, while the Student t for independent samples was used to compare each age group. Results: The Gnathion and Gonion points showed significant differences in the whole sample (p<0.001) as well as in the prepubescent (p<0.001) and pubescent groups (p<0.05). Rotational changes of the mandible measured using the facial axis and mandibular plane showed no statistical differences between both groups (p>0.05). Conclusion: The results show that the FR produces vertical orthopedic growth in the mandible but not horizontal growth compared to non-treated Class II-type I malocclusion patients. No rotational changes were found in the mandible, but we did record mandibular growth along the inclination of the facial axis. Key words:Fränkel appliance, orthodontics, functional appliances, mandibular growth.     

Roentgen stereometry with the aid of metallic implants in hemifacial microsomia

Displacement of the mandible and the maxilla with growth in relationship to the frontal bone was recorded in eleven children with hemifacial microsomia, aged 3 to 14 years at the initial examination. The goals were to assess the efficiency of the method for accurate recording of articular growth and to obtain information on facial development in each of these children. Correction of the skeletal asymmetry was not attempted during observation periods of from 707 to 1,484 days. In continued observations three of the children were treated with functional appliances. Roentgen stereometry with the aid of metallic implants proved to be an efficient method for highly accurate recordings of articular facial growth in relationship to the frontal bone. Displacement of the jaws was asymmetrical in all of the examined children as determined in the frontal and transverse planes of the head. In about 50 percent of the children the degree of asymmetry increased in one plane while it decreased in the other plane. No correlation was found between the extent of the mandibular deformity, as seen on orthopantomograms, and the displacements of the mandible. Generally, the displacement of the maxillary bones corresponded with the displacement of the mandible. Articular growth of the jaws was redirected toward a more favorable pattern in two of the children during the time they used a functional appliance. In the third child the use of a functional appliance had no such effect.     

Skeletal and dental effects of a mini maxillary protraction appliance

The aim of this study was to evaluate the skeletal and dentoalveolar changes achieved by a modified protractor in growing skeletal and dental Class III patients and to compare these changes with normal growth in a Class I untreated control group. The study group consisted of 25 patients (11 girls, 14 boys; mean age 11.74 +/- 1.81 years). The control group was composed of 20 patients (15 girls, five boys; mean age 11.89 +/- 1.08 years). The Class III patients were treated with a bonded acrylic cap splint type expander and a modified maxillary protractor until a positive overjet was achieved. The mean observation period was 0.65 years. Changes in study and control groups and differences between the groups were analyzed statistically. The results showed that protraction appliance produced a significant positive improvement in maxillo-mandibular relations. The forward movement of the maxilla was significant in treated Class III patients, but a slight difference was present between the two groups regarding maxillary rotation. The effective length of the maxilla was significantly increased in the Class III patients. The mandible was positioned backward, and posterior rotation of the mandible was significant in the treatment group. There was a significant increase in lower anterior facial height of treated Class III patients. The dentoalveolar measurements showed that the maxillary incisors proclined and the mandibular incisors significantly retroclined in the Class III group. A modified maxillary protractor treatment is effective for correcting skeletal Class III malocclusion.