MBT矫治前后牙弓宽度变化的模型分析研究

目的 分析牙列拥挤患者不拔牙与拔牙的MBT矫治对牙弓宽度变化的影响。方法 选择我院正畸科2008—2011年MBT矫治器治疗的牙列拥挤患者40例。其中轻中度牙列拥挤患者20例,使用MBT矫治器进行不拔牙正畸;中重度牙列拥挤患者20例,使用MBT矫治器进行拔除4颗第一前磨牙的拔牙正畸。测量术前术后石膏模型的牙弓宽度,对矫治前后不拔牙组和拔牙组的测量数据分别进行组内、组间统计学分析。结果 矫治前后不拔牙组:上颌尖牙间宽度增大,上下颌第一前磨牙、第一磨牙间宽度增大,有统计学意义;拔牙组:上颌尖牙间宽度增大,上下颌第二前磨牙、第一磨牙间宽度变小,有统计学意义。矫治前2组上下颌尖牙、第一磨牙间牙弓宽度相近,无统计学差异;矫治后不拔牙组上下颌第一磨牙间牙弓宽度大于拔牙组,有统计学意义,2组上下颌尖牙间牙弓宽度相近,差异无统计学意义。结论 不拔牙矫治牙弓宽度变化与拥挤部位、拥挤程度有关,拔牙矫治牙弓宽度变化主要与牙齿移动方向有关。拔牙矫治后尖牙间宽度不会减小。     

上颌拔牙矫治对骨性Ⅲ类错牙合畸形正颌术前牙弓宽度影响研究

目的 评价骨性Ⅲ类错牙合畸形患者正颌术前正畸治疗中拔除与不拔除上颌第一前磨牙对牙弓横向宽度的影响,为是否在术前正畸中拔除上颌前磨牙提供一个参考指标。方法 选择2007年1月至2012年7月在大连市口腔医院接受正畸-正颌联合治疗的骨性Ⅲ类错牙合畸形患者28例,其中12例术前正畸采取拔牙矫治（拔牙组）,16例采取不拔牙矫治（非拔牙组）。对两组病例正畸治疗前后的模型进行牙弓宽度对比研究。结果 经过术前正畸治疗,拔牙组较非拔牙组的上颌后段牙弓宽度减小明显,差异有统计学意义（P < 0.05）;拔牙组与非拔牙组的下颌牙弓中段及后段宽度均有增加,但两组差异无统计学意义（P > 0.05）。结论 在骨性Ⅲ类错牙合畸形的正畸-正颌外科联合治疗中,拔除上颌第一前磨牙有利于术前正畸有效去除后牙代偿,协调上下牙弓间横向关系,为正颌手术创建良好条件。     

拔牙与不拔牙矫正治疗对牙弓宽度的影响

目的比较拔牙与不拔牙矫正治疗对牙弓宽度的影响。方法选择25例拔除第一或第二前磨牙的正畸患者,25例未拔牙的正畸患者,测量治疗前后的牙颌模型,记录上、下颌牙弓宽度,其中包括尖牙间、前磨牙间及磨牙间宽度,比较拔牙与不拔牙矫正治疗对牙弓宽度的影响。结果上、下颌尖牙牙弓宽度的比较中,拔牙组比不拔牙组大,上颌大1.79mm,下颌大1.95mm,(P<0.01)。磨牙区牙弓宽度差异无显著性。结论拔牙治疗不会导致尖牙区宽度的减小。     

牙列拥挤与前突病例拔牙矫正后牙弓宽度变化对比研究

目的：通过研究尖牙、第一磨牙及第二磨牙间宽度的变化,对比牙列拥挤和牙列前突病例以及年龄因素对拔牙矫治前后牙弓宽度变化的影响。方法：随机选择60例拔除四个第一前磨牙MBT矫治技术治疗患者,分为拥挤组和前突组及16岁以上组和16岁以下组进行对比研究,取治疗前后记存模型进行测量,并经统计学分析。结果：拔除四个前磨牙病例矫治后,磨牙区牙弓宽度均减小,尖牙区牙弓宽度均增加;拥挤组及16岁以下组尖牙间牙弓宽度增加更明显,磨牙区牙弓宽度减小在各组间无明显差异。结论：拔牙矫正后拥挤组及16岁以下组的尖牙间牙弓宽度增加更明显,所以治疗后的保持需要时间更长。     

不同拔牙模式正畸矫治对成年女性牙弓宽度和软组织正貌的影响

目的：研究不同拔牙模式对安氏Ⅱ1错牙合成年女性治疗前后牙弓宽度和面部软组织正貌的影响。方法：将40例安氏Ⅱ1错牙合需拔牙矫治的成年女性患者随机分为两组。 A组拔除上颌2颗第一前磨牙,下颌拔除2颗第二前磨牙,B组拔除4颗第一前磨牙。分析比较两组病例治疗前后牙弓宽度和面部软组织正貌指标的变化。结果：正畸治疗后,组内比较显示两组病例上下颌尖牙间宽度均增加,上下颌第一磨牙间宽度均减小,差异有统计学意义（P＜0.05）;组间比较仅下颌尖牙和下颌第一磨牙间宽度变化有统计学意义（P＜0.05）,B组下颌尖牙宽度增加量大于A组,B组下颌第一磨牙牙弓宽度减小量小于A组。治疗前后比较,两组病例在面宽、口裂宽、下颌角间宽、容貌面长和鼻下颏下距的差异均无统计学意义（P＞0.05）。Pearson相关性分析显示牙弓宽度与软组织正貌指标之间无相关关系（P＞0.05）。结论：安氏Ⅱ1错牙合病例正畸矫治后成年女性软组织正貌的变化不受拔牙模式影响,不同拔牙模式仅影响矫治后牙弓宽度的变化。     

拔牙与非拔牙矫治前后牙弓宽度的变化

目的:比较拔牙与非拔牙矫治前、后牙弓前后部宽度的变化。方法:选择50例患者的矫治前后模型作为研究对象,其中25例采取拔除4个第一前磨牙的矫治方法,为拔牙组;25例采取非拔牙矫治,为非拔牙组。观察2组矫治前、后牙弓前后部宽度的变化,采用SPSS11.0软件包进行配对t检验和χ2检验。结果:2组上颌尖牙间宽度均增大,但组间无统计学差异(P>0.05);2组下颌尖牙间宽度均增大,且组间有显著统计学差异(P<0.01);2组第二磨牙间宽度均无变化。结论:与非拔牙矫治相比,拔牙矫治并不会引起牙弓的缩窄。     

安氏II~1治疗前后牙弓形态的分析与比较——应用β函数模拟牙弓形态

目的:应用β函数分析与比较安氏II1治疗前后牙弓形态。方法:选择安氏II类I分类上颌拔除2个第一前磨牙,下颌拔除2个第二前磨牙病例17例(,男6例,女11例),平均年龄13.8岁。取矫治前后石膏模型,将模型平行于基准平面扫描到计算机。由中切牙接触点、双侧尖牙牙尖点、和双侧第一磨牙远中颊尖点五个点确定个体牙弓形态。结果:①.上下牙弓宽度矫治前后有显著差异(p<0.05)。②.上下牙弓长度治疗前后尖牙长度变化不明显,第一磨牙长度具有高度显著性差异(p<0.001)。③.治疗前后上下牙弓形状无明显变化(p>0.05)。结论:牙弓形态包括牙弓大小及牙弓形状两方面。正畸治疗时有时因治疗需要改变牙弓大小,但应保持患者治疗前牙弓形状,以期获得稳定的长期疗效。     

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目的评价骨性Ⅲ类错矜畸形患者正颌术前正畸治疗中拔除与不拔除上颌第一前磨牙对牙弓横向宽度的影响,为是否在术前正畸中拔除上颌前磨牙提供一个参考指标。方法选择2007年1月至2012年7月在大连市口腔医院接受正畸一正颌联合治疗的骨性Ⅲ类错铪畸形患者28例,其中12例术前正畸采取拔牙矫治（拔牙组）,16例采取不拔牙矫治（非拔牙组）。对两组病例正畸治疗前后的模型进行牙弓宽度对比研究。结果经过术前正畸治疗,拔牙组较非拔牙组的上颌后段牙弓宽度减小明显,差异有统计学意义（P〈0．05）;拔牙组与非拔牙组的下颌牙弓中段及后段宽度均有增加,但两组差异无统计学意义（P〉0．05）。结论在骨性Ⅲ类错猞畸形的正畸一正颌外科联合治疗中,拔除上颌第一前磨牙有利于术前正畸有效去除后牙代偿,协调上下牙弓间横向关系,为正颌手术创建良好条件。     

Damon技术非拔牙矫治牙列拥挤患者的牙弓形态变化

目的探讨采用Damon技术对牙列拥挤患者进行非拔牙矫治的牙弓形态变化。方法 15例中度牙列拥挤患者,使用DamonⅢ矫治器进行非拔牙矫治。对治疗前后的记存模型进行测量分析,探讨牙弓形态的变化特点。结果矫治后的牙弓长度和宽度均有显著增加,具体的变化特点与牙列拥挤的程度和部位有关。牙弓宽度增加主要发生在上颌第一前磨牙和下颌第二前磨牙区。结论采用Damon技术非拔牙矫治牙列拥挤患者,牙弓形态改变主要是前磨牙区宽度及牙弓长度增加。     

拔牙与非拔牙矫治后牙弓宽度及颊廊变化的对比研究

目的比较拔牙矫治与非拔牙矫治对牙弓宽度及颊廊的影响,并探讨颊廊与牙弓宽度改变的关联性。方法收集符合要求的拔牙矫治与非拔牙矫治患者各50例,用石膏模型测量牙弓宽度,用正面自然微笑相测量颊廊宽度,比较拔牙矫治前后牙弓宽度及颊廊宽度的改变量、非拔牙矫治前后牙弓宽度及颊廊宽度的改变量,研究拔牙对牙弓宽度及颊廊宽度的影响,并通过分析牙弓宽度的改变量与颊廊宽度的改变量之间的关联性来探究拔牙与否对牙弓宽度及颊廊宽度的影响是否存在相关性。结果 1拔牙组矫治后的上尖牙牙弓宽度增加,非拔牙组无明显增加;2拔牙组与非拔牙组矫治后前磨牙宽度均有所增加,但拔牙组增加量大于非拔牙组;3拔牙组与非拔牙组矫治后上颌第一磨牙间的宽度均有所增加,但非拔牙组增加量大于拔牙组;4拔牙组与非拔牙组矫治前后的颊廊宽度均无统计学差异;5拔牙组与非拔牙组矫治前最后可视磨牙的宽度、矫治后尖牙牙弓宽度与颊廊宽度有相关性。结论 1矫治前后牙弓宽度的改变与拔牙与否有关;2矫治前后颊廊的改变与拔牙与否无关;3牙弓宽度的改变与颊廊的改变在大多数情况下无直接的相关性。     

上颌快速扩弓联合固定矫治器治疗的稳定性研究

目的 观察患者接受上颌快速扩弓联合直丝弓矫治器治疗后覆牙合、覆盖及上牙弓宽度的变化。方法 选择2003年2月—2008年1月于青岛市口腔医院进行治疗的患者37例（男19例,女18例）,将患者分为4个不同的时期进行测量（N1:治疗前;N2:进行上颌快速扩弓后;N3:固定治疗后;N4:保持1年后）。分别测量每位患者的上颌尖牙间宽度、前磨牙间宽度、磨牙间宽度,并对前牙覆盖和覆牙合进行测量。患者的平均年龄（11.3±1.4）岁（10.2～15.3岁）。结果 治疗全部结束后、尖牙间宽度、前磨牙间宽度、磨牙间宽度、覆盖、覆牙合分别增加（2.6±2.3）mm、（3.7±2.1）mm、（5.2±2.5）mm、（0.3±0.6）mm、（-0.1±1.6）mm,患者复发率在尖牙宽度为47%,前磨牙间宽度为21％,磨牙间宽度为10%,覆盖复发率为9%,覆牙合为13%。结论 患者经过上颌快速扩弓后,在固定矫治阶段复发明显,保持阶段也有一定程度的复发。 上颌快速扩弓能够减小覆牙合,增加覆盖。     

Short- and long-term evaluation of mandibular dental arch dimensional changes in patients treated with a lip bumper during mixed dentition followed by fixed appliances

Objective:To evaluate short- and long-term mandibular dental arch changes in patients treated with a lip bumper during the mixed dentition followed by fixed appliances, compared with a matched control sample.Materials and Methods:Dental casts and lateral cephalograms obtained from 31 consecutively treated patients before (T₀) and after (T₁) lip bumper, after fixed appliances (T₂), and a minimum of 3 years after fixed appliances (T₃) were analyzed. The control group was matched as closely as possible. Arch width, arch perimeter, arch length, and incisor proclination were evaluated. Repeated measures ANOVA was used to analyze changes in measurements over all four time points between treatment and control groups.Results:Arch widths and crowding were always significantly different except at T₂−T₁. At T₁−T₀, only crowding decreased 3.2 mm while intercanine, interpremolar, and intermolar widths increased by 3.8, 3.3, and 3.9 mm, respectively. Changes at T₃−T₂ showed a significant decrease of 2.1 mm for crowding and an increase of 3.5, 2.9, 2.7, and 0.8 mm for intercanine, interpremolar, and intermolar widths and arch perimeter, respectively. Finally, at T₃−T₀, the reduction in crowding of 5.03 mm was significant and clinically important in the treated group. The differences between intercanine, interpremolar, and intermolar widths were also significant (2.1, 3.8, and 3.6 mm, respectively). All those differences favored the treated group.Conclusions:Mandibular dental arch dimensions were significantly changed after lip bumper treatment. At follow-up, all arch widths were slightly decreased, generating an increase of 0.4 mm in crowding, considered clinically irrelevant. Overall changes remained stable after an average 6.3-year follow-up.     

Dental and alveolar arch widths in normal occlusion, class II division 1 and class II division 2

The aim of this study was to compare the transverse dimensions of the dental arches and alveolar arches in the canine, premolar, and molar regions of Class II division 1 and Class II division 2 malocclusion groups with normal occlusion subjects. This study was performed using measurements on dental casts of 150 normal occlusion (mean age: 21.6 +/- 2.6 years), 106 Class II division 1 (mean age: 17.2 +/- 2.4 years), and 108 Class II division 2 (mean age: 18.5 +/- 2.9 years) malocclusion subjects. Independent-samples t-test was applied for comparisons of the groups. These findings indicate that the maxillary interpremolar width, maxillary canine, premolar and molar alveolar widths, and mandibular premolar and molar alveolar widths were significantly narrower in subjects with Class II division 1 malocclusion than in the normal occlusion sample. The maxillary interpremolar width, canine and premolar alveolar widths, and all mandibular alveolar widths were significantly narrower in the Class II division 2 group than in the normal occlusion sample. The mandibular intercanine and interpremolar widths were narrower and the maxillary intermolar width measurement was larger in the Class II division 2 subjects when compared with the Class II division 1 subjects. Maxillary molar teeth in subjects with Class II division 1 malocclusions tend to incline to the buccal to compensate the insufficient alveolar base. For that reason, rapid maxillary expansion rather than slow expansion may be considered before or during the treatment of Class II division 1 patients.     

159例矫治前后牙弓测量结果分析

探讨和分析不同治疗方法不对病例矫治前后牙弓变化的规律。方法。对使用固定矫治器进行治疗的三组１５９例治疗前后研究模型进行牙弓测量。结果１治疗后,扩弓组６－６宽度增加;关隙组３－３长度,牙弓长度、３－３宽度减少;拔牙组３－３长度增加而牙弓长度,基骨长度减少,６－６宽度减少而基骨宽度增加。２治疗前基骨宽度关隙组〉扩弓组〉拔牙组;治疗后３－３长度关隙组〈扩弓组〈拔牙组和３－３宽度三组间无显著性差异。结论：     

Maxillary arch changes with transpalatal arch treatment followed by full fixed appliances

Objective:To evaluate short- and long-term maxillary dental arch dimensional changes in patients treated with a transpalatal arch (TPA) during mixed dentition followed by full fixed appliances in the permanent dentition compared with an untreated sample.Materials and Methods:Dental casts and lateral cephalograms obtained from 36 consecutively treated patients before TPA treatment (T₀), after TPA treatment (T₁), after fixed appliance treatment (T₂), and a minimum of 3 years after fixed appliance treatment (T₃) were analyzed. The control group was matched as closely as possible. Arch widths, perimeter, and length, as well as crowding and incisor proclination, were evaluated.Results:In the treated group, intercanine, interpremolar, and intermolar widths and arch perimeter increased significantly at T₁. At T₂, only the intercanine width increase was still significant. At T₃ all arch dimensions decreased, remaining larger than they were at T₀. The arch length increased after T₁, significantly decreased at T₂, and slightly decreased at T₃. The crowding decreased significantly at T₁, was eliminated at T₂, and increased at T₃. At T_3, 50% of the patients showed relapse with crowding ranging from 0.5 to 2 mm. In the control group at T1, only slight changes were noted but crowding increased. At T2, crowding and upper incisor inclination increased but arch length decreased. At T3, intercuspid width, arch perimeter, and arch length continued to decrease, thereby increasing crowding.Conclusion:Maxillary dental arch dimensions changed significantly after TPA followed by treatment with fixed appliances. Relapse occurred to some extent, especially in intercanine width and arch perimeter, but most of the dental arch changes remained stable.     

Relapse tendency in maxillary arch width in unilateral cleft lip and palate patients with different maxillary arch forms.

OBJECTIVE: The aim of this study was to investigate the relapse tendency in the maxillary dental arch widths in unilateral cleft lip and palate patients with different types of maxillary arch form. SUBJECTS: Thirty-two unilateral cleft lip and palate patients treated by one-stage surgical palatal closure were included. The subjects were divided into three groups according to the types of the maxillary arch forms: group A, symmetrical arch form; group B, collapse of minor segment; group C, collapse of both segments. METHODS: Using dental casts obtained at three different times, relapse in the intercanine, interpremolar, and intermolar widths in each group was assessed and differences between groups were investigated. Results: Patients in group A showed stable results in all measurements. Patients in group B showed posttreatment relapse in the intercanine width only, whereas patients in group C demonstrated significant posttreatment relapses in the interpremolar and intermolar widths. Comparison between groups showed more significant relapse in the interpremolar and intermolar widths of group C than in those of group B. CONCLUSION: The types of the maxillary arch forms in unilateral cleft lip and palate patients might play a stronger role in the stability of the maxillary dental arch widths after orthodontic treatment in patients with collapse of both segments and a severe degree of maxillary narrowness.     

自锁托槽非拔牙矫治下牙列拥挤的临床研究

目的 比较自锁托槽和传统结扎式托槽非拔牙矫治牙列拥挤患者的下牙列变化,探讨自锁托槽解除牙列拥挤的机制.方法 选择26例下牙列拥挤患者,分为自锁组和传统组,每组13例,分别使用自锁托槽(Damon3)和传统托槽(传统结扎式托槽)进行非拔牙矫治.对矫治前后变化进行配对t检验,逐步回归分析拥挤解除机制以及影响下切牙唇倾度改变量的相关因素.结果 矫治前后两组患者下颌尖牙间、前磨牙间牙弓宽度改变量及下切牙唇倾度改变量比较,差异均无统计学意义(P>0.1);矫治后自锁组下颌第一磨牙间牙弓宽度增加1.42 mm、下切牙凸距增加2.66 mm,传统组下颌第一磨牙间牙弓宽度增加0.65 mm、下切牙凸距增加1.57 mm,两组比较,差异有统计学意义(P<0.1).回归分析显示,自锁组对下切牙唇倾度变化量解释的总测定系数高达96.6%,被选入模型的变量为矫治前下颌拥挤度、下颌平面角、第一磨牙间牙弓宽度,以及矫治前后尖牙及第一前磨牙间牙弓宽度改变量.结论 非拔牙矫治下牙列拥挤时,自锁组和传统组患者均出现下切牙唇倾及下牙弓宽度增加,自锁组第一磨牙间牙弓宽度增加量及下切牙前移量较传统组多;自锁组下切牙唇倾度的改变不仅受拥挤度和矫治前牙弓宽度影响,而且受患者自身骨面型及牙弓宽度变化的影响.     

Predictors of postretention stability of mandibular dental arch dimensions in patients treated with a lip bumper during mixed dentition followed by fixed appliances

Objective:To identify which dental and/or cephalometric variables were predictors of postretention mandibular dental arch stability in patients who underwent treatment with transpalatal arch and lip bumper during mixed dentition followed by full fixed appliances in the permanent dentition.Materials and Methods:Thirty-one patients were divided into stable and relapse groups based on the postretention presence or absence of relapse. Intercuspid, interpremolar, and intermolar widths; arch length and perimeter; crowding; and lower incisor proclination were evaluated before treatment (T0), after lip bumper treatment (T1), after fixed appliance treatment (T2), and a minimum of 3 years after removal of the full fixed appliance (T3). Logistic regression analyses were performed to evaluate the effect of changes between T0 and T1, as predictive variables, on the occurrence of relapse at T3.Results:The model explained 53.5 % of the variance in treatment stability and correctly classified 80.6 % of the sample. Of the seven prediction variables, intermolar and interpremolar changes between T0 and T1 (P = .024 and P = .034, respectively) were statistically significant. For every millimeter of increase in intermolar and interpremolar widths there was a 1.52 and 2.70 times increase, respectively, in the odds of having stability. There was also weak evidence for the effect of sex (P = .047).Conclusions:The best predictors of an average 4-year postretention mandibular dental arch stability after treatment with a lip bumper followed by full fixed appliances were intermolar and interpremolar width increases during lip bumper therapy. The amount of relapse in this crowding could be considered clinically irrelevant.     

Dental and alveolar arch widths in normal occlusion and Class III malocclusion

The aim of this study was to compare the transverse dimensions of the dental arches and alveolar widths of Class III malocclusion group with a group of untreated normal occlusion subjects. This study was performed using measurements on dental casts of 150 normal occlusion (mean age, 21.6 +/- 2.6 years) and 100 Class III malocclusion (mean age, 15.4 +/- 2.2 years) subjects. Independent samples t-test was applied for comparing the groups. The findings of this study indicated that the mandibular intercanine and intermolar alveolar widths were significantly larger in the Class Ill group when compared with the normal occlusion sample (P < .001). Maxillary interpremolar, intermolar widths and all maxillary alveolar width measurements were significantly narrower in the Class III group (P < .001). In addition, the lower canine and premolar alveolar width measurements were also statistically significantly larger in the normal occlusion group when compared with the Class III malocclusion group (P < .001). Subjects with Class III malocclusion tend to have the maxillary teeth inclined to the lingual and mandibular teeth inclined to the buccal direction because of the restriction of maxillary growth and development according to dental arch width measurements. Therefore, rapid maxillary expansion should be considered before or during the treatment of a Class III patient with or without face-mask therapy.     

正畸治疗后牙弓稳定性的追踪研究

目的：探讨正畸治疗后牙弓的稳定性。方法：对正畸治疗后2－8年74例错He畸形患者治疗前后及保持后模型进行弓牙测量。结果：保持后，上基骨宽度较治疗后增加2．11％；上下6－6宽度、下基骨宽度没有显著性变化，其余均出现明显减少；减少百分率最大依次为上下3－3长度（7．79％，7．56％）、上下基骨长度（7．14％，5．12％）、上下牙弓长度（3．91％，3．37％）、上下3－3宽度（2．28％，3．30％）。结论：保持停止后，上下牙弓长度、基骨长度及3－3宽度有不断减少和3－3长度有回复治疗前水平的倾向，而6－6宽度较稳定。