Twin block结合下唇挡矫治Ⅱ类Ⅰ分类错疗效分析

目的本研究在Twin block上增加下唇挡,刺激下颌前端骨生长。方法选择16例伴下颌后缩的Ⅱ类Ⅰ分类错患者。替牙期或恒牙早期,随机分成二组,每组8例,一组设为对照组,采用Twin block治疗。另一组设为治疗组,采用Twin block与下唇挡联合治疗。经过8-10个月的矫治。双侧后牙基本正常建,然后对每组患者治疗前后X线头影片进行测量、对比。结果二组患者治疗后下颌骨均有明显的向前生长。但治疗组下颌前端B点生长较对照组明显(P<0．05)。结论Twin block与下唇挡联合矫治安氏Ⅱ类Ⅰ分类错,不仅发挥了Twin bIock原有的功效。同时还具有刺激下颌骨前端B点生长的作用。     

Twin block结合下唇挡矫治Ⅱ类Ⅰ分类错(牙合)疗效分析

目的 本研究在TWin block上增加下唇挡，刺激下颌前端骨生长。方法 选择16例伴下颌后缩的Ⅱ类Ⅰ分类错胳患者，替牙（牙合）期或恒牙（牙合）早期，随机分成二组，每组8例，一组设为对照组，采用Twin block治疗，另一组设为治疗组，采用Twin block与下唇挡联合治疗，经过8～10个月的矫治，双侧后牙基本正常建（牙合），然后对每组患者治疗前后X线头影片进行测量、对比。结果 二组患者治疗后下颌骨均有明显的向前生长，但治疗组下颌前端B点生长较对照组明显（P〈0．05）。结论 Twin block与下唇挡联合矫治安氏Ⅱ类Ⅰ分类错（牙合），不仅发挥了Twin block原有的功效，同时还具有刺激下颌骨前端B点生长的作用。     

Twin block在安氏Ⅱ1类错牙合矫正中的临床应用

目的了解Twin block 矫治器对安氏Ⅱ1类错牙合治疗效果.方法选择13例替牙后期或恒牙早期的安氏Ⅱ1类错牙合病人,Ⅰ期治疗用Twin block矫治器矫治,改善上下颌骨矢状不调;Ⅱ期用固定矫治器进一步精细调整牙位及牙合位.结果 Twin block矫治器可促进下颌生长,改善前牙的覆牙合覆盖关系.结论 Twin block矫治器对治疗早期安氏Ⅱ1类错牙合可取得明显的骨骼改变,降低Ⅱ期矫治的难度.     

生物调节器下唇挡联合矫治安氏Ⅱ类1分类错(牙合)的体会

目的探讨生物调节器下唇挡联合矫正安氏Ⅱ类1分类错(牙合)的作用机理和效果.方法选择采用生物调节器下唇挡联合矫正安氏Ⅱ类1分类混合牙列期患者9例,矫正前后均摄头颅侧位片,并对矫正前后头颅侧位片进行测量分析.结果生物调节器下唇挡联合矫正器除了前移下颌,刺激下颌髁突生长外,还有向前牵拉下唇,将下唇的肌力经矫正器传递到上颌,抑制上颌骨的生长,从而迅速矫正安氏Ⅱ类1分类患者上下颌骨矢状关系不调.结论采用生物调节器下唇挡联合矫正伴有咬下唇习惯的安氏Ⅱ类1分类患者,效果非常显著.     

生物调节器下唇挡联合矫治安氏Ⅱ类1分类错的体会

目的　探讨生物调节器下唇挡联合矫正安氏Ⅱ类 1分类错牙合的作用机理和效果。方法　选择采用生物调节器下唇挡联合矫正安氏Ⅱ类 1分类混合牙列期患者 9例 ,矫正前后均摄头颅侧位片 ,并对矫正前后头颅侧位片进行测量分析。结果　生物调节器下唇挡联合矫正器除了前移下颌 ,刺激下颌髁突生长外 ,还有向前牵拉下唇 ,将下唇的肌力经矫正器传递到上颌 ,抑制上颌骨的生长 ,从而迅速矫正安氏Ⅱ类 1分类患者上下颌骨矢状关系不调。结论　采用生物调节器下唇挡联合矫正伴有咬下唇习惯的安氏Ⅱ类 1分类患者 ,效果非常显著。     

改良Twinblock矫治器与方丝弓矫治器联合矫治骨性Ⅱ类错牙合

目的有效地将Twinblock矫治器与方丝弓矫正器联合以矫治复杂的AngleⅡ类错牙合.方法本实验将传统的Twinblock矫治器加以改良,通过改变固位装置,去除上颌唇弓,能较好地与方丝弓矫治器协调,在临床上矫治了10例处于生长发育高峰期的AngleⅡ类错牙合.结果患者治疗后的正、侧面轮廓明显改善;前牙覆牙合、覆盖正常,磨牙关系为AngleⅠ类.结论改良Twinblock矫治器联合方丝弓矫正器能迅速、有效地矫正AngleⅡ类错牙合.     

Twin block 矫治器矫治恒牙初期Ⅱ类错牙合的研究

目的：观察Twin block 矫治器矫治恒牙初期安氏Ⅱ类错牙合的效果。方法：在临床随机选择20 名安氏Ⅱ类错牙合用Twin block 矫治器进行矫治,以X 线头影测量分析法评价疗效。结果：Twin block 矫治器可促进下颌生长;同时引起上切牙舌倾,下切牙唇倾。结论：Twin block 矫治器可产生明显的生长改良效果。     

改良上颌斜面导板与Twin-block矫治器在前导下颌中的作用比较

目的:评估改良斜面导板在前导下颌中的作用.方法:选择12例Ⅱ类Ⅱ分类伴下颌后缩患者,设为第1组,男4例.女8例,平均年龄11岁8个月.先采用上颌同定矫治器纠正上前牙内倾,再采用改良上颌斜面导板前导下颌;同时选择12例Ⅱ类Ⅰ分类伴下颌后缩患者,设为第2组,男5例,女7例,平均年龄11岁6个月,采用Twin-block前导下颌:对2组患者前导下颌的疗效通过治疗前后头颅侧位定位片进行评估、对比,采用SAS6.0软件包对数据进行统计学处理.结果:2组患者下颌均向前生长,第1组下前牙唇向倾斜较第2组明显,但差异无统计学意义(P＞0.05);下颌第一磨牙近中向及(牙合)向的移动,第2组显著大于第1组,差异有统计学意义(P＜0.05).结论:矫治Ⅱ类Ⅱ分类伴下颌后缩的患者,采用改良上颌斜面导板前导下颌不失为一种经济、简化、有效的方法.     

下颌后缩畸形的联合功能矫治及固定矫治

目的探讨第Ⅰ期采用双阻板矫治器(twin block appliance,TBA)联合肌激动器矫治生长发育期下颌后缩畸形,第Ⅱ期进行固定矫治的临床效果。方法1例下颌后缩的骨性Ⅱ类错患者,第Ⅰ期第1阶段采用TBA矫治,使上下颌骨呈骨性Ⅰ类关系;第2阶段采用肌激动器使后牙建。第Ⅱ期采用直丝弓矫治技术排齐牙齿、整平曲线、以及调整磨牙至中性关系并维持之。结果第Ⅰ期第1阶段,TBA矫治后下颌后缩得到纠正,上下颌骨呈骨性Ⅰ类关系,前牙覆盖变小,面型明显改善;第2阶段肌激动器可使后牙建良好,并能维持第1阶段达到的牙、颌关系;第Ⅱ期直丝弓矫治结束时牙齿排列整齐、曲线平整、磨牙呈中性关系。结论矫治下颌后缩畸形,TBA联合肌激动器较使用单一功能矫治器有明显的优势;必要时,应作Ⅱ期固定矫正。     

Investigation and comparison of patient experiences with removable functional appliances:: Invisalign Teen with Mandibular Advancement versus Twin Block

ObjectivesTo compare patients'' experiences with the Invisalign Teen with Mandibular Advancement® (ITMA) and Twin Block (TB) appliances, both initially and after several months of wear.Materials and MethodsSixty-eight patients completed an anonymous survey after at least 2 months of wearing ITMA or TB. Forty-five patients treated with ITMA (18 boys, 27 girls, mean age 13.6 years, SD ± 1.54) and 23 patients treated with TB (13 boys, 10 girls, mean age 10.60 years, SD ± 1.92) were included.ResultsMore patients using the TB found their appliance to be visually intimidating as compared with patients using the ITMA (21.7% vs 8.9%). TB was more noticeable than the ITMA (69.6% vs 25%). Appliance insertion was more difficult for TB patients (21.8% vs 4.44% for ITMA). After several months, there were more reports of tooth soreness and lip/cheek soreness in the ITMA group. TB patients were more embarrassed even after several months (14.3% vs 0% for ITMA). More TB patients required extra appointments for breakage (50% vs 22.2% for ITMA). Speech, drooling, and jaw and lip/cheek soreness worsened initially for both groups but improved over time. There were no differences between the groups regarding visible facial changes, satisfaction with treatment experience, or time to acclimatize to the appliance.ConclusionsTB and ITMA patients shared similar experiences for most of the parameters measured, but there were significant differences between the groups regarding appliance wear and management, discomfort, and function.     

下颌固定舌弓调整牙弓对称性的临床初探

目的探讨利用下颌固定舌弓作为支抗矫治下牙弓前中部不对称。方法选择正畸临床下颌牙弓不对称患者6例,借助于固定舌弓作为支抗调整下颌牙弓形态,收集调整前后石膏模型并进行模型扫描,通过Dolphin 11.0软件建立三维数字化模型后进行测量。结果 6例患者使用下颌固定舌弓平均1~3个月,下颌牙弓基本对称,矫治前后两侧下颌第二前磨牙颊尖、尖牙牙尖、侧切牙切缘中点到矢状面距离的差值明显减小,并有统计学意义(P<0.05),两侧第一恒磨牙近中颊尖到矢状面距离的差值变化不显著(P>0.05),且第一恒磨牙间宽度治疗前后差异无统计学意义(P>0.05)。结论下颌固定舌弓作为舌侧支抗可有效调整下颌牙弓前中部的不对称,帮助建立正常的咬合关系。     

唇挡对儿童面下部硬软组织侧貌影响的研究

目的　研究唇挡对替牙期及恒牙初期儿童面下部硬软组织侧貌形态的影响。方法　选择替牙期及恒牙初期下颌发育不良伴下牙列轻度或中度拥挤患儿 30例 (男 14例 ,女 16例 ) ,采用下颌唇挡治疗 6～ 10个月 ,进行治疗前后面部硬软组织X线头影测量分析。结果　唇挡治疗后下切牙唇倾 3.2 5°,呈以根尖为转动中心的倾斜移动 ,下颌第一磨牙远中倾斜 6 .13° ,呈以根分叉为转动中心的远中倾斜移动。下颌平面角增加 1.15° ,SNB角与面角无明显改变。颏唇沟厚度平均增加 1.2 3mm ,致使颏唇沟变浅 ,下唇角增大 (6 .0 5°) ,下唇及颏唇沟形态改善。结论　在儿童颌面部生长发育高峰期 ,唇挡可有效促进下颌牙弓生长发育 ,改善面下部硬软组织侧貌形态。     

功能和固定矫治器联合矫治安氏Ⅱ类1分类骨性错畸形

目的 通过对功能和固定矫治器联合矫治恒牙列早期安氏Ⅱ类1分类骨性错(牙合)畸形的研究,探讨发育期骨性错(牙合)畸形一期矫治的优越性。方法 应用双(牙合)垫矫治器或斜面导板结合方丝弓矫治器对12例恒牙列早期安氏Ⅱ类1分类骨性错(牙合)联合矫治,对治疗前后头颅侧位定位片进行分析。结果 SNB角增加1.28°,FMA角无明显改变,OP-SN值变大,Go-Pog、Go-Ar都呈显著性增大,前牙覆盖减少7.26mm,上下唇至审美平面距离显著减小。结论 利用功能矫治器和固定矫治器联合一期矫治恒牙列早期安氏Ⅱ类1分类骨性错(牙合),,同样可收到双期矫治的效果。     

The induction of odontogenesis in non-dental mesenchyme combined with early murine mandibular arch epithelium

First and second branchial arches were dissected from mouse embryos of 9-13 days gestational age. The epithelial and mesenchymal components were separated after enzymic digestion. Scanning electron microscopy did not reveal a dental lamina along the dental arches before day 12, after which the lamina was formed locally in the incisor and molar regions. There was no epithelial down-growth in the diastema region. Heterotypic recombinations of mandibular arch and second branchial arch tissues showed that early mandibular arch epithelia, before day 12, have odontogenic potential and can elicit the formation of a dental papilla in non-odontogenic, neural-crest-derived mesenchymal cells of the second arch. However, the mandibular mesenchyme must interact with mandibular epithelium in order to have the competence to induce teeth in non-odontogenic epithelium.     

多曲钢丝唇挡对替牙期和恒牙初期上颌牙弓的影响

目的 研究多曲钢丝唇挡矫治器对上颌牙弓的影响。方法 选择安氏Ⅱ类错(牙合),第二恒磨牙未萌出,前牙拥挤Ⅰ～Ⅱ°患者15例,采用多曲钢丝唇挡治疗并对其矫治前后X线头颅侧位定位片和模型进行测量分析。结果 上颌牙弓长度增加3.43mm。磨牙向远中移动,切牙唇向移动。牙齿移动主要为倾斜移动。上颌磨牙区、第一前磨牙区、尖牙区的牙弓宽度均增加,平均分别达5.87mm、2.71mm和1.92mm。结论 多曲钢丝唇挡是一种有助于解除轻中度牙列拥挤的口内装置之一。     

A comparison of the Twin Block and Herbst mandibular advancement splints in the treatment of patients with obstructive sleep apnoea: a prospective study

This prospective, randomized, crossover study of 16 patients with obstructive sleep apnoea (OSA) [12 males, four females; median body mass index (BMI) 29.2 kg/m(2) (range 23.8-51.1); median age 44.8 years (range 24.0-68.4)] analysed the efficacy of the Twin Block (TB) in relation to the Herbst appliance as a mandibular advancement splint (MAS). Each subject was fitted with a TB and Herbst MAS in a random order with a washout period of 2 weeks between appliances. Once each patient was subjectively happy with the performance of each appliance, questionnaires and a visual analogue scale (VAS) were used to determine differences in snoring, daytime sleepiness, quality of life, side-effects of the appliances and patient preference. All patients underwent overnight domiciliary sleep recordings prior to and after fitting each appliance in order to objectively assess sleep quality in terms of the apnoea-hypopnoea index (AHI), snoring frequency and arterial oxygen saturation.The results suggested that there was no difference in the treatment performance of the TB and Herbst MAS for AHI (P = 0.71), snoring frequency (P = 0.49), arterial blood oxygen saturation (P = 0.97), quality of life and side-effects. The Herbst MAS proved to be the more effective appliance for reducing daytime sleepiness (P = 0.04) and was the more popular appliance among the patients. Side-effects with both appliances were minor and improved in the longer term. The TB MAS represents a viable alternative to the Herbst MAS in the treatment of patients with OSA.     

铸造个别牙弓夹板在下颌骨前段骨折中的应用

目的:评价铸造个别牙弓夹板在下颌骨前段骨折治疗中的作用。方法:制取牙模型,在骨折线处锯开下颌模型,再按上下颌关系重新行模型拼对、联结,在联结后的模型上制取颊舌侧个别牙弓夹板代型,完成个别牙弓夹板的铸造,将其安放于经手法复位后的下颌牙弓的颊舌侧并结扎固定,以恢复牙弓的连续性及咬合关系。结果:经上述方法治疗的18例下颌骨骨折患者,4周后拆除个别牙弓夹板,6～8周后咬合关系完全恢复正常。结论:铸造个别牙弓夹板是治疗下颌骨前段线性骨折的有效方法。