安氏I类拔牙病例关闭间隙时切牙移动方式分析

目的:探讨安氏I类错牙合拔牙病例关闭间隙时切牙的移动方式。方法:安氏I类错牙合牙列拥挤病例20例,均拔除4个第一前磨牙,采用方丝弓细丝弓技术矫治,牙性支抗(弱支抗)。矫治前后摄X线头颅定位侧位片,对切牙位置及硬、软组织进行测量分析。结果:上颌切牙牙冠平均后移2.55mm;牙根平均后移0.20mm,下颌切牙牙冠平均后移1.78mm、牙根平均后移0.28mm。结论:牙性支抗控制下,安氏I类错牙合拔牙病例关闭间隙时切牙移动是有控制的倾斜移动。     

安氏Ⅰ类拔牙病例关闭间隙时切牙移动方式分析

目的：探讨安氏Ⅰ类错[牙合]拔牙病例关闭间隙时切牙的移动方式。方法：安氏Ⅰ类错[牙合]牙列拥挤病例20例,均拔除4个第一前磨牙,采用方丝弓细丝弓技术矫治,牙性支抗（弱支抗）。矫治前后摄X线头颅定位侧位片,对切牙位置及硬、软组织进行测量分析。结果：上颌切牙牙冠平均后移2．55mm;牙根平均后移0．20mm,下颌切牙牙冠平均后移1．78mm、牙根平均后移0．28mm。结论：牙性支抗控制下,安氏Ⅰ类错[牙合]拔牙病例关闭间隙时切牙移动是有控制的倾斜移动。     

安氏Ⅱ^1类错He上颌尖牙远中移位后切牙及磨牙位置变化的研究

目的探讨安氏Ⅱ1类错拔牙矫治中,上下颌磨牙及切牙的位置变化。方法选择15名11－16岁拔除四个第一双尖牙的安氏Ⅱ1类错病例,用方丝弓矫治技术,口外力加强上颌磨牙支抗,治疗前及以间断力后移上颌尖牙到与第二双尖牙接触时,进行X线头影测量及统计分析。结果上颌磨牙前移了0.9mm,比下颌磨牙整体前移少约2mm;上切牙舌侧斜移动了4.1mm;下切牙舌向移动了1.8mm,比上颌磨牙前移少1mm。结论控制上颌磨牙支抗并增大弓丝的滑动,可使上颌切牙在未主动内收前舌向移动;减少下颌尖牙的后移则有利于下颌磨牙的前移。     

安氏Ⅱ~1类错上颌尖牙远中移位后切牙及磨牙位置变化的研究

目的　探讨安氏Ⅱ1类错拔牙矫治中 ,上下颌磨牙及切牙的位置变化。方法　选择 15名11— 16岁拔除四个第一双尖牙的安氏Ⅱ1类错病例 ,用方丝弓矫治技术 ,口外力加强上颌磨牙支抗 ,治疗前及以间断力后移上颌尖牙到与第二双尖牙接触时 ,进行X线头影测量及统计分析。结果　上颌磨牙前移了 0 9mm ,比下颌磨牙整体前移少约 2mm ;上切牙舌侧斜移动了 4 1mm ;下切牙舌向移动了 1 8mm ,比上颌磨牙前移少 1mm。结论　控制上颌磨牙支抗并增大弓丝的滑动 ,可使上颌切牙在未主动内收前舌向移动 ;减少下颌尖牙的后移则有利于下颌磨牙的前移     

安氏I类错[牙合]非常规拔牙模式的矫治体会

目的：观察安氏I类错[牙合]拔除上颌第一前磨牙，下颌第二前磨牙后对支抗的不同需求，以及对咬合关系的影响。方法：选择安氏I类错[牙合]需减数治疗病例25例，拔除上颌第一前磨牙，下颌第二前磨牙后，常规直丝弓矫治器矫治。结果：25例均获得正常覆耠覆盖，尖牙和磨牙中性关系，患者侧貌发生明显改变。结论：安氏I类错[牙合]非常规拔牙模式可消耗下颌支抗，保护上颌支抗，更好地维护了磨牙的中性关系，使疗程缩短。     

安氏Ⅰ类错(牙合)非常规拔牙模式的矫治体会

目的:观察安氏Ⅰ类错耠拔除上颌第一前磨牙,下颌第二前磨牙后对支抗的不同需求,以及对咬合关系的影响.方法:选择安氏Ⅰ类错(牙合)需减数治疗病例25例,拔除上颌第一前磨牙,下颌第二前磨牙后,常规直丝弓矫治器矫治.结果:25例均获得正常覆(牙合)覆盖,尖牙和磨牙中性关系,患者侧貌发生明显改变.结论:安氏Ⅰ类错(牙合)非常规拔牙模式可消耗下颌支抗,保护上颌支抗,更好地维护了磨牙的中性关系,使疗程缩短.     

安氏Ⅰ类错非常规拔牙模式的矫治体会

目的:观察安氏Ⅰ类错拔除上颌第一前磨牙,下颌第二前磨牙后对支抗的不同需求,以及对咬合关系的影响。方法:选择安氏Ⅰ类错需减数治疗病例25例,拔除上颌第一前磨牙,下颌第二前磨牙后,常规直丝弓矫治器矫治。结果:25例均获得正常覆覆盖,尖牙和磨牙中性关系,患者侧貌发生明显改变。结论:安氏Ⅰ类错非常规拔牙模式可消耗下颌支抗,保护上颌支抗,更好地维护了磨牙的中性关系,使疗程缩短。     

头帽口外弓在高角型拥挤病例治疗中的应用

目的:评价头帽口外弓高位牵引配合直丝弓矫治技术对中重度牙列拥挤伴高角错牙合畸形的矫治效果。方法:选取18例牙列中重度拥挤伴高角的病人,减数拔除4个前磨牙,应用头帽口外弓高位牵引加强磨牙支抗,并控制磨牙高度,结合固定矫治器进行矫治。结果:18例病人牙列排齐,面型得到保持或有良好改善,磨牙和尖牙关系均达到中性,下颌平面角维持或减小。结论:头帽口外弓在中重度拥挤伴高角错牙合畸形矫治中可起到控制磨牙高度和加强磨牙支抗的作用。     

安氏Ⅰ类拥挤拔牙病例软组织侧貌变化

目的　探讨安氏I类错牙合牙列拥挤经拔除 4个第一前磨牙矫治前后牙颌面软组织的变化 ,了解矫治对软组织变化的影响。方法　选择泸州医学院附属口腔医学院正畸科连续收治的安氏I类错牙合牙列拥挤患者 19例 ,采用拔除 4个第一前磨牙 ,用标准方丝弓技术矫治。在矫治前、后摄X线头颅定位侧位片 ,对 11个软组织标志点的变化进行分析。结果　H角平均减少 2 .4°(P <0 .0 5 ) ;软组织面角平均增大 3.2 8°(P <0 .0 5 ) ;颏唇沟深度平均增加 1.0 8mm(P <0 .0 5 )。结论　安氏I类错牙合牙列拥挤经拔除 4个第一前磨牙矫治后软组织变化主要表现在上唇相对于面前软组织的前突度减少     

微钛钉种植体支抗后移全牙弓16例临床分析

目的 研究微钛钉种植体作为支抗后移全牙弓矫治成人上颌Ⅱ度牙列拥挤的矫治效果。 方法 应用种植于磨牙颧牙槽嵴的微钛钉种植体整体向后移动全牙弓矫治16例上颌Ⅱ度牙列拥挤患者,以X线头影测量方法评价疗效。 结果 所有病例均获成功矫治,上颌第一磨牙平均远中移动2.93 mm、远中倾斜7.12°,第二前磨牙平均远中移动3.46 mm、远中倾斜11.09°,具有统计学意义(P＜0.05);上中切牙唇向倾斜度轻微增加2.12°、切缘平均前移0.66 mm,无统计学意义(P>0.05)。 结论 微钛钉种植体支抗是一种有效后移全牙弓矫治Ⅱ度牙列拥挤的方法。     

Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: First premolar extraction treatment with Invisalign

Objectives:To compare achieved and predicted tooth movements of maxillary first molars and central incisors in first premolar extraction cases treated with Invisalign.Materials and Methods:The present study included 30 patients who received maxillary first premolar extraction treatment with Invisalign. The actual posttreatment model was registered with the pretreatment model on the palatal stable region and superimposed with the virtual posttreatment model. Achieved and predicted tooth movements of maxillary first molars and central incisors were compared using paired t-test. Linear mixed-effect model analyses were used to explore the influence of age (adolescents vs adults), attachment (G6-optimized vs 3-mm vertical, 3-mm horizontal, and 5-mm horizontal), and initial crowding on the differences between predicted and achieved tooth movement (DPATM).Results:First molars achieved greater mesial tipping, mesial translation, and intrusion than predicted. Central incisors achieved less retraction and greater lingual crown torque and extrusion than predicted. Adolescents showed greater DPATM in the mesiodistal translation of first molars and labiolingual translation of central incisors and smaller DPATM in the occlusogingival translation of the first molars and crown torque of the central incisors than adults. The 3-mm vertical attachment group showed greater DPATM in the mesiodistal translation of the first molars vs the G6-optimized attachment group. Initial crowding had an inverse correlation with DPATM in angulation and mesiodistal translation of the first molars.Conclusions:First molar anchorage control and central incisor retraction were not fully achieved as predicted in first premolar extraction treatment with Invisalign. Age, attachment, and initial crowding affected the differences between predicted and achieved tooth movement.     

安氏Ⅱ类1分类拔牙病例正畸治疗后后牙关系的稳定性研究

目的　探讨安氏Ⅱ类1分类患者正畸治疗前、后后牙关系的变化趋势,分析可能影响后牙关系复发的因素。方法　选取采用拔牙治疗的安氏Ⅱ类1分类患者29例,其中男12例,女17例。根据ANB角进一步分为牙性Ⅱ类14例,骨性Ⅱ类15例。分别对其正畸治疗前、后进行模型测量和X线头影测量。结果　所有患者的Ⅱ类磨牙关系在治疗后均得到明显改善,随访时仅有少量复发。牙性Ⅱ类患者治疗后下磨牙近中移动量(4·52±2·15) mm,大于上磨牙移动量(3·62±2·62)mm,而骨性Ⅱ类患者上下磨牙近中移动量相似,但ANB角由治疗前的(6·27± 1·08)°明显减小为(4·64±1·17)°。随访时两类错患者上下颌磨牙均近中移动,且上颌磨牙移动量大于下颌磨牙。多元回归分析提示下颌骨水平向生长和上前牙不齐指数与磨牙关系复发有关。结论　Ⅱ类错患者正畸治疗后磨牙关系较为稳定。牙性Ⅱ类错磨牙关系的解除有赖于上下颌磨牙相对移动调整,骨性Ⅱ类错则依靠上下颌骨间位置关系的改变。有利的下颌生长型和上颌前牙不齐程度等与磨牙关系的保持有密切关系。     

摆形矫治器与直丝弓矫治器治疗安氏Ⅱ类骨性Ⅰ类错畸形的研究

目的　分析安氏Ⅱ类骨性Ⅰ类错畸形患者经摆形矫治器结合直丝弓矫治器治疗后的牙颌面形态变化, 探讨此方法建立正常牙关系的机制。方法　10例接受摆形矫治器结合直丝弓矫治器治疗的安氏Ⅱ类骨性Ⅰ类 错患者,分别在治疗前(T1阶段)、摆形矫治器治疗后(T2阶段)及直丝弓矫治结束后(T3阶段)拍摄头颅定位侧位 片,对3个阶段牙齿、颌骨及软组织的位置变化进行测量及分析,同时观察上颌第二、三磨牙的位置和萌出情况。 结果　摆形矫治器治疗阶段上颌第一、二磨牙远中整体移动并适度远中倾斜,上切牙唇向倾斜,上齿槽座点前移; 直丝弓矫治后上颌第一、二磨牙位置与治疗前无明显差异,下齿槽座点和下颌第一磨牙明显前移;上颌第二磨牙萌 出顺利。结论　摆形矫治器可使上磨牙明显远中移动,但固定矫治结束后上磨牙前后位置因上颌骨生长和一定程 度的支抗丧失而有所复原;Ⅰ类磨牙关系的建立可能是上下磨牙差别移动和颌骨差别生长的综合结果。     

微种植体支抗钉结合改良滑动杆近中移动 上颌前磨牙的临床应用

目的 探讨微种植体支抗钉结合改良滑动杆近中移动上颌前磨牙关闭缺牙间隙的可行性及有效性。方法 选取上颌侧切牙或尖牙缺失的患者5例（男2例,女3例）,年龄14~25岁。缺失侧磨牙关系均为安氏Ⅱ类。在上颌第二前磨牙及第一磨牙间植入微种植体支抗钉,结合改良滑动杆近中移动前磨牙。前磨牙移动到位后更换支抗钉位置,利用支抗钉拉磨牙近中移动,关闭剩余间隙。前磨牙移动疗程6~10个月。通过矫治前后石膏模型测量前磨牙近中移动有效性。结果 5例患者均得到有效治疗,上颌前磨牙及磨牙近中移动,缺牙间隙关闭,缺牙侧磨牙关系完全远中,治疗效果均令人满意。上颌前磨牙近中平均移动4.1 mm,平均移动速度0.96 mm/月。结论 对于上颌侧切牙或尖牙缺失的患者,微种植体支抗钉结合改良滑动杆可简单高效实现前磨牙近中移动,并最终关闭缺牙间隙,临床上可作为一种备选治疗方案。     

Treatment of Class II protrusion with severe crowding using indirect miniscrew anchorage

This report describes the nonsurgical treatment of a patient with skeletal Class II protrusion and severe crowding. A 20-year-old woman presented with the chief complaint of lip protrusion and crowding. To correct the Class II relationship, severe crowding, and lip protrusion, distal movement of the maxillary first molars using indirect miniscrew anchorage and nickel-titanium coil springs, along with extraction of the first premolars and maxillary second molars, was planned. After the distal molar movement phase was complete, the maxillary first molars had moved 8.0 mm to the distal, and the first premolars, which were splinted to the miniscrews, had moved 0.5 mm to the mesial. The results show that the distal molar movement mechanics were efficient and stable. After treatment, all of the patient's chief complaints were relieved and an esthetic facial profile was obtained.     

Effectiveness of computer-assisted orthodontic treatment technology to achieve predicted outcomes

Objective:To evaluate the effectiveness of computer-assisted orthodontic treatment technology to produce the tooth position prescribed by the virtual treatment plan.Materials and Methods:Posttreatment models of 23 patients treated with SureSmile were digitally superimposed on their corresponding virtual treatment plan models utilizing best-fit surface-based registration. Individual tooth-position discrepancies between virtual treatment plan and actual outcome were computed. Discrepancies less than 0.5 mm in mesial-distal, facial-lingual, and vertical dimensions, and less than 2° for crown torque, tip, and rotation were considered clinically ideal. One-sided test of equivalence was performed on each discrepancy measurement, with P < .05 considered statistically significant.Results:Mesial-distal tooth position was clinically ideal for all teeth with the exception of maxillary lateral incisors and second molars. Facial-lingual tooth position was clinically ideal for all teeth except maxillary central incisors, premolars, and molars, and mandibular incisors and second molars. Vertical tooth position was clinically ideal for all teeth except mandibular second molars. For crown torque, tip, and rotation, discrepancy exceeded the limits considered clinically ideal for all teeth except for crown torque on mandibular second premolars and crown tip on mandibular second premolars and first molars.Conclusions:The effectiveness of computer-assisted orthodontic treatment technology to achieve predicted tooth position varies with tooth type and dimension of movement.     

拔除下颌磨牙矫治安氏Ⅲ类错（牙合）关系的临床分析

目的：评价下颌第一磨牙拔除进行正畸治疗安氏Ⅲ类错（牙合）关系的疗效,第二磨牙向前移动代替第一磨牙的适应症,支抗控制方法等。方法：选择正畸门诊16例Ⅲ类错（牙合）关系并伴有下颌第一恒磨牙残冠、残根或牙冠大面积充填,在患者知情同意下拔除第一恒磨牙,使用直丝弓技术进行矫治。结果：所有16例病例均拔牙间隙完全关闭,无近中倾斜及舌倾现象。双侧磨牙Ⅰ类关系,面角减少,患者侧貌较直,取得较为满意的矫治疗效。结论：拔除下颌磨牙结合矫正技术可成功矫治恒牙期轻度骨性Ⅲ类错（牙合）畸形,并使患者软组织侧貌发生明显改变。     

拔除病变第一磨牙后上、下颌第三磨牙正畸近移疗效比较

目的探讨拔除病变第一磨牙后上、下颌第三磨牙近移进行正畸治疗的效果。方法收集20例第一磨牙病变同时需要进行正畸治疗的患者,平均年龄18.6岁。根据患者口内情况将患者分为2组,每组10例。第一组上颌无明显拥挤,仅拔除病变的上颌第一磨牙,下颌拔牙或非拔牙矫治;第二组下颌无明显拥挤,仅拔除病变的下颌第一磨牙,上颌牙列拔牙或非拔牙治疗。全部病例均采用方丝弓矫治器,排齐整平牙列,关闭拔牙间隙,精细调整咬合关系。结果 20例患者都达到良好的矫治效果,双侧的磨牙、尖牙均达到良好的咬合关系。上颌第三磨牙前移平均8.8个月,平均近移7.94mm;下颌第三磨牙前移平均9.7个月,平均近移7.12mm。结论上、下颌由于存在骨质结构的差异,拔除无法保存的第一磨牙后,上颌第三磨牙近移比下颌磨牙较快。扶正簧的使用使倾斜的下颌磨牙得以直立。