功能和固定矫治器联合矫治安氏Ⅱ类1分类骨性错(牙合)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1.28o,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.     

上颌斜面导板在安氏Ⅱ类1分类错(牙合)矫治中的疗效分析

目的 观察上颌斜面导板在安氏Ⅱ类1分类错(牙合)矫治中临床疗效.方法 选择2006年10月-2010年6月在溧阳市中医院口腔正畸门诊就诊的安氏Ⅱ类1分类错(牙合)患儿34例.使用方丝弓技术配合采用上颌斜面导板导下颌向前,矫治前、后均拍摄头颅侧位片并对X线头影测量结果进行分析.结果 34例患儿经上颌斜面导板辅助治疗4～8...     

Dynamax矫治器早期矫治安氏Ⅱ类1分类错的软硬组织改变

目的:探讨Dynamax矫治器治疗早期安氏II类1分类错(牙合)患者的疗效.方法: 应用Dynamax矫治器对15 例Hagg手腕骨片为 FG-G 期的安氏II类1分类下颌后缩患者进行治疗,拍摄治疗前后的头颅侧位片,并应用Winceph 7.0头影测量软件进行测量和分析.结果: Dynamax矫治器治疗后,SNB角、下颌骨综合长度、下切牙唇倾度、鼻唇角增大;ANB角、Wits值、上前牙唇倾度、前牙覆盖、覆(牙合)、面凸角、ANB减小,以上变化均有统计学意义(P<0.05).结论: Dynamax功能矫治器促进下颌发育能有效的改善面部美观,使软硬组织侧貌面型趋于正常.     

功能和固定矫治器联合矫治安氏Ⅱ类1分类骨性错He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1.28o,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.     

应用Van-Beek A ctivator矫治安氏Ⅱ类Ⅰ分类错畸形

目的评价Van-BeekActivator矫治安氏Ⅱ类Ⅰ分类错牙合的治疗效果。方法7例替牙期或恒牙早期安氏Ⅱ类Ⅰ分类错牙合患者,用Van-BeekActivator矫治器进行矫治,对治疗前后的头颅定位片进行测量,并作统计学分析。结果各项指标测量值,治疗后均得到显著好转,外观容貌得到改善。结论Van-BeekActivator矫治器对抑制上颌骨的发育,促进下颌骨向前、向上旋转有较好的疗效。     

不对称拔牙模式矫治安氏Ⅱ类1分类错(牙合)的疗效评价

目的:分析不对称拔牙模式矫治安氏Ⅱ类1分类错(牙合)前后软硬组织的变化,为临床治疗方案的选择提供参考.方法:选择安氏Ⅱ类1分类错(牙合)患者30例(男11例,女19例,平均年龄13.6岁),根据不同的拔牙模式分为2组.实验组拔除2颗上颌第一前磨牙,1颗下颌第一前磨牙;对照组拔除4颗第一前磨牙.对治疗前后头颅侧位定位片进行测量分析,采用SAS6.12软件包进行独立样本t检验,比较2组软硬组织的结构变化.结果:2组矫治前、后组内比较显示,颌骨测量项目NAPog角、SNA角、ANB角、MP-SN角均有显著差异;上、下前牙的倾斜度、突度除实验组的LI-MP角外均有统计学意义;软组织测量项目中,上、下唇倾角,上唇厚度,上、下唇突度,上、下唇长度,Z角和鼻唇角均有显著差异,而下唇厚度、颏沟倾角无显著差异.2组矫治前、后变化量的组间比较显示.仅L1-MP角、U1-L1角的变化量有显著差异.结论:不对称拔牙矫治后,患者的上、下前牙均内收,软组织侧貌明显改善,能达到满意的治疗效果.     

Twin-block矫治器治疗安氏Ⅱ类错后牙和骨骼变化的研究

目的　通过X线头影测量分析 ,比较生长发育期安氏Ⅱ类Ⅰ分类错牙合患者用Twin block矫治器治疗后 ,牙和骨骼的变化。方法　选择 14例以下颌后缩为主的安氏Ⅱ类Ⅰ分类错牙合患者 ,年龄 10～ 12岁 ,后牙均为远中关系。全天戴用Twin block矫治器 9～ 12个月 ,测量治疗前后X线头颅定位侧位片 ,进行统计学分析。结果　ANB角减小 1 6 8°(P <0 0 1) ,Pg OLP增加 3 2 3mm(P <0 0 1) ,上切牙唇倾度 (ls NSL)减小 5 6 1°(P <0 0 1) ,下切牙唇倾度增加 2 96°(P <0 0 1) ,覆盖及磨牙位置关系均有显著差异 (P <0 0 1) ,腭平面角、牙合平面角、下颌平面角均未发生显著性改变。结论　Twin block矫治器用于早期以下颌功能性后缩为主的安氏Ⅱ类Ⅰ分类错牙合的功能性矫治 ,可取得明显的牙牙合骨骼的改变。?     

Twin-block功能矫正器矫治下颌后缩型安氏Ⅱ类Ⅰ分类错的研究

目的通过对用Twin-block功能矫正器矫治安氏Ⅱ类1分类下颌后缩型错(牙合)进行头影测量分析,揭示该功能矫正器引起的硬组织变化特点,强调早期阻断矫治的必要性。方法随机选择15例下颌后缩型Ⅱ类错(牙合)患者,年龄8-12岁,平均10.8岁,男8例,女7例,全部病例用Twin-block功能矫正器矫正骨骼的矢状关系,时间6-9个月,矢状关系稳定后即拍摄侧位头影测量进行分析。结果在替牙期侧切牙萌出后即用Twin-biock功能矫正器进行阻断矫治,可以纠正骨骼矢状关系不调,促进下颌骨的发育。上颌骨相对于颅底的矢状关系无显著性变化。SNB、AO-BO及下颌骨长度明显增加,ANB角明显减小,Ⅱ类关系得到明显改善。结论Twin-block矫正器在一定程度上促进了下颌骨的发育,改善了Ⅱ类骨骼关系和(牙合)关系。     

应用Van-Beek Activator矫治安氏Ⅱ类Ⅰ分类错(牙合)畸形

目的评价Van-Beek Activator矫治安氏Ⅱ类Ⅰ分类错(牙合)的治疗效果.方法7例替牙期或恒牙早期安氏Ⅱ类Ⅰ分类错(牙合)患者,用Van-Beek Activator矫治器进行矫治,对治疗前后的头颅定位片进行测量,并作统计学分析.结果各项指标测量值,治疗后均得到显著好转,外观容貌得到改善.结论Van-Beek Activator矫治器对抑制上颌骨的发育,促进下颌骨向前、向上旋转有较好的疗效.     

Frankel 2 appliance versus the Modified Twin Block appliance for Phase 1 treatment of Class II division 1 malocclusion in children and adolescents: A randomized clinical trial

Objective:To compare Phase 1 treatment, using the Frankel 2 (FR2) or the modified Twin Block (MTB), for Class II division 1 malocclusion in children and adolescents with respect to: treatment duration, number of appliance breakages, occlusal outcome, and patient and parent perspectives.Materials and Methods:Sixty participants with a Class II division 1 malocclusion were randomly assigned to either the FR2 or MTB appliance in a two-armed parallel randomized clinical trial with an allocation ratio of 1 to 1. Time to achieve a Class I incisor relationship was the primary outcome. The number of appliance breakages was recorded. The Peer Assessment Rating (PAR) index was used to evaluate pre- and post-treatment occlusal outcome on study models. Participants completed the child OHRQoL (oral health-related quality of life), Piers-Harris, Standard Continuum of Aesthetic Need (SCAN), and Oral Aesthetic Subjective Impact Score (OASIS) questionnaires pre- and post-treatment; parents completed a SCAN questionnaire.Results:Forty-two participants completed treatment (FR2: 20; MTB: 22). Multiple imputation was used to impute missing data for noncompleters. Mean treatment duration was similar for the two appliances (FR2: 376 days [SD 101]; MTB: 340 days [SD 102]; P = .41). There were no significant differences in mean number of appliance breakages (FR2: 0.3 SD 0.7; MTB: 0.4 SD 0.8; P = .67 or mean PAR score P = .48). Patient and parent perspectives did not differ between appliances (P > .05).Conclusions:Phase 1 treatment duration, number of appliance breakages, occlusal outcome, and patient and parent perspectives were similar in 11–14 year olds with Class II division 1 malocclusion treated using the FR2 or MTB appliance.     

Early treatment of Class II,division 1 malocclusion — Comparison of alternative treatment modalities

The purpose of this paper was to compare the findings from three randomized clinical trials that investigated alternative treatments of Class II, division 1 malocclusion in young children. The trials were conducted at the University of North Carolina, the University of Florida, and the University of Pennsylvania. The appliances investigated in each center were a functional appliance versus a headgear. Variations in the specific aims and the working hypotheses were noted. The types of appliances, length of treatment, and methods of evaluation were also different. A general comparison of selected clinically relevant findings reveals similarities and differences in conclusions, but underlines the importance of assessing each study on the basis of its original hypothesis. The separate and combined contribution of these studies to the state of knowledge and research is discussed.     

Twin-block矫治器对骨性Ⅱ类错儿童早期矫治的疗效分析

目的 分析Twin-block矫治器治疗生长发育期骨性Ⅱ类错儿童的临床疗效,探讨其机制。方法 选择生长发育期骨性Ⅱ类患者20例（男9例,女11例）,进行Twin-block功能矫治。所有患者治疗前后拍摄X线头颅侧位片,应用Pancherz分析法测量患者治疗前后硬组织指标变化情况,同时,测量治疗前后的上气道线距变化,采用配对t检验检测治疗前后各指标差异。结果 Twin-block治疗前后,ss/OLP、pg/OLP明显增大, Co/OLP和前牙覆盖明显减小, Go-Me长度明显增加,磨牙关系明显改善,有统计学意义（P<0.05）,其余各参数无统计学差异。气道测量值Adl-PNS、Ad2-PNS、Mcnamara线、U-MPW、TB-TPPW治疗后均有增大,差异有统计学意义（P<0.05）。结论 Twin-block功能矫治器能有效地改善骨性Ⅱ类患者的咬关系和侧貌,可以有效增加上气道各段前后径长度,这些变化主要由髁突前移导致的下颌骨生长发育所致。     

Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion

Objective:To analyze the long-term skeletal and dentoalveolar effects and to evaluate treatment timing of Class II treatment with functional appliances followed by fixed appliances.Materials and Methods:A group of 40 patients (22 females and 18 males) with Class II malocclusion consecutively treated either with a Bionator or an Activator followed by fixed appliances was compared with a control group of 20 subjects (9 females and 11 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (mean age 10 years), end of treatment with functional appliances (mean age 12 years), and long-term observation (mean age 18.6 years). The treated sample also was divided into two groups according to skeletal maturity. The early-treatment group was composed of 20 subjects (12 females and 8 males) treated before puberty, while the late-treatment group included 20 subjects (10 females and 10 males) treated at puberty. Statistical comparisons were performed with analysis of variance followed by Tukey''s post hoc tests.Results:Significant long-term mandibular changes (Co-Gn) in the treated group (3.6 mm over the controls) were associated with improvements in the skeletal sagittal intermaxillary relationship, overjet, and molar relationship (∼3.0–3.5 mm). Treatment during the pubertal peak was able to produce significantly greater increases in total mandibular length (4.3 mm) and mandibular ramus height (3.1 mm) associated with a significant advancement of the bony chin (3.9 mm) when compared with treatment before puberty.Conclusion:Treatment of Class II malocclusion with functional appliances appears to be more effective at puberty.     

Predictors of patient compliance during Class II division 1 malocclusion functional orthodontic treatment

ObjectivesTo determine factors that could predict Class II/1 malocclusion patient compliance during functional treatment.Materials and MethodsThe sample consisted of 77 subjects (aged 11–13 years; 47% girls) presenting with Class II/1 malocclusion. Inclusion criteria were distal molar relationship, overjet greater than 5 mm, and confirmed pubertal growth spurt. Removable functional appliances (62% Twin Block [TB], 38% Sander Bite Jumping [BJ]) with built-in maxillary expansion screws were used. Follow-up period was 1 year. Patients and parents independently filled out the Child Perception Questionnaire, Parental/Caregiver Perception Questionnaire, and Family Impact Scale to assess emotional and social well-being, oral symptoms, functional limitations, parental emotions, family activities, conflicts, and financial burden as possible predictors of compliance during treatment. Sex, overjet, and appliance type were also analyzed.ResultsThere were more noncompliant than compliant patients (55% vs 45%). Parental perception of altered emotional well-being of their children was the strongest predictor, increasing compliance odds 3.4 times (95% confidence interval [CI], 1.2–9.4; P = .017). Patients were 3.2 times (95% CI, 1.1–9.3; P = .033) more likely to cooperate with TB compared with BJ appliance. OJ ≥ 8 mm increased compliance odds 3.1 times (95% CI, 1.0–9.4; P = .044).ConclusionsParental perception of child''s emotional well-being alteration, severity of malocclusion, and type of appliance are major predictors of compliance. Psychosocial issues and oral function limitations reported by children and family impact are of negligible influence.     

Twin-block矫治器治疗安氏Ⅱ类1分类错的软硬组织变化

目的探索安氏Ⅱ类1分类错畸形在应用Twin-block矫治器治疗后软硬组织侧貌的变化。方法将50例处于生长发育高峰前期或高峰期的安氏Ⅱ类1分类错患者分为2组,治疗组（27例）接受Twin-block矫治器治疗,对照组（23例）不进行治疗,随访观察。对2组治疗（观察）前后的X线头影测量数据进行统计学分析。结果软组织指标中治疗组Ls-E、Li-E、U1-Stms、Stms-Stmi、NsLs-FH、LsNsLi、LsNsPg’、H角减小;Sn-Stms、Stmi-Me’、Ns-Me’、Sn-Me’、NsLi-FH、NsPg’-FH、A’Ls-FH、B’Li-FH、LiB’Pg’、CmSnLs、GSnPg’、Z角增大,与对照组比较有统计学差异（P<0.05）。硬组织指标中治疗组SNB、L1-NB、IMPA增大;ANB、U1-SN、U1-NA、FMIA减小,与对照组比较有统计学差异（P<0.05）。结论Twin-block矫治器可显著改善下颌后缩患者上下颌骨的矢状关系,促进面下1/3高度的生长,使软组织侧貌趋于直面型。     

Class II division 1 malocclusion treated with extraction of upper first premolars: Case report

This report describes the treatment of a 13.7-year-old girl with a severe maxillary protrusion. She indicated Class II molar and canine relationship and showed 7-mm overjet, 0-mm overbite, and slight lower midline deviation with an unstable mandibular position. Treatment was started using a splint to stabilize the position of the mandible, followed by extractions of maxillary first premolars and fixed appliances to reduce lip protrusion. Molars were finished in a Class II relationship with canine guidance, and ideal overjet and overbite relationships were established. Also the final result was esthetically well balanced. The treatment results were stable 6 years after debonding.     

Cephalometric characteristics of Class II division 1 malocclusion in a Saudi population living in the western region

Objective

To describe and analyze the cephalometric dento-skeletal characteristics associated with Angle’s Class II, division 1 malocclusion in Saudi population living in the western region.

Materials and methods

The material examined included 149 lateral head radiographs comprising two series: (1) 85 films of children with Class II, division 1 malocclusion and (2) 62 films of children with “normal” occlusion. Age range of the representing children was 10–13 years.

Results

In Class II division 1 subjects, the maxilla was prognathic in relation to anterior cranial base. The mandible was normally positioned in relation to anterior cranial base. Upper incisors were proclined and lower incisors were normally positioned. The cranial base angle was not different between the two groups.

Conclusions

In the western region of Saudi Arabia, Class II division 1 malocclusion has specific characteristics. The presence of prognathic maxilla, in this sample, indicates that the use of head gear therapy might be more appropriate than functional appliances when treating Class II division 1 malocclusion in Saudis living in the Western region.