The B.S.S.O. M.Orth. Prize of the Royal College of Surgeons of England 1998

Abstract

Aim: To determine the relationship between treatment need assessment scores of orthodontists, general practitioners, and pediatric dentists.

Study design: Observational.

Sample: Ten general dental practitioners, 18 orthodontists and 15 pediatric dentists reviewed 137 dental casts and recorded their opinion on whether orthodontic treatment was needed.

Results: We found a high level of agreement between pediatric dentists, orthodontists and general practitioners (Kappa range 0.86–0.95). Between the groups, the amount of agreement was lower.

Conclusions: Orthodontists, general dental practitioners, and pediatric dentists in this sample exhibit high levels of agreement on orthodontic treatment need.     

10种国内期刊正畸牙移动动物模型应用研究的统计分析

目的:了解国内学者对正畸牙移动动物模型的应用现状.方法:利用数据库检索和手动检索相结合方式,数据库检索以清华同方知网技术产业集团出版的CNKI数据库为主要检索工具,对国内10种口腔核心期刊进行调查,检索近10年刊登的文献中有关正畸牙移动动物模型的文献,应用文献计量学方法对其进行统计分析.结果:检出文献86篇,其中69篇是关于正畸牙移动中牙周组织改建机制研究方面(80.25％)；5篇是关于正畸牙移动疼痛机制研究方面(5.81％);7篇与动情周期有关(8.13％)；5篇与正畸牙移动牙根吸收有关(5.81％).结论:目前对于正畸牙移动的研究主要在牙周组织改建方面,而关于正畸疼痛、正畸牙根吸收及生理周期等方面还有待进一步深入研究.     

自锁托槽的临床应用及研究进展

自锁托槽是一种新的托槽类型,可以通过托槽槽沟唇侧的滑盖或弹簧夹固定弓丝,简便了结扎过程,节省了椅旁操作时间,还有助于减小滑动阻力,减少关闭间隙的阻力,使矫治效力增加。自锁托槽与传统托槽一样,能三维方向控制牙的移动。大部分学者认为,使用自锁托槽矫治可以减少总治疗时间,延长复诊间隔时间,减少复诊次数,并且自锁托槽的脱落率和意外打开率和传统托槽无显著差异。     

口腔正畸托槽与弓丝之间最大静摩擦力与静摩擦系数的实验研究

目的 设计一种体外装置,研究正畸托槽与弓丝之间的最大静摩擦和静摩擦系数.方法 实验选择了一种方丝托槽与两种直径0.4 mm的正畸钢丝,设计实验装置在干燥和有唾液条件下测量托槽与弓丝之间在不同正压力下的最大静摩擦力和静摩擦系数.结果 研究发现,在干燥条件下,国产弓丝与托槽之间产生的最大静摩擦力和静摩擦系数显著大于3 M弓丝,在有唾液时两者无显著区别.结论 不同条件下,弓丝与托槽之间产生的静摩擦力与静摩擦系数不同.     

正畸治疗中拔牙矫治的临床分析

目的：分析拔牙矫治疗在临床中的应用情况，了解拔牙理念对拔牙比例的影响。方法：选择1995年－2000年400例恒牙期错He病例分为两组（1995年－1997年为第一组，1998年－2000年为第二组）进行统计分析。结果：第一组拔牙比例是50．0％，第二组组拔牙比例是38．8％，安氏Ⅱ^1类错He拔牙比例较其他类型的错He高，两组分别是69．8％和68．8％，双尖牙的拔除占总拔牙数的百分比最高，两组分别为95．9％和94．3％。结论：1995年－2000年拔牙比例发生较大变化，拔牙比例减少主要受矫治理念的影响。     

骨性开畸形正颌外科手术前后的正畸治疗

目的：通过分析总结骨正开He畸形手术前后正畸治疗的原则和方法,以指导临床。方法：前牙开He畸形32例,男性9例,女性23例,开He度1－8．5mm,平均4mm31例伴下颌前突,1例伴下颌后。单纯术前正8 ,纯术后正3 ,余21例在手术前后均行正畸治疗。结果：术产术畸疗程为4－33个月,平均12个月;术后正畸疗程为3－17个月,平均8．5个月。开He畸形的术前治疗的;排齐上下牙列,解除牙列拥挤;去代偿治疗,避免上下切牙He向伸长移;支上下牙列列的唇颊向倾斜度。上下颌骨垂直牵引,防止开He复发,上下颌间Ⅱ类或Ⅲ类牵引,调整磨牙关系,结论通过系统的术前术后正畸治疗及正颌外科手术,可矫正前牙开He畸形,并取得良好的矫治效果。     

国产无托槽隐形矫治技术的临床应用初探

目的 将我国自主研发的无托槽隐形矫治技术应用于口腔正畸临床,探讨该矫治器的临床应用情况、存在的问题以及应用前景.方法 选取41例较简单的错(牙合)畸形患者,主要包括牙列间隙、牙列拥挤以及牙周病止畸治疗,应用国产无托槽隐形矫治技术进行正畸治疗.通过层析扫描建立数字化三维牙颌模型,通过激光快速成形技术加工无托槽隐形矫治器,根据治疗方案,为每例患者设计10～40副矫治器.患者每2～3周更换一副矫治器,矫治后评估疗效.结果 所有病例均完成矫治并取得良好的矫治效果,矫治后牙列排齐、无间隙、前牙覆(牙合)覆盖正常,矫治疗程6～25个月,平均18个月.结论 目前,国产无托槽隐形矫治技术仅町矫治相对简单的错(牙合)畸形,并以其透明、美观、舒适、卫生等优点,而具有良好的临床应用前景.     

Lower Fixed Retainers: Bonded On All Teeth Or Only On Canines? A Systematic review

ObjectiveTo evaluate the stability after orthodontic treatment between two types of lower fixed retainers: those bonded onto all anterior teeth or those bonded only onto the canines.Materials and MethodsThe following electronic databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, OpenGrey, ClinicalTrials, and Google Scholar. No restriction of language or year were applied. After selection of studies, risk-of-bias evaluation and qualitative synthesis of the included studies were performed using The Cochrane Collaboration''s tool for randomized studies and the “Risk of Bias in Non-randomized Studies of Interventions” (ROBINS-I) tool for nonrandomized studies, and a summary of the overall strength of evidence was presented using the “Grading of recommendations, assessment, development and evaluation” tool.ResultsAmong the 180 studies retrieved from the searches, five were included in this review. Three of them showed a low risk of bias, while two presented a high risk of bias. With regard to stability, two studies reported better stability for retainers bonded to all six teeth, while the other three showed no difference. The retainer bonded to all teeth presented a higher breakage rate in one study.ConclusionsStability seems better with lower fixed retainers bonded on all anterior teeth. The breakage rate may not change according to the bonding. However, studies with greater methodological soundness are necessary to reach a more reliable conclusion.     

Frictional resistance of self-ligating versus conventional brackets in different bracket-archwire-angle combinations

Objective

To compare the influence of archwire material (NiTi, beta-Ti and stainless steel) and brackets design (self-ligating and conventional) on the frictional force resistance.

Material and Methods

Two types of brackets (self-ligating brackets - Smartclip, 3M/Unitek - and conventional brackets - Gemini, 3M/Unitek) with three (0, 5, and 10 degrees) slot angulation attached with elastomeric ligatures (TP Orthodontics) were tested. All brackets were tested with archwire 0.019"x0.025" nickel-titanium, beta-titanium, and stainless steel (Unitek/3M). The mechanical testing was performed with a universal testing machine eMIC DL 10000 (eMIC Co, Brazil). The wires were pulled from the bracket slots at a cross-head speed of 3 mm/min until 2 mm displacement.

Results

Self-ligating brackets produced significantly lower friction values compared with those of conventional brackets. Frictional force resistance values were directly proportional to the increase in the bracket/ wire angulation. With regard to conventional brackets, stainless steel wires had the lowest friction force values, followed by nickel-titanium and beta-titanium ones. With regard to self-ligating brackets, the nickel-titanium wires had the lowest friction values, significantly lower than those of other materials.

Conclusion

even at different angulations, the self-ligating brackets showed significantly lower friction force values than the conventional brackets. Combined with nickel-titanium wires, the self-ligating brackets exhibit much lower friction, possibly due to the contact between nickel-titanium clips and wires of the same material.     

高弹性压膜式口腔矫治器治疗OSAS的临床应用研究

目的:通过应用高弹性压膜式口腔矫治器治疗阻塞性睡眠呼吸暂停综合症(OSAS),探求一种解除不能耐受手术或手术失败的,拒绝戴用CPAP的有效治疗方法,并且此方法还能解决塑料矫治器力量过于强硬而造成颞颌关节区不适等问题。方法:应用此技术临床治疗14例轻中度OSAS患者,治疗前后进行多导睡眠仪检测并拍摄头颅侧位片,观察疗效,并与塑料矫治器进行比较。结果:经临床应用及比较观察,患者乐于戴用此压膜式口腔矫治器,戴用后AI,AHI明显下降(P<0.01),SaO2明显上升(P<0.01)。头颅侧位片测量各指标显示下颌前移,软腭后、舌背后的上气道明显扩张,鼾声、日间嗜睡等症状明显改善。结论:高弹性压膜式口腔矫治器能有效治疗0SAS,消除或减少鼾声及呼吸暂停,提高血氧饱和度,比塑料矫治器力量柔和,固位好,便于摘戴和携带,有利颞颌关节的健康,而且制作过程简便,快捷,是一项值得推广应用的技术[1]。     

正畸牙移动的形象化目标分析法及临床应用

目的：介绍正畸牙移动的形象化目标分析法的临床应用。方法：结合临床病例，介绍通过形象化的手段以第一磨牙、尖牙及中线情况为研究中心的VTO法的使用。结果：该方法对于拔牙与否的确定、拔牙后间隙的分配与支抗的控制、安氏Ⅱ类错He的分析等方面具有明显优势。结论：正畸牙移动的形象化目标分析方法，是X线头影测量的一个重要补充部分，是指导临床设计与治疗的有效手段。     

口腔综合防治措施对正畸儿童龋病和牙龈炎的影响

目的 :本实验通过对年龄 13～ 15岁 ,均为矫治仅 1周的患者进行口腔防治措施及口腔健康教育。方法 :防治措施包括氟制剂和绿茶多酚制剂的应用。对对照组儿童不采取任何防治措施。结果用团体T检验的方法进行统计。结果 :实验组无新龋发生 ,对照组龋均比实验前有所上升 ,但两组之间无统计学上的显著性差异。而实验组儿童口腔内GI、SBI、PLI指数明显降低 ,与对照组相比有显著性差异。结论 :对正畸儿童在矫治期间进行龋病和牙龈炎的防治非常必要 ,它可以防止龋病和牙龈炎的发生。     

The biomechanics of posterior maxillary arch expansion using fixed labial and lingual appliances

ObjectiveTo compare the biomechanics of straight labial, straight lingual, and mushroom lingual archwire systems when used in posterior arch expansion.Materials and MethodsAn electro-mechanical orthodontic simulator allowing for buccal–lingual and vertical displacements of individual teeth and three-dimensional force/moment measurements was instrumented with anatomically shaped teeth for the maxillary arch. In-Ovation L brackets were bonded to lingual surfaces, and Carriere SLX brackets were bonded to labial surfaces to ensure consistency of slot dimensions. Titanium molybdenum archwires were bent to an ideal arch form, and the teeth on the orthodontic simulator were set to a passive position. Posterior teeth from the canine to second molar were moved lingually to replicate a constricted arch. From the constricted position, the posterior teeth were simultaneously moved until the expansive force decreased below 0.2 N. Initial force/moment systems and the amount of predicted expansion were compared for posterior teeth at a significance level of α = 0.05.ResultsArchwire type affected both the expected expansion and initial force/moment systems produced in the constricted position. In general, the lingual systems produced the most expansion. The archwire systems were not able to return the teeth to their ideal position, with the closest system reaching 41% of the intended expansion.ConclusionsIn general, lingual systems were able to produce greater expansion in the posterior regions when compared with labial systems. However, less than half of the intended arch expansion was achieved with all systems tested.     

"图钉"样钛合金表面种植体作为正畸支抗的稳定性研究

目的 检测一种新的“图钉”样钛合金表面种植体的稳定性。方法 新的表面钛合金种植体，直径8．0mm，最大厚度2．0mm，钉状突起的底部直径为1．0mm，高1．5mm。在3只成年新西兰兔两侧后肢的胫骨处总共植入24个种植体。45天后，把24个种植体分成3组，每组8个。三组分别受力100克、200克和不受力。在每个种植体受力前、受力30天后分别测量其与定位钉之间的距离；受力30天后测量将表面种植体去除的最小剪切力，HE染色，观察种植体周围骨组织的变化。结果①除了一个在加力过程中由于误操造成脱落外，其余23个种植表面种植体均固住良好。②以定位钉为标准，100克受力组、200克受力组和不受力组的种植体在受力实验前后的平均位移的差异没有统计学意义。③三组种植体受力后去除种植体的最小剪切力，最小为18．59N；最大为57．13N，实验三组间以及两两之间去除种植体的最小剪切力的差异无统计学意义。④在大体标本和X光片中，可以见到骨组织将盘状种植体部分覆盖。⑤组织学切片显示：骨与种植体接触面有新骨形成，同时新骨沿着种植体的表面生长，并且覆盖了部分的种植体表。结论“图钉”样钛舍金表面种植体在兔的实验中有良好的稳定性，可以预测试种植体可以提供较为理想的正畸支抗。     

Force changes associated with different intrusion strategies for deep-bite correction by clear aligners

Objectives:To investigate the relationships among different intrusion patterns of clear overlay aligners and the corresponding orthodontic forces and to provide guidance for clinical treatment.Materials and Methods:Five sets of removable thermoplastic-formed aligners with the same thickness, designed for different intrusion procedures (G0 aligners as a control group, with no activation; G1 aligners for intruding canines; G2 aligners for intruding incisors; G3 aligners for intruding canines and incisors with the same activations; G4 aligners for intruding canines and incisors with different activation), were manufactured, and the corresponding intrusion forces were measured with a multiaxis force/torque transducer measurement system in real time.Results:With the same activation (0.2-mm intrusion) and rectangular attachments placed on the premolars and first molars, the canines experienced the largest intrusive force when intruded alone using G1 aligners. The canines received a larger intrusive force than incisors in G3. The incisors received similar forces in G2 and G3. First premolars endured the largest extrusive forces when all anterior teeth were intruded with G3 aligners. Extrusion forces were exerted on canines and lateral incisors when using G4 aligners.Conclusions:Aligners with different intrusion patterns exert different forces on incisors, canines, and premolars, and the forces were closely related to the designed activation, shape and position of the attachment and relative movement of the adjacent teeth.     

腭部专用正畸支抗种植体Straumann Orthosystem Implant

腭部专用正畸支抗种植体Straumann Orthosystem Implant是专门设计植入腭正中区的一种骨内牙种植体,为口腔正畸移动牙齿提供临时固定支抗功能。本文详细综述了该种植体的基本结构、植入方法、实验研究、临床应用以及其优缺点,旨在为正畸医生提供参考与帮助。     

Calendar of Meetings

Abstract

Over a 1-year period, all patients attending a consultant orthodontist's new patient clinics in North Derbyshire and whose treatment plans involved active appliance treatment, were accepted into a prospective longitudinal study. In all 294 patients were included in the study. Subsequent to the consultant's new patient clinic the patients' active treatments were undertaken in the Hospital, General, or Community Dental Services. Four years after the commencement of the study, 207 patients had completed active treatment and 50 had non-completed during active treatment. This gave an overall non-completion rare (NCR) of 19·5 percent for the study. Of the 50 patients who did not complete treatment during active treatment 23 (46 per cent) non-completed during the first 6 months of active treatment. A predictive model of non-completion of active orthodontic treatment (NCT) over time is suggested.     

正畸治疗中牙龈增生的致病因素分析

Objective To investigate the pathogenesis of gingival enlargement (GE) in orthodontic treatment. Methods The study sample included 12 patients with GE undergoing fixed orthodontic treatment and 12 periodontally healthy controls. At baseline, periodontal variables,subgingival plaque samples and gingival cervical fluid (GCF) samples were taken from two pre-selected sites in both the GE group and control group. The levels of Porphyromonas gingivalis (Pg),Aggregatibacter actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Treponema denticola (Td) and Tannerella forsythensis (Tf) were determined by real-time PCR. GCF interleukin (IL)-1β were detected by ELISA. Periodontal therapy was administered to the patients in the GE group and all the parameters were reassessed after 4 weeks. Results At baseline, the GE group showed higher prevalence of five periodontal pathogens than the control group (P＜0. 05). IL-1β levels at the GE sites were also significantly higher than those at the control sites (P＜ 0. 05). Four weeks after periodontal therapy, the GE group showed significant improvements in the clinical parameters associated with significant reductions of Pg, Aa and Td. The levels of IL-1β also decreased significantly compared with baseline (P＜0. 05). Conclusions Periodontal pathogens and IL-1β may be related to the initiation and development of GE in orthodontic treatment.