改良[牙合]垫矫治器矫正后牙锁[牙合]的临床应用22例

目的观察改良[牙合]垫矫治器矫正后牙锁[牙合]的临床疗效和矫治特点。方法对22例后牙锁[牙合]患者采用改良[牙合]垫矫治器进行矫治。结果22例患者解除后牙锁[牙合],治疗时间为2．1—3．8个月,平均3．1个月,治疗后上下磨牙建立良好的咬合关系。结论改良[牙合]垫矫治器矫正后牙锁[牙合]支抗稳定,牵引方向灵活,效果良好。     

后牙锁的矫治及其常见问题的预防与处理

后牙锁 牙合是一种临床较为常见的错牙合畸形 ,以第二磨牙正锁牙合更为多见 ,也可见到第一磨牙及前磨牙锁牙合 ,可表现为个别牙锁牙合或多个牙锁牙合 ,影响患者咬合功能 ,并对美观及口腔健康带来危害。锁牙合牙齿不仅存在水平向(颊舌向 )而且存在垂直向及近远中方向。针对不同锁牙合应采用不同的治疗方法。治疗后牙锁牙合的固定矫治方法有改良腭杠腭侧牵引矫正法、方丝“T”形曲矫正法、附弓丝固定矫正法、腭杠或腭弓缩弓法、舌弓扩弓法、固定矫治器弓丝矫正法及拔牙矫治法等。在治疗后牙锁牙合中 ,解除拥挤开辟间隙是前提 ,对锁牙合牙齿进行垂直向控制是关键 ,根据锁牙合类型确定矫治方法是保证。拔牙矫治不失为一种治疗锁牙合的简便方法。     

后牙正锁的正畸治疗体会

后牙正锁牙合对咀嚼功能、颌面发育及颞颌关节的健康影响很大,需尽早矫治。作者对２０例后牙锁牙合进行治疗,现报告如下。临床资料一、本组后牙正锁牙合２０例,年龄１２～２０岁,平均年龄１４．５岁,男性１１例,女性９例,其中第二恒磨牙锁牙合１４例,双尖牙锁牙合...     

多数后牙正锁[牙合]的矫治

目的探讨多数后牙正锁[牙合]畸形的临床矫治方法。方法选择11.3～32.0岁多个后牙正锁[牙合]的各类错[牙合]患者19例,比较治疗前、治疗后的临床症状、模型改变,并分析患者软、硬组织头影测量指标的变化。结果19例患者锁[牙合]关系全部解除,[牙合]面有咬合接触,覆盖关系基本恢复正常,尖窝关系基本正常,恢复至个别正常[牙合]关系。生长发育期的10例患者原有的颌面部不对称得到改善。对需要正颌外科治疗严重骨性不调的1例成人患者进行了术前正畸治疗,为正颌外科手术创造有利的条件。结论治疗多数后牙锁[牙合]的患者要根据不同情况确定矫治方法。     

改良带翼扩弓矫治器的临床应用

目的研究改良带翼扩弓矫治器矫治单侧后牙反(牙合)的临床效果。方法选择12例单侧后牙反(牙合)的病例,应用改良带翼扩弓矫治器进行矫治,并对矫治前后模型测量分析。结果 12例单侧后牙反(牙合)的病例经过2.5～6.0个月的矫治,临床效果满意。结论改良带翼扩弓矫治器矫治单侧后牙反(牙合),既可保持正常(牙合)侧咬合关系良好,又可快速矫治后牙反(牙合)。     

单侧后牙正锁[牙合]正畸矫治的临床研究

目的：评价单侧后牙正锁[牙合]的矫治效果,进一步探讨单侧后牙正锁[牙合]的矫治方法。方法：单侧后牙正锁[牙合]患者11例（男4例,女7例）,年龄13-26岁,采用直丝弓矫治技术矫治,治疗中上颌使用前牙平面导板和健侧后牙[牙合]垫,患侧上下颌后牙交互牵引。治疗前后常规拍摄头颅定位侧位片,并进行X线头影测量分析。结果：治疗结束后,后牙正锁[牙合]得到了矫治,牙弓形态正常,前牙覆[牙合]超[牙合]正常,后牙咬合关系良好,面下1/3高度增加。结论：直丝弓矫治器配合适当的后牙交互牵引能够有效的矫治单侧后牙正锁[牙合]。     

后牙锁(ya he)的矫治及其常见问题的预防与处理

后牙锁是一种临床较为常见的错畸形,以第二磨牙正锁更为多见,也可见到第一磨牙及前磨牙锁 ,可表现为个别牙锁或多个牙锁 ,影响患者咬合功能,并对美观及口腔健康带来危害.锁牙齿不仅存在水平向(颊舌向)而且存在垂直向及近远中方向.针对不同锁应采用不同的治疗方法.治疗后牙锁的固定矫治方法有改良腭杠腭侧牵引矫正法、方丝"T"形曲矫正法、附弓丝固定矫正法、腭杠或腭弓缩弓法、舌弓扩弓法、固定矫治器弓丝矫正法及拔牙矫治法等.在治疗后牙锁中,解除拥挤开辟间隙是前提,对锁牙齿进行垂直向控制是关键,根据锁类型确定矫治方法是保证.拔牙矫治不失为一种治疗锁的简便方法. 后牙锁是一种临床较为常见的错畸形,以第二磨牙正锁更为多见,也可见到第一磨牙及前磨牙锁 ,可表现为个别牙锁或多个牙锁 ,影响患者咬合功能,并对美观及口腔健康带来危害.本文针对临床常见的后牙锁类型及其矫治方法、效果及常见问题进行探讨.     

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.     

非拔牙矫治成人功能性Ⅲ类错的临床分析

目的:总结成人功能性安氏Ⅲ类错牙合的矫治效果。方法:本组7例功能性Ⅲ类错牙合病例采用非拔牙矫治,以活动式上颌后牙牙合垫打开咬合,然后用固定矫治器唇向移动上前牙,纠正前牙反牙合,最后调整全牙列咬合关系。结果:7例患者反牙合全部解除,磨牙呈中性关系,面型改善,颞颌关节无变化。反牙合解除时间平均2.5个月;全部矫治完成时间10.5个月。结论:采用非拔牙设计,联合应用活动式上颌后牙牙合垫与固定矫治器矫治成人功能性安氏Ⅲ类错牙合,疗程短,疗效满意。     

变异Herbst矫治器的临床应用与评价

目的:观察变异Herbst矫治技术的临床矫治效果。方法:12例II类错牙合患者,采用变异Herbst矫治器,经6～8个月的矫治,观察、评估该方法的矫治效果。结果:12例II类错牙合患者,经变异Herbst矫治器矫治,均获得快速、显著的治疗效果。治疗前后ANB角改变有显著的统计学差异。结论:变异Herbst矫治器是一种疗效肯定的固定功能性矫治器,适用于青少年(恒牙列)、青少年后期和年轻成人的II类错牙合,这种治疗方法能使边缘性骨性II类错牙合避免正颌外科手术,操作简便,易于在临床推广应用。     

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后牙锁[牙合]畸形一般需要通过拔牙手段才能得到有效矫治。结合临床,本文提出了以下矫治理念：（1）制定矫治计划时上下牙列尽可能选择正畸拔牙矫治;（2）欲矫治第二磨牙的错[牙合],应先拔除第三磨牙才能获得满意的疗效;（3）有时可直接拔除锁[牙合]的第二磨牙,让第三磨牙自行调整至正常位置;（4）为消除咬合干扰,在矫治之前在前牙区放置一平面导板,有利于锁[牙合]牙的快速纠正。     

Association between malocclusion in the mixed dentition with breastfeeding and past nonnutritive sucking habits in school-age children

ObjectivesTo evaluate the association between malocclusion characteristics in the mixed dentition stage, breastfeeding, and past nonnutritive sucking habits in school-age children.Materials and MethodsA total of 547 school children in the mixed dentition, in the age range between 7 and 13 years, were evaluated by means of questionnaire and clinical examination. Binomial and multinomial logistic regression models were used to evaluate the associations between breastfeeding and finger and pacifier sucking habits, the malocclusion characteristics of posterior crossbite, and excessive or deficient overjet and overbite.ResultsIndividuals who had nonnutritive sucking habits had 2.16 times greater chance of having anterior open bite (odds ratio [OR] 2.16; 95% confidence interval [CI], 1.07–4.33) and 2.39 times greater chance of having posterior crossbite (OR 2.39; 95% CI, 1.56–5.49). Children who were exclusively breastfed up to at least 6 months of age had a higher frequency of normality for overjet and overbite and the lowest posterior crossbite index. However, in adjusted analysis, breastfeeding showed no association with malocclusion characteristics in the mixed dentition stage.ConclusionsBreastfeeding was not associated with the presence of malocclusion in the mixed dentition, whereas past nonnutritive sucking habits were associated with the occurrence of malocclusion.     

Camouflage treatment for skeletal Class III patient with facial asymmetry using customized bracket based on CAD/CAM virtual orthodontic system:: A case report

When considering camouflage orthodontic treatment for Class III malocclusion with skeletal facial asymmetry, it is crucial to preserve the favorable compensated posterior occlusion. Once the inclination of the compensated occlusion is changed during orthodontic treatment, unstable occlusion, such as crossbite or scissor bite may occur. A 23-year-old female patient had anterior spacing with Class III malocclusion and a mandibular asymmetry. A nonsurgical approach was adopted. The treatment objectives were to establish a Class I molar relationship with compensated inclination of the posterior dentition and to correct the midline deviation. To achieve these goals, the computer-aided design/computer-aided manufacturing (CAD/CAM) orthodontic system plus customized brackets was applied, and miniscrews were used to distalize the left mandibular dentition for midline correction. The results suggested that the CAD/CAM-based customized brackets can be efficiently used in camouflage treatment to achieve a correct final occlusion.     

The rationale and indications for equilibration in the primary dentition.

One type of malocclusion in the primary dentition is posterior crossbite caused by premature deflective occlusal interferences. The primary canines are the teeth that most frequently contribute to a laterally guided centric occlusion that creates a functional malocclusion. Because this is not a self-correcting situation, these types of posterior crossbites should be identified early and evaluated for possible correction through occlusal equilibration. A case that illustrates early correction of a unilateral functional posterior crossbite by equilibration and the 5-year results are presented.     

Orthodontic-surgical treatment of Class III malocclusion with mandibular asymmetry

Class III skeletal malocclusion may present several etiologies, among which maxillary deficiency is the most frequent. Bone discrepancy may have an unfavorable impact on esthetics, which is frequently aggravated by the presence of accentuated facial asymmetries. This type of malocclusion is usually treated with association of Orthodontics and orthognathic surgery for correction of occlusion and facial esthetics. This report presents the treatment of a patient aged 15 years and 1 month with Class III skeletal malocclusion, having narrow maxilla, posterior open bite on the left side, anterior crossbite and unilateral posterior crossbite, accentuated negative dentoalveolar discrepancy in the maxillary arch, and maxillary and mandibular midline shift. Clinical examination also revealed maxillary hypoplasia, increased lower one third of the face, concave bone and facial profiles and facial asymmetry with mandibular deviation to the left side. The treatment was performed in three phases: presurgical orthodontic preparation, orthognathic surgery and orthodontic finishing. In reviewing the patient's final records, the major goals set at the beginning of treatment were successfully achieved, providing the patient with adequate masticatory function and pleasant facial esthetics.     

Meeting Reports

Abstract

This article describes treatment of a patient presenting with a class II malocclusion, maxillary and mandibular crowding, posterior crossbite and an increased deep bite, where the specific treatment goals were achieved in the early mixed dentition by only working on the primary teeth. A Haas-type rapid maxillary expansion (RME) appliance was modified to be anchored on the primary second molars and canines and activated once a day, with each activation equal to 0.20 mm. The appliance was blocked after 30 days and left as a retainer. After 6 months, the RME appliance was removed and bands were cemented to the primary second molars in order to apply traction with headgear. After complete eruption of the mandibular central and lateral incisors, sequential slicing of the lower primary teeth was performed to transfer the leeway space from the distal to the mesial part of the arch. When the patient had entered the permanent dentition, a dental class I relationship was achieved, the crossbite corrected and the crowding improved. The overjet and overbite were also improved. No permanent teeth were involved during this phase of treatment. The outcome of this case report shows that it is possible to work only on primary teeth in the mixed dentition and this can be an effective way to correct a class II malocclusion with deep bite, posterior crossbite and maxillary and mandibular crowding.     

Prevalence and determinant factors of malocclusion in children with special needs

Careful attention to malocclusion in children with special needs leads to a considerable improvement in the quality of life. The present study analysed the prevalence of malocclusion in children with Down syndrome (DS) and cerebral palsy (CP) as well as associations with individual, socio-economic, and behavioural factors. A cross-sectional study was carried out that included 181 mothers and their children with DS and CP (aged 3-12 years) at two institutions for individuals with special needs in Rio de Janeiro, Brazil. Data were collected using a questionnaire administered to the mothers and a dental examination of the children. Clinical examination recorded the following: anterior/posterior crossbite and anterior openbite (AOB). The control variables were the mother's level of education as well as the gender and age of the child. Statistical analysis of the data was performed using the chi-square test and multiple logistic regression. An anterior crossbite was present in 20.4 percent, a posterior crossbite in 21.5 percent, and an AOB in 29.8 percent. The presence of DS, bottle feeding, and non-nutritive sucking habits for 24 months or more was determinant factors for an anterior crossbite and the presence of DS, bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months was determinant factors for a posterior crossbite. The presence of CP and non-nutritive sucking habits for 24 months or more was determinant factors for an AOB. Thus, the prevalence of malocclusion in children with special needs was associated with the type of disability, use of bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months.     

Management of occlusal canting with miniscrews

A 14-year-old boy with a skeletal Class II malocclusion and open bite whose chief complaint was a posterior crossbite showed a canted occlusal plane with asymmetric gummy smile and mandibular deviation at clinical examination. The treatment with miniscrews focused on the bilateral intrusion of the maxillary posterior teeth and, after resolving the open bite, a new biomechanical technique involving joined miniscrews was applied for an en masse intrusion of the left side. This treatment strategy achieved optimal occlusion with improvements to the sagittal, vertical, and transverse relationships and achieved a harmonious smile.     

安氏Ⅰ类错畸形的临床分析

目的探讨安氏Ⅰ类错畸形所包含的各种错畸形。方法选择267例恒牙列安氏Ⅰ类错畸形患者,根据临床特征并结合X线头影测量,分析各种错畸形的构成比。结果①矢状向:Ⅰ类骨面型202例(75.66%),Ⅱ类骨面型45例(16.85%),其中上颌前突16例,下颌后缩30例,上颌前突合并下颌后缩1例,Ⅲ类骨面型20例(7.49%)。②垂直向:正常型99例(37.08%),高角型153例(57.30%),低角型15例(5.62%)。③安氏Ⅰ类错畸形的构成情况:牙列拥挤245例,(91.76%),牙间隙21例(7.87%),双颌前突12例(4.49%),前牙反43例(6.10%),前牙深覆盖105例(39.33%),前牙深覆110例(41.20%),其中闭锁型深覆4例,后牙反14例(5.24%),后牙正锁6例(2.25%),个别牙错位2例(0.75%),前牙及双尖牙开5例(1.87%)。结论安氏Ⅰ类错畸形临床表现多样,安氏分类法对错畸形特征的概括太笼统。