固定矫治中带环与直接粘接颊面管应用的回顾性研究

目的比较固定矫治中使用带环和直接粘接颊面管的应用效果。方法回顾163例固定矫治病例中磨牙带环和直接粘接颊面管的脱落情况,检查磨牙牙周状况,测量磨牙带环间隙,并进行统计学分析。结果带环脱落率为16.73%,直接粘接颊面管脱落率为14.53%,两者差异无统计学意义(P>0.05);与粘接颊面管磨牙相比粘接带环磨牙的牙周状况较差,两组的出血指数、探诊深度具有统计学差异(P<0.01);带环拆除后遗留明显的带环间隙。结论固定矫治中使用直接粘接颊面管有利于牙周状况的维护,粘接效果可靠,而且避免了分牙过程和带环间隙的遗留。     

磨牙带环与粘接式颊面管的临床应用比较

随牯接技术与粘接式颊面管底部工艺的进步,粘接式颊面管成为更多正畸医生的首选.在规范的操作下,粘接式颊面管能达到临床正畸用力强度,相对于磨牙带环,颊面管更加便捷,节省临床时间,对牙齿牙周的不利影响也减少[1].本研究通过对粘接式颊面管与带环的临床应用,就这两种材料作对比研究.     

粘接型颊面管替代磨牙带环的初步研究

目的研究粘接型颊面管代替磨牙带环的可行性。方法选取因牙周病拔除的第一恒磨牙30颗,分为3组,按临床操作程序粘接颊面管,在粘接5 min、30 min和24 h后分别测量粘接型颊面管的粘接强度;统计正畸患者中粘接型颊面管和带环的脱落率,并进行统计分析。结果粘接24h后粘接型颊面管的抗剪切强度为(14.11±0.41)MPa,抗张强度为(3.04±0.11)MPa。粘接型颊面管和磨牙带环的脱落率相同。结论在多数情况下,粘接型颊面管都可替代磨牙带环。     

直接粘结颊面管与带环颊面管在直丝弓矫治技术中的对比研究

目的：比较直接粘结颊面管与带环颊面管在直丝弓矫治技术中的临床应用。方法：选择临床病例60例共274颗磨牙,随机分成2组,分别使用直接粘接法和带环法粘结颊面管,观察一年半内颊面管脱落率,并评价治疗前后磨牙区的牙周探诊深度变化。结果：两组病例1.5年内颊面管脱落率无显著性差异,而直接粘接颊面管磨牙区牙周情况明显优于带环颊面管。结论：直接粘接颊面管的粘接强度能达到预期的矫治目标,更易于磨牙区口腔卫生的维护。     

固定正畸中使用颊面管的支抗牙与使用带环的支抗牙的卫生情况的临床调查

固定正畸是矫治牙列错[牙合]畸形的常用方法。但某些正畸部件如带环影响口腔生理性自洁作用导致支抗牙牙周病发生率增高，严重时可导致支抗牙丧失。为进一步了解带环及颊面管对支抗牙牙周组织的影响，我们对78例病人的312个支抗牙的菌斑指数，牙龈指数进行了动态观察。     

正畸带环粘接的程序及护理要点

带环是固定矫治器的重要组成部件之一 ,它粘固在支抗牙上 ,起固位、连接颊面管及托槽的作用 ,带环粘接的好坏 ,直接影响到正畸治疗的效果 ,而带环的大小 ,消毒 ,干澡 ,粘接剂的粘稠度及用量对带环的粘接起重大作用。目前国内尚未见到关于粘接带环护理的文章报道 ,本文通过临床病例 ,讨论并分析带环粘接的程序及护理配合要点 ,拟进一步提高护理质量。临床资料本文共收集病例 12 3例。其中女性 6 9例 ,年龄 10～ 33岁 ;男性 5 4例 ,年龄 11～ 2 4岁。均采用固定矫治器治疗 ,每个患者约需 4～ 8个带环。带环选用杭州西湖巴尔牌 ,粘接剂选用上海…     

玻璃离子粘合剂粘接带环的临床效果观察

固定矫正器已广泛应用于现代正畸治疗 ,但矫正器附件的脱落是临床常见又必须解决的问题。以往国内普遍采用磷酸锌水门汀粘接带环 ,带环脱落率较高。笔者于 1998年起采用玻璃离子作带环粘接剂 ,观察 14个月 ,效果明显材　料　和　方　法1　病例选择 :　正畸就诊患者 56名共 2 2 4颗支抗磨牙 ,牙体发育良好 ,无大面积龋坏 ,无牙体组织大面积缺损 ,摄片见牙根发育良好 ,无根尖炎症及牙槽骨的吸收。2　实验方法及材料 :　 56名患者随机选择一侧上下支抗磨牙用玻璃离子粘接带环 ,对侧上下支抗磨牙用磷酸锌水门汀粘接带环以作对照。两种粘合剂均采…     

带环颊面管及带网颊面管的临床应用

一、材料与方法１．带环颊面管，带网颊面管均为杭州西湖生物材料研究所生产。带网颊面管采用京津釉质粘接剂粘接；带环用磷酸锌粘固剂粘接。２．正畸患者５０名，男性１１人，女性３９人，年龄１３～３０岁，均采用Ｂｅｇｇ技术，拔４４４４。所有病例均为６６粘带环。观...     

活动翼与直丝弓矫治系统磨牙颊面管脱落情况对比

目的 比较活动翼颊面管、直丝弓粘结型颊面管及磨牙带环的临床脱落率,了解其临床应用可行性。方法 将120例采用固定矫治病例随机分为3组,分别于第一磨牙粘结活动翼颊面管、普通直丝弓粘结型颊面管以及带环,记录临床主动矫治观察期内颊面管与带环的脱落情况,并进行对比分析。结果 直丝弓颊面管组、活动翼颊面管组和磨牙带环组的临床脱落率分别为14.38%、8.13%和6.25%;直丝弓颊面管组的临床脱落率高于其他两组,差异有统计学意义(P0.01)。结论 活动翼矫治系统颊面管的改良设计能够降低临床脱落率,可以很好地满足正畸临床需要。     

颊面管直接粘结技术及脱落原因分析

磨牙带环作为固定矫正器的主要附件,由于其临床制作复杂,增加了椅旁时间;而成品带环又因其种类、型号较多,使术者感到挑选与修改的繁琐。同时应用带环患者需承受分牙所带来的不适。笔者自1995年起在临床上有选择地使用颊面管直接粘结技术,取得了满意的效果。 一、材料:颊面管为杭州奥索公司生产;粘结剂为天津产的京津釉质粘合剂。 二、方法:①磨牙牙面清洁;②酸处理;③冲洗干燥;④粘结磨牙颊面管。 三、临床资料 1995年6月～1997年6月共收治使用固定矫正方法者186例,粘结颊面管528个,最大年龄38岁,最小     

Begg-edgewise diagnosis-determined totally individualized orthodontic technique: foundations, description, and rationale

This article presents an appliance system designed to facilitate efficient treatment by the use of the biomechanical approach considered most suitable by the orthodontist for the individual patient. The system described uses narrow, single brackets with 0.022 X 0.028 inch edgewise arch wire slots and 0.020 X 0.020 inch vertical slots for various auxiliaries. There are five brackets that differ only in the torque of the arch wire slot-0 degree, 5 degrees, 10 degrees, 15 degrees, and 20 degrees. Thus, an appropriate bracket can be selected for any tooth in any situation. The brackets and bonding pads are small in all dimensions to ensure optimal appearance and interbracket arch wire spans and minimal lip and cheek irritation. This also lessens occlusal interference, enamel surface involved in bonding, and problems with gingival proximity and oral hygiene. The basic buccal tubes are conventional 4.5 mm long, 0.022 X 0.028 inch torqued edgewise tubes. A buccal tube assembly with a similar additional rectangular tube carried diagonally at a 15 degree angle across the buccal surface of the basic tube (its mesial end pointing gingivally) is used in extraction cases with deep overbites or moderate-to-severe anchorage requirements. The angulated outer tube carries the main (working) arch wire during the bite-opening and retraction phases of treatment. A rectangular sectional wire in the inner tube and second premolar bracket locks the molar and premolar teeth together so that neither can tip independently. As a unit they provide anchorage for bite opening and retraction. The gingivally positioned and angulated outer tube directs the arch wire out of danger of distortion from mastication and provides a built-in biteopening effect. The molar and premolar teeth, in effect, become a single large tooth with its center of resistance (CR) further mesial than the CR of the molar. Sectional wires result in a more favorable system of moments created by arch wires and elastics. This delivers more intrusive force to the incisors with less tendency to tip the anchor units. The appliance provides the orthodontist with an extensive range of options in treatment mechanics--from anchorage conservation and rapid movement of limited tipping by light forces to translation or stabilization with precise three-dimensional control.     

Effects of buccal versus lingual surfaces, enamel conditioning procedures and storage duration on brackets debonding characteristics

OBJECTIVES: To determine the influence of two enamel conditioning techniques on buccal and lingual tooth surfaces at two different times on debonding strength and tooth damage. METHODS: The study included 50 premolars. Buccal and lingual surfaces of 10 teeth were scanned using SEM before (N=4) and after enamel conditioning by either acid etching or sandblasting prior to acid etching (N=6) for their morphology. The remaining 40 teeth were divided into 2 equal groups, differing in enamel conditioning prior to metallic bracket bonding on the buccal and lingual surfaces. Each group was equally subdivided into short-term (48h) or long-term (12m) water storage. Debonding strength was measured followed by SEM and EDAX for adhesive remnant index (ARI) and calcium remnant index (CRI) left on bracket bases. ANOVA with repeated measures was applied to the results. RESULTS: The buccal enamel was rougher than the lingual one. The surface morphology after the two types of conditioning showed a different pattern. A significantly higher debonding strength was needed to debond the buccal brackets compared to the lingual ones (p<0.05). A significantly higher ARI (p<0.002) and higher CRI (p<0.005) were found in the lingual surface compared with the buccal. No differences were found in debonding strength ARI or CRI regarding the different conditioning or storage duration. CONCLUSIONS: Lingual bonding leads to higher ARI and CRI than buccal bonding. Sandblasting prior to etching does not improve bonding strength for lingual or buccal bonding.     

Load fatigue of teeth restored by a dentin bonding agent and a posterior composite resin

A three-surface MOD preparation measuring one third of the isthmus cavity distance at the isthmus was prepared for five extracted, intact human maxillary premolar teeth. The teeth were restored with a posterior resin and a dentin bonding agent. Each tooth was tested under a cyclically varying load in a fatigue machine made at the University of Washington. The cyclic load rate was 75 cycles per minute. A strain gauge was applied to the buccal surface of each tooth. Under the load applied at an angle of 60 degrees to the long axis of the tooth, reinforcement of the tooth was established by the reduced deflection of the buccal surface of the restored tooth as compared with the unrestored tooth. The loss of this reinforcement due to the application of the cyclically varying load established the end point of the fatigue testing. Four different load values of 13, 16, 19, and 22 lb loads were applied separately to each tooth. The results of this testing were classic wherein the smallest load required the greatest number of load cycles before loss of adhesion was registered by the strain gauge. Failure always occurred within the adhesive joint.     

Bond strength of fiber-reinforced composite bars for orthodontic attachment

Long fiber-reinforced composites (FRC) have been shown to have enhanced mechanical properties that allow their use in orthodontic appliances as bars that join teeth to form either anchorage or active units. This study was designed to determine if the bonding of an orthodontic attachment has sufficient strength to withstand loading during clinical use. The experimental model consisted of a hydroxyapatite stone that simulated enamel, FRC bars, and a bonded metal hook. Three specimen types were compared: (1) a metal hook-pad (the control), (2) a woven FRC with a hook-pad, and (3) a unidirectional FRC with a hook-pad. Loads were applied both parallel and at 90 degrees to the tooth surface. Under no condition was the FRC pad combination weaker than the control pad. Under some loading conditions, the loads before failure were as much as 3 times greater than those for the control. The lowest strength was found with loads at 90 degrees to the tooth surface for all 3 types. Failure normally occurred in the FRC and rarely at the bracket or tooth interface. The excellent bonding of the orthodontic attachment to the FRC and the high strengths of the FRC attachment combination demonstrate the ability to form connecting bars between teeth for either anchorage or active segmental movements. These bars offer advantages in simplicity in treatment by reducing the need for some bands, attachments, or wires.     

Performance of techniques used for re-attachment of endodontically treated crown fractured teeth

OBJECTIVES: The aim of this study was to compare the fracture strength of three techniques used to re-attach tooth fragments in sound and endodontically treated fractured teeth with or without fiber post placement. MATERIAL AND METHODS: Ninety human lower incisors were randomly divided into three groups of 30 teeth each. In group A teeth were not subjected to endodontic treatment; while teeth from groups B and C were endodontically treated and the pulp chamber restored with a composite resin. All teeth were fractured by an axial load applied to the buccal area in order to obtain tooth fragments. Teeth from each group were then divided into three subgroups, according to the re-attachment technique: bonded-only, buccal-chamfer and circumferential chamfer. Before the re-attachment procedures, fiber posts were placed in teeth from group C using dual cure resin luting cement (Duo-Link). All teeth (groups A-C) had the fragments re-attached using a same dual cure resin luting cement. In the bonded-only group, no additional preparation was made. After re-attachment of the fragment, teeth from groups buccal and circumferential chamfer groups had a 1.0 mm depth chamfer placed in the fracture line either on buccal surface or along the buccal and lingual surfaces, respectively. Increments of microhybid composite resin (Tetric Ceram) were used in subgroups buccal chamfer and circumferential chamfer to restore the chamfer. The specimens were loaded until fracture in the same pre-determined area. The force required to detach each fragment was recorded and the data was subjected to a three-way analysis of variance where factors Group and Re-attachment technique are independent measures and Time of fracture is a repeated measure factor (first and second) and Tukey's test (alpha=0.05). RESULTS: The main factors Re-attachment technique (p=0.04) and Time of fracture (p=0.02) were statistically significant. The buccal and circumferential chamfer techniques were statistically similar (p>0.05) and superior to the bonded-only group (p<0.05). The first time of fracture was statistically superior to second time of fracture (p<0.001). CONCLUSIONS: The use of fiber post is not necessary for the reinforcement of the tooth structure in re-attachment of endodontically treated teeth. When bonding a fractured fragment, the buccal or circumferential re-attachment techniques should be preferable in comparison with the simple re-attachment without any additional preparation. None of the techniques used for re-attachment restored the fracture strength of the intact teeth.     

Direct bonding of unerupted teeth for orthodontic movement.

The surgical technique for exposing unerupted teeth by the use of direct bonding brackets has been described. Twenty unerupted teeth were successfully exposed and bracketed with direct bonding with a minimum of surgical trauma and postoperative complications while ensuring the preservation of tooth structure. Difficulties previously described in maintaining a dry field were obviated with a quick-setting adhesive and good suction technique.     

Short term human primary pulpal response after direct pulp capping with fourth-generation dentin adhesives

The purpose of this study was to evaluate the effects of the total-etch and direct pulp capping techniques on the short-term response of mechanically exposed human primary tooth pulps using three commercially available adhesive resin systems. Class V cavities were prepared on the buccal surface of intact mandibular primary molars and exposed with a carbide bur on the cavity floor. The entire cavity except the exposure site received 36% phosphoric acid gel conditioning. Exposed pulps were capped with one of the three adhesive resins, followed by restoration of the cavities with the respective restorative materials. The teeth were extracted after 60 days and prepared according to normal histological techniques. Serial sections were stained with H/B for histological evaluations. The histopathological evaluation showed that a few of the samples in the Scotchbond Multi Purpose (SMP) and Prime & Bond 2.1 (PB) groups exhibited "attempted bridge formation", while no bridge formation was evident in the other samples. Syntac Single Component (Syntac) exhibited the most severe histological response, while the mildest reactions were observed in the SMIP group. Based on the conditions of the present study, direct pulp capping with dentin bonding agents following the total-etch technique in primary teeth can not be recommended.     

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复合树脂粘接修复技术近年来发展迅速,许多传统观念发生了彻底改变。本文讨论了后牙复合树脂粘接修复中的几个临床关键问题,回顾了近年来相关研究的最新进展,从而为临床医生提供参考。     

国产微型钛钉即刻负载正畸支抗临床应用初步研究

目的：评价国产微型钛钉支抗临床使用效果.方法：选取13例需拔除上颌双侧第一双尖牙并需使用最大支抗的患者为研究对象,在其双侧颧牙槽嵴第二双尖牙和第一磨牙间,植入国产微型钛钉各一枚,以其为支抗移动尖牙.利用尖牙到位前后的研究模、头侧位定位X片,计测尖牙移动速度及磨牙相对于参考平面的位移量.结果：移动尖牙的平均速度为1.05mm/月,与磨牙支抗无统计学差异;磨牙位移量平均为0.50mm,明显小于传统强支抗方式.结论：牙移动速度种植支抗与传统支抗无差别;种植支抗几为绝对支抗.     

Orthopedic protraction with skeletal anchorage in a patient with maxillary hypoplasia and hypodontia

Multipurpose titanium miniplates were placed on the lateral nasal wall of the maxilla as anchorage for face mask protraction in an 11-year-old girl presenting with severe maxillary hypoplasia and hypodontia. Applying orthopedic forces directly to the maxilla resulted in an eight mm maxillary advancement. Intraosseous titanium screws were also placed on the palatal bone, near the alveolar crests, to provide anchorage for the expansion appliance. The maxilla was expanded from the median palatal suture, and seven mm of expansion was achieved across the buccal segments. No other tooth support was used for the expansion or the protraction of the maxilla.