MEAW技术矫治错(牙合)的临床观察

目的:通过多曲方丝弓(MEAW)技术矫治各类骨性错(牙合),观察临床矫治效果.方法:前牙开(牙合)病例2例,骨性Ⅲ类错(牙合)12例,骨性Ⅱ类错(牙合)7例,均采用MEAW技术进行前牙覆(牙合)、覆盖的矫治以及磨牙关系的调整.结果:2例前牙开(牙合)病例前牙覆(牙合)平均增加6mm;7例骨性Ⅱ类错(牙合)病例覆(牙合)覆盖平均减小3.62 mm和4.5 mm;12例骨性Ⅲ类错(牙合)病例覆盖平均改变4.14 mm.结论:MEAW技术在骨性错(牙合)病例的非手术方法矫治上有明显的临床疗效.     

多曲方丝弓技术矫治骨性Ⅲ类错16例临床观察

目的观察多曲方丝弓技术(MEAW)矫治骨性Ⅲ类错的临床疗效。方法选取应用MEAW技术治疗的骨性Ⅲ类错畸形的患者16例,测量矫治前后的X线头颅侧位定位片并进行配对t检验评估疗效。结果与矫治前相比,SNA角平均增加2.08°,SNB角平均减少1.49°,L6-FHV平均减少3.12mm,L6-MP角平均减少9.83°,OJ平均增加4.92mm。结论MEAW技术可以有效矫治轻、中度骨性Ⅲ类错。     

骨性Ⅲ类错的早期矫治

骨性Ⅲ类错是临床较常见的错畸形,其早期治疗一直是临床的难题之一。多数学者认为,临床上若早期开始治疗,大多数轻中度骨性Ⅲ类错畸形能得到明显的临床改善或治疗成功。文献报道约25%的患者需正颌手术治疗,因此,大部分骨性Ⅲ类错的早期治疗是必需的。学者对此进行了大量的研究以及临床探索,本文就国内外关于骨性Ⅲ类错的治疗时机、治疗方法以及适应证的选择作一综述。     

多曲方丝弓技术矫治骨性Ⅲ类错前后变化的观察

目的对比多曲方丝弓(MEAW)技术矫治骨性Ⅲ类错畸形前后患者X线片变化,探讨MEAW技术矫治骨性Ⅲ类错畸形的机制。方法选用骨性Ⅲ类错畸形患者15例采用0.56mm×0.64mm的直丝弓托槽系统治疗。测量矫治前、后患者的定位X线头颅侧位片并进行比较。结果由于下后牙的远中直立,L6/MP,L7/MP平均增加了7.2°和7.6°,OP-FH平均减少4.23°,OP-MP平均增加5.64°。结论MEAW技术矫治骨性Ⅲ类错畸形主要通过下后牙的远中竖直,以及平面的改变来完成,而矫治前后骨组织及软组织的变化有限。     

多曲方丝弓技术矫治骨性Ⅲ类错畸形的临床应用

目的　通过MEAW技术矫治骨性前牙反 ,研究颌面部硬组织变化 ,以丰富骨性前牙反非手术矫治的方法。方法　骨性前牙反患者七名 ,其中男三人 ,女四人 ,年龄最大为 18岁 ,最小为 12岁 ,平均年龄为 14.5岁。用多曲方丝弓进行矫正 ,治疗前后均拍摄头颅定位侧位片 ,并进行两组矫治前后的X线头影测量分析比较。结果　研究发现 :上下前牙出现代偿性移动 ,下后牙段得到远中竖直 ,上后牙近中移动。下后牙高度得到较好的控制 ,下前牙升高与上前牙建立正常的覆覆盖关系 ,上前牙在较粗的方丝控制下 ,体现出良好的整体向前移动趋势。ANB角减小 ,但减小幅度很小 ,矫治并未改善骨性前牙反的矢状生长型 ,严重的骨性Ⅲ类错尚需进行外科矫正。颌骨的垂直向生长尚未得到充分控制 ,但平面变平。结论　多曲方丝弓矫治技术通过改善牙齿三维方向的位置 ,可以有效、快速地矫治骨性前牙反。     

拔除智齿矫治成人Ⅲ类骨性错1例

通过拔除第三磨牙,利用第二磨牙远中与上颌结节后缘/下颌升支前缘之间的剩余间隙,最终解除了上牙弓的Ⅱ度拥挤及上下牙弓矢状关系的不调。     

摇椅形弓丝矫治骨性Ⅲ类错的临床探讨

目的研究摇椅形弓丝矫治骨性前牙反后的颌面部硬组织变化。方法骨性Ⅲ类错畸形患者9例,男3例,女6例,年龄12～17岁,平均14.3岁,治疗时间为（2.3±0.4）年,使用摇椅形弓丝技术进行矫治,测量矫治前（T1）和矫治后（T2）的头颅侧位X线片,对数据做配对t检验分析。结果治疗结束后上下前牙均代偿性移动,建立正常覆覆盖关系。治疗后L1-MP减小9.51°（t=7.19,P〈0.01）,U1-SN增加了2.17°,差异无统计学意义（t=-1.47,P〉0.05）,下磨牙远中直立,上磨牙趋向于前倾,OP-MP增大3.5°（t=-5.79,P〈0.01）,平面变平,ANB角平均增大0.62°（t=-5.14,P〈0.01）,但幅度有限,SN-MP变化无统计学意义（t=-0.08,P〉0.05）,提示患者的垂直向得到较好的控制。结论摇椅形弓丝能有效矫治骨性Ⅲ类错,其矫治机理与多曲方丝弓技术相似,但其临床操作简便。     

前方牵引器矫治早期骨性反的临床疗效分析

目的评价上颌前方牵引器矫治早期骨性Ⅲ类错畸形的疗效。方法应用面框和改良颏兜前方牵引器对23例骨性Ⅲ类错的儿童进行早期治疗。结果经过6~12个月的前方牵引以及二期固定矫治器的矫治,使前牙覆覆盖以及侧貌得到显著的改善。结论对轻中度的骨性Ⅲ类错采取早期的前方牵引可促进上颌骨生长,前方牵引是Ⅲ类错早期轿治的有效手段。     

前方牵引矫治骨性Ⅲ类错20例临床体会

目的应用上颌前方牵引矫治器矫治骨性Ⅲ错。方法应用上颌前方牵引矫治器对替牙期16例,恒牙早期4例的骨性Ⅲ类错进行矫治。结果上颌前方牵引矫治器具有促进上颌骨向前发育,抑制下颌骨向前发育的作用。患者矫治前后的侧貌得到明显改善,并且建立了基本正常的前牙覆、覆盖关系。结论上颌前方牵引矫治器对矫治上颌发育不足的骨性Ⅲ类错有明显效果。     

小平板矫治安氏Ⅱ类2分类错的临床体会

目的　缩短安氏Ⅱ类２ 分类错牙合的矫治时间。方法　采用小平牙合板与固定矫治器同时使用。结果　１１ 名患者打开咬牙合时间为１ ～６ 个月,平均２ ．８ 个月少于对照组（１２ ．６ 个月） 。结论　小平牙合板配合固定矫治器矫治安氏Ⅱ类２ 分类错牙合是一种快捷有效的方法。     

多曲方丝弓技术矫治安氏Ⅱ类2分类错(牙合)

目的：通过多曲方丝弓（MEAW）技术矫治安氏Ⅱ类2分类错[牙合]，探讨其矫治原理、方法、临床矫治效果。方法：对14例安氏Ⅱ类2分类恒牙列错[牙合]，均用多曲方丝弓进行矫治。治疗前后均拍摄X线头颅定位侧位片，并对矫治前后的X线头影测量资料进行分析比较。结果：MEAW技术能快速有效的改正前牙内倾型深覆殆，建立前牙的正常覆聒覆盖和磨牙中性关系，明显改善病人面型。SNA角平均增大1．6度、SNB角平均增大3度，ANB角平均减小1．4度。结论：多曲方丝弓矫治技术通过改善牙齿二维方向的位置，可有效地矫治安氏Ⅱ类2分类错[牙合]；     

多曲方丝弓技术矫治前牙开畸形的临床研究

目的研究多曲方丝弓(MEAW)技术矫治前牙开牙合前后颌面部软、硬组织变化,探讨MEAW技术矫治开牙合的机制,并总结影响其疗效的因素。方法分析比较15例成人前牙开牙合患者应用MEAW进行矫治前、后的X线头颅侧位片变化。结果矫治后上下磨牙直立并略压低,上、下颌切牙伸长且上切牙内收,牙合平面平整,前牙覆牙合覆盖正常,上下唇略内收。结论MEAW技术通过使前后牙及牙槽发生变化,有效矫治成人前牙开牙合。     

Initial effect of multiloop edgewise archwire on the mandibular dentition in Class III malocclusion subjects. A three-dimensional finite element study

The purpose of this study was to compare the effect of a multiloop edgewise archwire (MEAW) with a plain ideal archwire (IA) on distal en masse movement of the mandibular dentition. A three-dimensional finite element model (3D FEM) of the mandibular dentition, without third permanent molars, was constructed to include the periodontal membrane (PDM), alveolar bone, standard edgewise bracket (0.018 x 0.025 inch), stainless steel IA (0.016 x 0.022 inch), and MEAW (0.016 x 0.022 inch). Stress distribution and displacement of the mandibular dentition were analyzed when Class III intermaxillary elastics (300 g/side) and 5 degree tip-back bends from the first premolar to the second molar were applied to the IA and the MEAW for distal en masse movement of the mandibular dentition. Compared with the IA, the discrepancy in the amount of tooth displacement was less and individual tooth movement with the MEAW was more uniform and balanced. There was minimal vertical displacement or rotation of the teeth with the MEAW when compared with the IA. The MEAW seems to have advantages for distal en masse movement of the mandibular dentition.     

Aesthetic and functional outcomes using a multiloop edgewise archwire for camouflage orthodontic treatment of a severe Class III open bite malocclusion

Occasionally, orthodontists will be challenged to treat malocclusions and skeletal disharmonies, which by their complexity one might think that the only treatment alternative is the surgical-orthodontic approach. A male patient, aged 17 years old, was diagnosed with a skeletal Class III malocclusion, anterior open bite and negative overjet. An unpleasant profile was the patient’s ‘chief complaint’ showing interest in facial aesthetics improvement. Nevertheless, the patient and his parents strongly preferred a non-surgical treatment approach. He was treated with a multiloop edgewise archwire to facilitate uprighting and distal en-masse movement of lower teeth, correct the Class III open bite malocclusion, change the inclination of the occlusal plane and obtain the consequent morphological-functional adaptation of the mandible. The Class III malocclusion was corrected and satisfactory changes in the patient’s profile were obtained. Active treatment was completed in 2 years, and facial result remained stable at 2 years 6 months after debonding.     

骨性开[牙合]畸形的早期治疗

数据来源：检索Cochrane对照临床实验注册数据库和MEDLINE数据库。     

Cephalometric evaluation of anterior open-bite nonextraction treatment, using multiloop edgewise archwire therapy

There are very few reports of extensive and detailed cephalometric investigations of nonextraction treatment changes for patients with anterior open bite. The purpose of this study was to evaluate changes in dentomaxillofacial morphology by way of lateral and oblique cephalograms of patients who had undergone multiloop edgewise archwire (MEAW) therapy for anterior open-bite correction. The subjects consisted of 21 Japanese female patients who received MEAW therapy without premolar extraction. The mean pre- and posttreatment ages were 16 years 9 months and 19 years, respectively. Lateral and oblique cephalograms were taken before and after treatment. Fifteen angular and 29 linear measurements were obtained from the lateral cephalograms; 17 angular and 20 linear measurements were obtained from the oblique cephalograms. Treatment changes were evaluated by the paired t-test. The upward and forward rotational changes of the mandible consequent to the use of the MEAWs and anterior vertical elastics were larger than the downward and backward rotational changes of the mandible, due to the extrusion of the posterior teeth by leveling and alignment. The uprighting and retrusion of the premolars and molars, and the extrusion, uprighting, and/or retrusion of the incisors and canines played important roles in the anterior open-bite nonextraction treatment by dint of the MEAW technique.     

多曲方丝弓技术矫治前牙开（牙合）的探讨

目的：通过多曲方丝弓技术矫治前牙开He，研究颌面部硬组织变化，探讨其作用机制，总结其操作要领及注意事项。方法：前牙开He患者20名，其中男7名，女13名，年龄范围13～25岁。用多曲方丝弓进行矫治，治疗前后进行X线头影测量的分析比较。结果：20例前牙开始患者均取得了满意的疗效。结论：多曲方丝弓技术通过改善牙齿三维方向的位置，可以有效快速地矫治前牙开He。