功能矫治器矫治安氏Ⅱ类1分类错后舌的形态、位置和舌骨位置变化的初步分析

目的 :探讨用功能矫治器 (FR Ⅰ )矫治安氏Ⅱ类 1分类错 ,矫治前后舌的形态、位置和舌骨位置的变化。方法 :通过X线头影测量 ,分析个体治疗前后的变化。结果 :治疗后舌体形态有改变 ,随着口腔功能间隙增大 ,舌体在口腔内充盈度增大 ,舌位置有前移趋势 ,舌尖位置靠前。舌骨位置在水平向前移 ,垂直向下降。结论 :进一步证实FR Ⅰ矫治器矫治安氏Ⅱ类 1分类错原理之一是引导下颌向前 ,同时使舌体及颈部软组织向前改建 ,改善矢状不调的颌骨关系 ;同时矫治使口腔功能间隙增大 ,舌的形态随之改变 ,达到矫治下颌发育不足的Ⅱ类错畸形的目的。     

Forsus促进骨性安氏Ⅱ类下颌生长的研究

目的：观察Forsus推杆式矫治器治疗青少年骨性安氏Ⅱ类1分类错的临床效果。方法：15例恒牙列初期骨性下颌后缩患者,应用标准直丝弓固定矫治加用Forsus推杆式矫治器,并于正畸治疗前、后拍摄X线头颅侧位定位片,取研究模型进行测量和统计学分析。结果：Forsus平均使用6.5个月,前牙覆覆盖明显减小,Ⅱ类磨牙关系矫治为Ⅰ类。矢状向变化为下颌骨生长及下前牙唇倾。垂直向变化为下面高增加,下磨牙伸长,上下平面角增加。横向上下颌牙弓宽度增加。结论：Forsus结合标准直丝弓治疗恒牙列初期骨性下颌后缩,可以促进下颌骨生长,部分改善及掩饰患者骨性不调。     

下颌后缩畸形的联合功能矫治及固定矫治

目的探讨第Ⅰ期采用双阻板矫治器(twin block appliance,TBA)联合肌激动器矫治生长发育期下颌后缩畸形,第Ⅱ期进行固定矫治的临床效果。方法1例下颌后缩的骨性Ⅱ类错患者,第Ⅰ期第1阶段采用TBA矫治,使上下颌骨呈骨性Ⅰ类关系;第2阶段采用肌激动器使后牙建。第Ⅱ期采用直丝弓矫治技术排齐牙齿、整平曲线、以及调整磨牙至中性关系并维持之。结果第Ⅰ期第1阶段,TBA矫治后下颌后缩得到纠正,上下颌骨呈骨性Ⅰ类关系,前牙覆盖变小,面型明显改善;第2阶段肌激动器可使后牙建良好,并能维持第1阶段达到的牙、颌关系;第Ⅱ期直丝弓矫治结束时牙齿排列整齐、曲线平整、磨牙呈中性关系。结论矫治下颌后缩畸形,TBA联合肌激动器较使用单一功能矫治器有明显的优势;必要时,应作Ⅱ期固定矫正。     

Twin-block矫治器治疗年轻成人安氏Ⅱ1错邪(牙合)的临床研究

目的 探讨Twin-block矫治器(TB)矫治年轻成人下颌后缩型安氏Ⅱ1类错(牙合)的矫治效果.方法 选取11例下颌后缩型安氏Ⅱ1错(牙合)的年轻成人,采用Twin-block矫治器(TB)以及固定矫治器双期矫治.对治疗前后测量结果进行统计学分析.结果 经TB治疗后,所有患者Ⅱ1错(牙合)得到有效矫治:磨牙中性,覆、覆盖正常,侧貌面型明显改善.结论 Twin-block矫治器可以有效矫治年轻成人下颌后缩型安氏Ⅱ1错(牙合),能使边缘性病例避免正颌手术.     

方丝弓联合上颌斜面导板矫治下颌后缩型安氏Ⅱ^1类错He

目的：观察恒牙列早期下颌后缩型安氏Ⅱ^1类错He的治疗效果。方法：选取16例处于恒牙到早期的下颌后缩型安氏Ⅱ^1类错He患者,用方丝弓矫治器联合颌斜面导板对其矢状向、垂直向及横向不调进行治疗,治疗前后拍摄头颅贮位侧位片进行测量并做统计学分析。结果：治疗后磨牙关系中性、前牙覆He覆盖正常,下颌后缩面型得到改善,头影测量的相关项目治疗前后有显著性差异。结论：下颌后缩型安氏Ⅱ^1类错He在恒牙列早期治疗可以取得疗效。     

正畸治疗中磨牙的拔除和保留(二十五)——减数下颌第二磨牙矫治骨性Ⅲ类错对垂直向关系的影响

目的:观察恒牙期骨性Ⅲ类错病例在拔除下颌第二磨牙矫治后患者牙、、面垂直关系的变化。方法:恒牙期骨性Ⅲ类错畸形病例16例,男4例、女12例。年龄13.4～17.2岁,平均15.0±1.6岁。所有病例在拔除下颌第二磨牙后采用直丝弓矫治器进行掩饰治疗。对治疗前后X线头颅侧位片上反映垂直向关系的角度、线距及比例进行测量分析。结果:与矫治前相比,矫治后UM-PP增加1.83mm、LM-Gn增加5.38mm(P<0.05),UM-S及LM-MP无显著改变。SN-OP减小4.57°,SN-PP增加1.45°,差异具有统计学意义(P<0.05),SN-MP无显著改变。ANS-Me和Na-Me分别增加了2.22mm和2.77mm(P<0.05),但Na-ANS、S-Gn、ANS-Me/Na-Me及S-Go/Na-Me均无显著改变。结论:恒牙期骨性Ⅲ类错病例在拔除下颌第二磨牙矫治后下颌平面角无显著改变。但上颌第一磨牙伸长,平面出现逆时针旋转,同时腭平面发生了顺时针旋转。下颌第一磨牙远中移动显著,而上颌第一磨牙近远中位置保持不变,从而使磨牙关系得到基本改善。上颌磨牙的伸长导致前下面高及总面高有所增加,提示在矫治的过程中应采取措施保持上磨牙高度的稳定,从而避免前面高的增加。     

改良Lokar磨牙远移器的临床运用

安氏类错是临床最常见的错畸形之一,其中牙源性的类错占有一定的比例。对这类错畸形的矫治,常需将上颌磨牙推向远中,以达到安氏类磨牙关系〔1,2,3〕。我科自1998年以来,选用Lokar磨牙远移器,对其进行了改良,共矫治8例需推磨牙向后的安氏类患者,收到良好疗效,现将该矫治器的制作和临床应用体会介绍如下:矫治器的组成矫治器有支抗和作用力两部分组成(图1)。图1　Lokar矫治器示意图支抗部分:为抵抗推磨牙向后所产生的反作用力,应用Nance托作支抗装置。常规在5　5　或　　上制作带环,在带环颊侧焊接托槽或牵引钩,腭侧焊接连接丝,埋于N…     

方丝弓联合上颌斜面导板矫治下颌后缩型安氏Ⅱ~1类错

目的　观察恒牙列早期下颌后缩型安氏Ⅱ1类错牙合的治疗效果。方法　选取 16例处于恒牙列早期的下颌后缩型安氏Ⅱ1错牙合患者 ,用方丝弓矫治器联合颌斜面导板对其矢状向、垂直向及横向不调进行治疗 ,治疗前后拍摄头颅定位侧位片进行测量并做统计学分析。结果　治疗后磨牙关系中性 ,前牙覆牙合覆盖正常 ,下颌后缩面型得到改善 ,头影测量的相关项目治疗前后有显著性差异。结论　下颌后缩型安氏Ⅱ1类错牙合在恒牙列早期治疗可以取得疗效。     

MBT直丝弓矫治器与SUS^2下颌前伸矫治器治疗安氏Ⅱ类下颌后缩错[牙合]12例报告

目的：采用MBT直丝弓矫治器与SUS^2下颌前伸矫治器治疗安氏Ⅱ类下颌后缩错[牙合]畸形,观察其临床疗效。方法：对12例安氏Ⅱ类下颌后缩错胎病例应用MBT直丝弓矫治器常规排齐整平上下牙列,再装配SUS^2下颌前伸矫治器进行矫治,对治疗前后面[牙合]像及头颅侧位定位片进行分析。结果：SNB增加2．2°,ANB减少2．5°,SNA无明显变化,前牙覆盖减小4．4ram,MP-FH增加1．2°,NP-FH增加1．6°。结论：用MBT直丝弓矫治器与SUS^2下颌前伸矫治器治疗安氏Ⅱ类下颌后缩错[牙合]畸形可以有效地利用下颌骨向前生长的潜力,刺激下颌骨的生长,抑制上颌骨的生长,同时可以使上颌磨牙远中移动,下颌磨牙近中移动,改善骨性及牙性矢状关系不调,从而达到矫治Ⅱ类错[牙合]的目的,取得明显的骨骼和侧貌改变。     

安氏Ⅱ类1分类错功能矫治的X线头影测量分析

安氏Ⅱ类 1分类是较常见的错类型 ,临床主张双期矫治 ,即生长活跃期矫治上下颌骨之间的矢状不调 ,待恒牙完全建后矫正错位牙齿。作者对收治的 13例替牙期或恒牙列初期的安氏Ⅱ类 1分类患者 ,用改良Ａｎｄｒｅｓｅｎ矫治器进行矫治 ,并对矫治前后软硬组织的变化进行Ｘ线头影测量分析 ,探讨其对牙颌面软硬组织的影响。1　材料和方法13例安氏Ⅱ类 1分类错患者 ,男性 9例 ,女性 4例 ,年龄 8～ 12岁 ,平均 10 9岁 ,混合牙列期或恒牙初期 ,均为面下 1/ 3短、下颌后缩 ,有Ⅱ°以上深覆和深覆盖 ,磨牙关系远中或安氏Ⅱ类 1分类的亚类。牙…     

Herbst矫治器治疗年轻成人安氏Ⅱ类2分类错的研究

目的评价Herbst矫治器治疗年轻成人安氏Ⅱ类2分类错的疗效。方法对12名安氏Ⅱ类2分类错的年轻成人患者,采用铸造夹板式Herbst矫治器及固定矫治器矫治,通过X线头影测量比较矫治前后有关指标的变化并进行统计分析。结果矫治后SNA、Co-Go、Go-Po变化无统计学意义,SNB增加,ANB减小,上下前牙唇倾,上磨牙后移,下磨牙升高并前移,下颌平面、平面顺时针旋转。患者矫治后前牙达到浅覆、浅覆盖关系,磨牙达到中性关系。结论年轻成人安氏Ⅱ类2分类错可通过铸造夹板式Herbst矫治器结合固定矫治器获得满意的效果。     

Twin-block矫治Ⅱ类错He 12例分析

目的：定量评价双He垫矫治器(Twin-block)对生长期安氏Ⅱ类Ⅰ分类错He患者的颌骨及牙槽骨的影响。方法：12例10～12岁安氏Ⅱ类错He患者，用Twin-block进行矫治，治疗结果与11例未经治疗的10～12岁安氏Ⅱ类错He患者比较。观察时间为12个月。采用团体t检验进行组间比较。结果：Twin-block治疗组，覆盖和磨牙关系均得到改善，覆盖的减小主要是由于上切牙的远中移动，及下颌骨的向前生长；磨牙关系的矫正，下颌骨的生长与牙槽骨的变化各占50％作用。下颌骨长度(Ar-Gn)比对照组增加2．29mm，后面高(Ar-Go)与前下面高(ANS-Me)均有增加，分别为2．28mm与2．58mm，未观察到不利的垂直向生长。结论：Twin-block能有效减小前牙覆盖，矫正磨牙关系，改善软组织侧貌。并增强Ⅱ类错He患者下颌骨的生长。     

Begg及Edgewise矫治器减数治疗安氏Ⅱ类1分类错的硬组织变化及其稳定性

目的对Begg及Edgewise矫治器减数治疗安氏Ⅱ类1分类错的硬组织变化及其稳定性进行分析和比较。方法对30例拔除4个第一前磨牙的安氏Ⅱ类1分类错患者（其中19例Begg矫治器治疗、11例Edgewise矫治器治疗）治疗前后及追踪时的头影测量片进行扫描测量分析，用配对t检验和非配对t检验对数据进行统计分析。结果治疗结束时，Begg矫治组和Edgewise矫治组的上颌前牙均发生明显的舌向移动和伸长，Edgewise矫治组的上颌磨牙无明显近中移动，但其下颌磨牙及Begg矫治组的上下磨牙均发生明显的近中移动及伸长。治疗后追踪观察时，Begg矫治组和Edgewise矫治组的上颌前牙均发生唇向移位和伸长，上颌磨牙均发生近中移位和伸长，而下颌磨牙除Edgewise矫治组伸长外，其余均无明显变化。Begg矫治组和Edgewise矫治组在治疗结束时及追踪时的硬组织变化均无统计学差异（P>0.05）。结论Begg矫治器和Edgewise矫治器矫治安氏Ⅱ类1分类错拔牙患者的硬组织变化及其稳定性无统计学差异。     

A preliminary report of a new design of cast metal fixed twin-block appliance

The present paper describes a cast metal fixed twin-block appliance utilized to correct a Class II malocclusion, which is designed for full-time wear. The object of the present paper is to achieve rapid functional correction of Class II malocclusions by transmitting favourable occlusal forces to inclined planes which are cemented to the posterior teeth. In the meantime, pre-adjusted fixed edgewise appliances can be placed on the anterior teeth to correct their malpositions. This new functional appliance design may shorten the total treatment duration and reduce the need for patient compliance.     

种植体支抗辅助舌侧矫治双牙弓前突畸形的临床研究

目的 通过头影测量比较种植体支抗辅助舌侧隐形矫治双牙弓前突患者治疗前后牙颌面结构的变化.方法 随机选取20例双牙弓前突畸形患者,均使用舌侧矫治器配合微螺钉种植体支抗矫治,观察微螺钉种植体的稳定性,并对患者治疗前后的头颅侧位片进行头影测量,评价治疗效果.结果 微螺钉种植体的成功率为97.5％.上颌第一磨牙平均近中移动0.23 mm±0.76 mm（P＞0.05）,上中切牙切端平均远中移动5.31 mm±2.02 mm（P＜0.001）,治疗后U1-SN角度为99.4度.结论 舌侧隐形正畸联合微螺钉种植体支抗治疗双牙弓前突患者,能够有效控制磨牙支抗,在内收上颌前牙的同时能有效控制转矩,达到了良好的治疗效果.     

滑动直丝MBT矫治器与Roth矫治器对咬合关系及后牙支抗影响的比较研究

目的 比较研究两种直丝弓矫治器及矫治技术对咬合关系及后牙支抗的影响。方法 选择安氏Ⅰ类错(牙合)40人,平均13.8岁。牙列轻度及中度拥挤,需拔除4个第一双尖牙,中度支抗设计。患者均分两组,分别使用Roth矫治器、治疗程序和MBT矫治器、治疗程序进行治疗。X线头影测量分析及模型测量。结果 滑动直丝组上磨牙较Roth直丝组多前移1.0mm,但差异无显著性。滑动直丝组下磨牙伸长量大于Roth直丝组,此差异呈显著性。滑动直丝技术及MBT托槽在关闭拔牙间隙时,对下后牙舌倾度有较好的控制能力,两组差异呈高度显著性(P<0.01)。结论 中度支抗病例,滑动直丝技术上磨牙支抗丢失程度与传统直丝技术相差不大。滑动直丝MBT矫正器的后牙转矩适用于东方人的治疗,Roth矫正器的上下前牙转矩增大2-3°后,更适合东方人的拔牙矫治。     

A preliminary report of a new design of cast metal fixed twin-block appliance

Abstract

The present paper describes a cast metal fixed twin-block appliance utilized to correct a Class II malocclusion, which is designed for full-time wear. The object of the present paper is to achieve rapid functional correction of Class II malocclusions by transmitting favourable occlusal forces to inclined planes which are cemented to the posterior teeth. In the meantime, pre-adjusted fixed edgewise appliances can be placed on the anterior teeth to correct their malpositions. This new functional appliance design may shorten the total treatment duration and reduce the need for patient compliance.     

Hyperefficient orthodontic treatment using tandem mechanics

This article presents an advanced and efficient noncompliance method of therapy referred to as tandem treatment. Tandem treatment was devised to harness the predictable orthodontic and orthopedic responses elicited by two proven fixed Class II correction devices, the pendulum and Herbst appliances. Tandem treatment involves two separate actions to resolve certain types of Class II malocclusions. First, the upper arch is expanded and the upper molars moved distally into a Class I relation. The pendulum appliance uses palatal and tooth-borne anchorage to move the upper molars distally. The pendulum is followed by a simplified version of the fixed Herbst appliance, which serves as anchorage to retract the remainder of the maxillary teeth to previously Class I positioned molars. This tandem of “pendex” appliance and fixed anchorage Herbst appliance has the ability to greatly improve treatment efficiency when used in appropriately selected patients. A case report is used to illustrate the treatment protocol.     

Three-dimensional diagnosis andorthodontic treatment of complex malocclusions with the invisalign appliance

Recent developments in software technology have made it possible to create a virtual three-dimensional (3D) model of the dental arches from digitally scanned impressions of a patient's dentition. This model may then be manipulated with software to produce stages of tooth movement from the initial malocclusion to the final desired occlusion. A stereolithographic model is made for each stage of tooth movement which is the basis for construction of a series of clear, thin, overlay appliances. These appliances are worn full time by the patient to move the teeth according to the programmed stages of movement. Malocclusions involving mild to moderate crowding and space closure have been proven to be successfully treated with this appliance. The present study shows orthodontic treatment of patients with more complex orthodontic problems, requiring dental expansion, Class II and Class III correction, extraction treatment and correction of overbite. Experience with this appliance, thus far, has demonstrated excellent patient compliance with less discomfort, and improved esthetics and oral hygiene, when compared with fixed orthodontic appliances. Orthodontic treatment with this appliance is a potentially useful alternative approach to fixed appliances for treatment of a variety of malocclusions in patients with fully erupted permanent teeth.     

Soft tissue profile after distal molar movement with a pendulum K-loop appliance versus cervical headgear

OBJECTIVE: To evaluate the soft tissue changes associated with the pendulum appliance that was supported with a K-loop buccally and to compare these treatment changes with a cervical headgear group. MATERIALS AND METHODS: The records of 30 patients having skeletal Class I, dental Class II malocclusions were divided to two groups. Group 1 consisted of 7 girls, 8 boys (mean age, 15.0 +/- 3.4 years), and Group 2 consisted of 10 girls, 5 boys (mean age 14.2 +/- 2.9 years). The first group was treated with a pendulum appliance that was supported with a K-loop buccally, and the second group was treated with cervical headgear. Lateral cephalograms were taken at the beginning of treatment and at the end of distal molar movement. Treatment changes within the groups were analyzed using the paired t-test, and between group changes were analyzed with the independent t-test. RESULTS: The results showed that the pendulum/K-loop appliance had no significant effect on skeletal and dental variables and soft tissue A point, upper lip thickness, and sagittal upper lip position relative to the E plane. A significant difference for the change in Vp-Ls distance was found in patients in the pendulum/K-loop group (P < .05). Patients in the cervical headgear group showed significant retrusion in skeletal, dental, and soft tissue measurements (P < .05). CONCLUSIONS: The pendulum/K-loop appliance produces distal molar movement without causing any significant changes in the sagittal or vertical positions of either the jaw or the soft tissue profile.