高位口外牵引在青少年骨性Ⅱ类错(牙合)治疗中的作用

目的：探讨高位口外牵引在青少年骨性Ⅱ类错[牙合]早期矫治中的作用，并评价其临床疗效。方法：选取11例生长发育期骨性安氏Ⅱ类错[牙合]病例，采用高位口外牵引治疗，与7例未经治疗的生长发育期骨性Ⅱ类错[牙合]进行对照。摄取X线头影侧位定位片，用Pancherz分析法评判治疗过程发生的骨性和牙性变化，以SPSS11．0软件进行独立样本t检验。结果：高位口外牵引可以限制上颌发育，SNA、A—Olp2项指标在治疗组与对照组间具有统计学差异（P〈0．01）。上颌磨牙远中移动具有显著差异（P〈0．01）。结论：高位口外牵引能够限制上颌发育，有利于下颌发育，达到矫治目的；同时，垂直方向和矢状方向的牙及牙槽反应，有利于患者牙颌面形态的进一步改善．     

前牙迷你垫与口外牵引装置治疗Ⅱ类Ⅰ分类错的疗效观察

目的　通过采用前牙迷你牙合垫加口外牵引装置探讨其在生长发育期间治疗安氏Ⅱ类Ⅰ分类错牙合患者疗效。方法　对 1 8例处于生长发育期的Ⅱ类Ⅰ分患者 ,用前牙迷你牙合垫加口外牵引装器治疗。结果　应用前牙迷你牙合垫加口外牵引装置在生长发育期能成功治疗安氏Ⅱ类Ⅰ分类错牙合 ,获得良好的侧貌 ,为固定矫治打好基础。结论　前牙迷你牙合垫加口外牵引装置对下颌生长起积极作用 ,对上颌生长可能有抑制作用     

前牙迷你[牙合]垫与口外牵引装置治疗Ⅱ类Ⅰ分类错[牙合]的疗效观察

目的 通过采用前牙迷你牙合垫加口外牵引装置探讨其在生长发育期间治疗安氏Ⅱ类Ⅰ分类错牙合患者疗效.方法 对18例处于生长发育期的Ⅱ类Ⅰ分患者,用前牙迷你牙合垫加口外牵引装器治疗.结果 应用前牙迷你牙合垫加口外牵引装置在生长发育期能成功治疗安氏Ⅱ类Ⅰ分类错牙合,获得良好的侧貌,为固定矫治打好基础.结论 前牙迷你牙合垫加口外牵引装置对下颌生长起积极作用,对上颌生长可能有抑制作用.     

方丝弓配合高位J钩牵引治疗安氏II类I分类错

目的　探讨高位J钩牵引在方丝弓矫治技术治疗安氏II类I分类错牙合中的作用。方法　临床评价 7例安氏II类I分类错牙合患者应用高位J钩牵引的疗效 ,并作X线头影测量分析。结果　高位J钩牵引能有效地牵引尖牙 ,内收前牙和保护支抗 ,抑制上颌前下方生长和控制下颌旋转。结论　J钩牵引能有效地配合治疗安氏II类I分类错牙合 ,其力系尤其对改善异常生长型有利     

前方牵引矫治不同年龄组骨性Ⅲ类错《牙合》临床研究

目的:研究上颌前方牵引矫治不同年龄段安氏骨性Ⅲ类错<牙合>的临床效果.方法:19例骨性Ⅲ类错<牙合>病例分为4.5～8.5岁,9～13岁两个年龄组,均行前方牵引治疗,对两组病例矫治前后X线头颅定位侧位片进行测量分析.结果:矫治结束后上颌骨前移、上颌长度增加,ANB角增大,下颌骨向后下旋转.上前牙唇倾,下前牙轻度舌倾,上唇位置前移,下唇位置无明显改变,软组织侧貌改善.两组病例对比小年龄组颌骨变化大,大年龄组牙齿的改变大.结论:上颌前方牵引矫治因上颌发育不足而导致的安氏骨性Ⅲ类错<牙合>能很好地促进上颌骨生长和前移,又可控制下颌骨的生长,并有效影响下颌骨的生长方向.     

上颌前方牵引矫治器在骨性Ⅲ类错矫治中的作用

目的　探讨上颌前方牵引矫治器在骨性Ⅲ类错牙合矫治中的作用机理。方法　应用上颌前方牵引矫治12例安氏Ⅲ类骨性错牙合的患者 ,比较矫治前后的临床表现及X线头影测量的结果。结果　患者矫治前后的侧貌得到改善 ,并建立了正常前牙覆牙合、覆盖关系和后牙中性关系。治疗前后的SNA角、ANB角、1-SN角、MP -SN角有显著性的差异。结论　上颌前方牵引矫治器有促进上颌骨向前发育、抑制下颌骨向前发育的效果 ,从而调整上下颌骨的相对位置关系 ,使骨性Ⅲ类错牙合得到矫治     

上颌前方牵引矫治器在骨性Ⅲ类错(牙合)矫治中的作用

目的探讨上颌前方牵引矫治器在骨性Ⅲ类错牙合矫治中的作用机理.方法应用上颌前方牵引矫治12例安氏Ⅲ类骨性错牙合的患者,比较矫治前后的临床表现及X线头影测量的结果.结果患者矫治前后的侧貌得到改善,并建立了正常前牙覆牙合、覆盖关系和后牙中性关系.治疗前后的SNA角、 ANB角、 1-SN角、 MP-SN角有显著性的差异.结论上颌前方牵引矫治器有促进上颌骨向前发育、抑制下颌骨向前发育的效果,从而调整上下颌骨的相对位置关系,使骨性Ⅲ类错牙合得到矫治.     

颈牵引装置矫治替牙期安氏Ⅱ类1分类错(牙合)矫治时机的临床探讨

目的:比较替牙早期及替牙晚期骨性安氏Ⅱ类1分类错(牙合)行口外颈牵引治疗的疗效,探讨合适的矫治时机.方法:样本包括11例替牙早期患者及15例替牙晚期患者,均为骨性安氏Ⅱ类1分类错(牙合),ANB≥5°,分别予以口外颈牵引治疗.治疗前后摄取X线头颅侧位定位片,进行头影测量及统计学分析.2组治疗前后比较采用配对t检验,2组之间采用团体t检验.结果:2组上颌骨生长均受到了抑制,SNA角、上颌骨长度(A-Ptm)及ANB角均有减小.U1-SN角减小,上前牙前突得到改善.2组比较,替牙晚期组变化更明显,2组之间有显著性差异(P＜0.01).而上颌第1恒磨牙远移距离在2组间则无显著性差异(P＜0.01).结论:在替牙晚期对骨性安氏Ⅱ类1分类错(牙合)患者行口外颈牵引治疗较为合适,有利于恒牙期的二期矫正治疗.     

颈牵引装置矫治替牙期安氏Ⅱ类1分类错矫治时机的临床探讨

目的:比较替牙早期及替牙晚期骨性安氏Ⅱ类1分类错行口外颈牵引治疗的疗效,探讨合适的矫治时机。方法:样本包括11例替牙早期患者及15例替牙晚期患者,均为骨性安氏Ⅱ类1分类错牙合,ANB≥5°,分别予以口外颈牵引治疗。治疗前后摄取X线头颅侧位定位片,进行头影测量及统计学分析。2组治疗前后比较采用配对t检验,2组之间采用团体t检验。结果:2组上颌骨生长均受到了抑制,SNA角、上颌骨长度(A-Ptm)及ANB角均有减小。U1-SN角减小,上前牙前突得到改善。2组比较,替牙晚期组变化更明显,2组之间有显著性差异(P<0.01)。而上颌第1恒磨牙远移距离在2组间则无显著性差异(P<0.01)。结论:在替牙晚期对骨性安氏Ⅱ类1分类错患者行口外颈牵引治疗较为合适,有利于恒牙期的二期矫正治疗。     

应用Coben分析法评价前方牵引治疗上颌发育不足的临床疗效

目的 应用Coben分析法评价前方牵引治疗上颌发育不足的临床疗效,阐明Coben分析法在骨性安氏Ⅲ类错牙合畸形致病机制的诊断及矫治计划制定中的优势。方法 对120例处在生长发育期的由上颌发育不足所致的骨性安氏Ⅲ类错患者行上颌前方牵引治疗,分别对上颌前方牵引矫治前、后的头颅定位侧位片采用Coben分析法和北医大分析法进行头影测量分析。结果 上颌前方牵引后,Coben分析法测量结果中,面中1/3深度增加且Ptm-A段的变化有统计学差异,面下1/3深度减小,颜面高度增加（P<0.001）;北医大分析法测量结果中,SNA、ANB、U1/NA、U1/SN、MP/SN、Y轴角显著增加（P<0.001）,SNB、U1/L1显著减小（P<0.001）,L1/MP减小（P<0.05）。结论 上颌前方牵引疗法对以Coben分析法中Ptm-A段过小为主要机制的生长发育期骨性安氏Ⅲ类错畸形有显著疗效;Coben分析法是一种比较直观、容易理解的头影测量分析方法,在错畸形尤其是骨性安氏Ⅲ类错的诊断中具有临床意义。     

颈牵引装置矫治替牙期安氏Ⅱ类1分类错he矫治时机的临床探讨

目的比较替牙早期及替牙晚期骨性安氏Ⅱ类1分类错(牙合)行口外颈牵引治疗的疗效,探讨合适的矫治时机.方法样本包括11例替牙早期患者及15例替牙晚期患者,均为骨性安氏Ⅱ类1分类错(牙合),ANB≥5°,分别予以口外颈牵引治疗.治疗前后摄取X线头颅侧位定位片,进行头影测量及统计学分析.2组治疗前后比较采用配对t检验,2组之间采用团体t检验.结果2组上颌骨生长均受到了抑制,SNA角、上颌骨长度(A-Ptm)及ANB角均有减小.U1-SN角减小,上前牙前突得到改善.2组比较,替牙晚期组变化更明显,2组之间有显著性差异(P＜0.01).而上颌第1恒磨牙远移距离在2组间则无显著性差异(P＜0.01).结论在替牙晚期对骨性安氏Ⅱ类1分类错(牙合)患者行口外颈牵引治疗较为合适,有利于恒牙期的二期矫正治疗.     

Treatment of Class II, division 1, cases with a maxillary traction splint

Class II, division 1 cases are treated by many different techniques depending on the age of the patient and cause of the malocclusion. To overcome the undesirable effects of headgear on anchor teeth, a removable appliance, the maxillary traction splint, is used with extraoral forces. In this study, 15 patients with maxillary dentoalveolar protrusions and Class II, division 1, malocclusions were treated with a maxillary traction splint. Cephalograms taken before and after treatment and the sagittal skeletal and dental changes were evaluated and quantified. The results showed that use of the maxillary traction splint prior to fixed appliance therapy is effective in correcting dentoalveolar protrusion in growing patients.     

口外颈牵引装置早期矫治安氏Ⅱ类1分类错的疗效研究

目的 评价口外颈牵引装置对生长发育期的安氏Ⅱ类1分类错(牙合)患者的疗效。方法 采用侧位X线头影测量,对15例患者进行观察分析。结果 上颌骨向前生长受到抑制,下颌骨生长得到充分表达,上下颌骨矢状不调得以改善。上颌第一恒磨牙伸长并向远中移动,上颌切牙唇倾角度减小,第一恒磨牙关系恢复至中性(牙合),覆(牙合)、覆盖有不同程度的减小。同时发现,腭平面角、(牙合)平面角、下颌平面角均无显著性变化。结论 口外颈牵引装置对生长发育期安氏Ⅱ类1分类错(牙合)有明显的矫形效果。     

Orthopedic coordination of dentofacial development in skeletal Class II malocclusion in conjunction with edgewise therapy. Part I

The skeletal Class II malocclusion may be considered to develop as a failure of the coordinating process to maintain harmonious relationships within the developing dentofacial apparatus. If the skeletal elements are too far apart for adaptation to occur and/or if there are functional abnormalities of the orofacial musculature which inhibit coordination from taking place, a malocclusion will result. An orthopedic technique and appliance system has been developed with the intention of improving those factors responsible for the development and perpetuation of the skeletal Class II malocclusion in a primary stage of treatment. This is accomplished by means of restraint and redirection of forward maxillary growth and an increase in the velocity of mandibular growth. Concurrently, adverse soft-tissue influences are eliminated or ameliorated. Edgewise appliance therapy is subsequently carried out for the final correction. The subject is considered in two articles. This first article describes the effects of the restraint of maxillary growth on craniofacial development and the dental changes produced by a maxillary removable splint with extraoral traction and shows how they can be used clinically for correction of the skeletal Class II malocclusion. The experimental and clinical evidence supporting this approach is considered, and case histories show the clinical use of the maxillary splint. This form of maxillary therapy for the skeletal Class II malocclusion has limitations, and it is desirable for it to be incorporated into a comprehensive orthopedic system.     

Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis

OBJECTIVE: To evaluate the anteroposterior short-term skeletal and dental effects on Class II malocclusion in growing patients following treatment with functional appliances (activators or twin block), extraoral traction, or combination appliances (appliances with both functional and extraoral traction components), based on published data. MATERIALS AND METHODS: A literature search was carried out identifying a total of nine prospective clinical trials. The data provided in the publications underwent meta-analysis using the random effects model with regard to SNA, SNB, ANB, and overjet. RESULTS: All appliance groups showed an improvement in sagittal intermaxillary relationships (decrease in ANB) when compared to untreated subjects. Activators and twin block appliances accomplish this mainly by acting on the mandible (increases in SNB) while twin block appliances also seem to act on the maxilla (decrease in SNA). Extraoral traction appliances achieve this by acting on the maxilla (decreases in SNA). Combination appliances mainly act on the mandible (increase in SNB). Activators, twin block, and combination appliances also reveal a decrease in overjet, which is not the case in the singular use of extraoral traction. CONCLUSIONS: Intermaxillary changes being present in all appliance groups, anteroposterior treatment response following the use of functional appliances and/or extraoral traction in growing class II malocclusion patients is most evident in one of the two jaws (mandible for activators and combination appliances and maxilla for extraoral traction) except for the twin block group, which shows changes on both jaws.     

Treatment effects of mandibular anterior position training versus a fixed Class II corrector in growing patients with skeletal Class II malocclusion

Purpose

To compare treatment effects of Class II elastics and anterior mandibular position training against fixed Class II corrector (PowerScope?) during the correction of skeletal Class II malocclusion with fixed appliance in growing patients.

Treatment efficiency in skeletal Class II patients treated with the jasper jumper

OBJECTIVE: To analyze the effects of the Jasper Jumper appliance during the treatment of skeletal Class II malocclusion. MATERIALS AND METHODS: Lateral cephalograms and hand-wrist radiographs were collected from 45 Class II growing patients (22 boys, 23 girls). Three sets of records (initial, before Jasper Jumper, after Jasper Jumper) from 25 patients were compared with 20 control subjects of similar skeletal developmental stage. Mean age of the treatment and control groups were 11.83 years and 11.3 years, respectively. The data were analyzed by using paired t-tests. RESULTS: The results demonstrated that the Jasper Jumper effectively corrected Class II malocclusion, but the changes were 80% dentoalveolar. The Jasper Jumper induced a clockwise rotation of the occlusal plane without much alteration in vertical dimension. Skeletally, the maxillary growth was restricted and pogonion moved forward, improving the profile. CONCLUSION: The Jasper Jumper appliance may be an effective method to improve both the skeletal imbalance and the profile in growing patients.     

口外弓推磨牙向后治疗安氏Ⅱ类1分类错(牙合)的分析研究

目的 :探讨口外弓推磨牙向后治疗安氏 II类 1分类错牙合的机制。方法 :对 12例安氏 II类 I分类错牙合的少年进行口外弓推磨牙向后治疗 ,第二期用方丝弓矫治器治疗 ;对两期相关的软硬组织进行 X线头影测量。结果 :口外弓推磨牙向后的治疗使颌骨、牙齿、软组织有不同程度的改变 ,主要通过抑制上颌骨 ,使下颌正常生长而使 ANB明显减小 ;口外力也使上中切牙倾斜度明显减小。方丝弓矫治器使治疗更完善。结论 :口外弓推磨牙向后配合方丝弓矫治器是不拔牙治疗安氏 II类 1分类错牙合简便有效的方法之一。