用新型组合式矫治装置早期矫治安氏Ⅱ~1错

目的:用新型组合式矫治装置治疗替牙期及恒牙初期安氏Ⅱ1错牙合。方法:采用由口外弓、下颌唇挡及上颌斜面导板组成的矫治装置,治疗替牙期及恒牙初期安氏Ⅱ1错牙合66例(男3 0例,女3 6例) ,治疗前后进行X线头影测量分析。结果:66例患者的覆牙合、覆盖及颌关系调整时间为3～13个月,平均7.6个月。治疗后覆牙合平均减小2 .5mm ,覆盖减小4.3mm ,SNB角增加1.8°,ANB角减小1.9°,U 1 NA角减小8.8°,L1 NB角增加6.4°,IMPA角增加5 .7°,Z角增加4.5°,Wits值减小1.6,ANS Me增加4.0mm。结论:该组合式矫治装置对替牙期及恒牙初期安氏Ⅱ1错牙合具有良好的矫治效果。     

用新型组合式矫治装置早期矫治安氏Ⅱ1错

目的用新型组合式矫治装置治疗替牙期及恒牙初期安氏Ⅱ1错牙合.方法采用由口外弓、下颌唇挡及上颌斜面导板组成的矫治装置,治疗替牙期及恒牙初期安氏Ⅱ1错牙合66例(男30例, 女36例),治疗前后进行X线头影测量分析.结果66例患者的覆牙合、覆盖及颌关系调整时间为3～13个月,平均7.6个月.治疗后覆牙合平均减小2.5 mm,覆盖减小4.3 mm,SNB角增加1.8°,ANB角减小1.9°,U1-NA角减小8.8°,L1-NB角增加6.4°,IMPA角增加5.7°,Z角增加4.5°,Wits值减小1.6,ANS-Me增加4.0 mm.结论该组合式矫治装置对替牙期及恒牙初期安氏Ⅱ1错牙合具有良好的矫治效果.     

用新型组合式矫治装置早期矫治安氏Ⅱ1错(牙合)

目的:用新型组合式矫治装置治疗替牙期及恒牙初期安氏Ⅱ1错牙合.方法:采用由口外弓、下颌唇挡及上颌斜面导板组成的矫治装置,治疗替牙期及恒牙初期安氏Ⅱ1错牙合66例(男30例, 女36例),治疗前后进行X线头影测量分析.结果:66例患者的覆牙合、覆盖及颌关系调整时间为3～13个月,平均7.6个月.治疗后覆牙合平均减小2.5 mm,覆盖减小4.3 mm,SNB角增加1.8°,ANB角减小1.9°,U1-NA角减小8.8°,L1-NB角增加6.4°,IMPA角增加5.7°,Z角增加4.5°,Wits值减小1.6,ANS-Me增加4.0 mm.结论:该组合式矫治装置对替牙期及恒牙初期安氏Ⅱ1错牙合具有良好的矫治效果.     

下颌前牙切代帽联冠式斜导矫治替牙期牙性反[牙合]的初步探讨

目的：观察应用下颌前牙联冠式斜面导板矫治替牙期牙性反[牙合]的临床疗效。方法：对28例因替牙障碍而造成的替牙期前牙牙性反[牙合]患者进行下颌前牙切代帽联冠式斜面导板矫治,对矫治效果进行评价。结果：28例患者通过平均2．8＋0．7个月的矫治,均成功解除前牙反殆,建立前牙正常覆殆覆盖关系。结论：对于因上前牙迟萌或阻生引起建[牙合]障碍的替牙期牙性反殆,用下颌前牙切代帽联冠式斜面导板矫治,可获得良好的矫治效果。     

唇挡对儿童牙弓及下颌骨生长发育的影响

目的研究下颌唇挡对替牙期及恒牙初期儿童下颌牙弓及下颌骨生长发育的影响,探索用下颌唇挡早期矫治下颌牙列拥挤的作用机理.方法选择替牙及恒牙初期下牙列拥挤患者30名(男14例、女16例),戴用下颌唇挡治疗6-10个月,进行治疗前后模型测量及X线头影测量分析.结果治疗后牙弓周长平均增加3.22mm,牙弓长度增加1.37mm,尖牙间宽度、第二双尖牙间宽度与第一磨牙间宽度分别增加1.63mm,2.35mm和1.83mm,切牙不齐指数减小1.66mm.表明切牙的唇移,牙弓宽度增大及第一磨牙远中直立对牙弓周长的影响较大.唇挡治疗后下颌平面角有所增加,但下颌骨位置与突度无明显改变.结论在儿童颌面部生长发育期间,下颌唇挡有助于增加下颌牙弓的长度与宽度,对治疗替牙期及恒牙初期下颌牙弓轻度或中度拥挤产生积极作用.     

拔除下颌第二磨牙矫治骨性安氏Ⅲ类错[牙合]

目的 探讨拔除下颌第二磨牙结合固定矫治器矫治恒牙期严重骨性Ⅲ类错(牙合)畸形的疗效与机制.方法 8例恒牙期严重骨性Ⅲ类错(牙合)畸形患者,男4例,女4例,年龄12.0～17.8岁,平均(14.5±0.7)岁,全部患者采用拔除下颌第二磨牙,直丝弓矫治器矫治,治疗前后头颅侧位片及常规头影测量分析.结果 8例严重骨性Ⅲ类错牙争患者均取得良好的矫治效果.上颌前牙发生明显的唇向倾斜移动,下颌前牙发生明显舌向移动,前牙建立良好覆(牙合)、覆盖关系,磨牙关系由完全近中变为中性关系,面型由凹面型变为直面型.疗程15～25个月.平均18个月.结论 严重的骨性Ⅲ类错(牙合),拔除第二磨牙后,通过结合固定矫治器、应用差动力技术,可有效地矫正严重的骨性反(牙合),并且面型可以得到较大改善.     

用新型组合式矫治装置早期矫治安氏Ⅱ类1分类错

目的 :用一种新型组合式矫治装置治疗替牙期及恒牙初期安氏二类 1分类错。方法 :采用由口外弓、下颌唇挡及上颌斜面导板组成的矫治装置 ,治疗替牙期及恒牙初期安氏二类 1分类错 6 6例 (男 30例 ,女 36例 ) ,在治疗前后进行X线头影测量分析。结果 :经矫治 6 6例安氏二类 1分类错患者的覆、覆盖及颌关系调整时间为 3 13个月 ,平均 7.6个月。治疗后覆平均减小 2 .5mm ,覆盖减小 4 .3mm ,SNB角增加 1.8度 ,ANB角减小 1.9度 ,U1 NA角减小 8.8度 ,L1一NB角增加 6 .4度 ,IMPA角增加 5 .7度 ,Z角增加 4 .5度 ,Wits值减小 1.6 ,ANS Me增加 4 .0mm。结论 :该组合式矫治装置对替牙期及恒牙期安氏二类 1分类错具有良好的矫治效果。     

62例伴先天缺牙错畸形的正畸治疗临床分析

目的回顾性总结分析伴有先天缺牙的错畸形患者先天缺牙的部位、类型和矫治方法。方法选择结束治疗的正畸患者中伴有先天缺牙者62例,对缺牙数目、部位、类型和矫治方法进行总结分析。结果缺牙部位最常见的是下颌中切牙、上颌侧切牙和下颌侧切牙,以少数牙缺失为主,女性多于男性。7例替牙期患者行一期矫治,恒牙列中23例结合拔牙减数,19例行集中间隙、结合义齿修复,10例结合邻面去釉减径,2例行前移后牙替代的方法进行矫治,矫治结果满意。结论对伴有先天缺牙的错畸形,替牙期先行一期矫治后观察,恒牙期根据缺牙数目、部位、类型及错采用结合减数、减径或集中间隙修复的方法均可获得满意的矫治效果。     

前方牵引联合下颌多曲方丝弓技术矫治恒牙早期骨性Ⅲ类错[牙合]的疗效评价

目的:观察前方牵引联合下颌多曲方丝弓矫治技术矫治恒牙早期骨性Ⅲ类错(牙合)患者前、后软硬组织及牙(牙合)的变化,探讨该方法矫治骨性Ⅲ类错(牙合)的原理、机制和优缺点.方法:选择23例恒牙早期骨性Ⅲ类错(牙合)患者,男11例,女12例,年龄12～14岁.应用前方牵引联合下颌多曲方丝弓技术进行同期治疗.分别在正畸前(T1)、矫治7个月后(T2)及矫治结束后(T3)进行头影测量分析,采用SPSS10.0软件包对数据进行配对t检验.结果:患者骨组织的改变主要发生在T2期,其中SNA角平均增加2.37°,OP-MP平均增加4.85°,Wits平均增加4.79mm,差异有统计学意义.而T2期和T3期比较,差异无显著性.覆(牙合)、覆盖在T2期即发生明显变化,其中覆盖在T2期平均增加4.43mm,覆(牙合)加深2.66mm.治疗结束后,覆(牙合)、覆盖进一步加大.结论:恒牙早期骨性Ⅲ类错(牙合)患者由于生长潜力有限,前方牵引和下颌多曲方丝弓矫治技术同期联合应用是有效的矫治方法之一.     

Twin block在安氏Ⅱ1类错牙合矫正中的临床应用

目的了解Twin block 矫治器对安氏Ⅱ1类错牙合治疗效果.方法选择13例替牙后期或恒牙早期的安氏Ⅱ1类错牙合病人,Ⅰ期治疗用Twin block矫治器矫治,改善上下颌骨矢状不调;Ⅱ期用固定矫治器进一步精细调整牙位及牙合位.结果 Twin block矫治器可促进下颌生长,改善前牙的覆牙合覆盖关系.结论 Twin block矫治器对治疗早期安氏Ⅱ1类错牙合可取得明显的骨骼改变,降低Ⅱ期矫治的难度.     

唇挡对儿童面下部硬软组织侧貌影响的研究

目的　研究唇挡对替牙期及恒牙初期儿童面下部硬软组织侧貌形态的影响。方法　选择替牙期及恒牙初期下颌发育不良伴下牙列轻度或中度拥挤患儿 30例 (男 14例 ,女 16例 ) ,采用下颌唇挡治疗 6～ 10个月 ,进行治疗前后面部硬软组织X线头影测量分析。结果　唇挡治疗后下切牙唇倾 3.2 5°,呈以根尖为转动中心的倾斜移动 ,下颌第一磨牙远中倾斜 6 .13° ,呈以根分叉为转动中心的远中倾斜移动。下颌平面角增加 1.15° ,SNB角与面角无明显改变。颏唇沟厚度平均增加 1.2 3mm ,致使颏唇沟变浅 ,下唇角增大 (6 .0 5°) ,下唇及颏唇沟形态改善。结论　在儿童颌面部生长发育高峰期 ,唇挡可有效促进下颌牙弓生长发育 ,改善面下部硬软组织侧貌形态。     

Combined Therapy with Pendulum and Lingual Arch Appliances in the Early Mixed Dentition

PATIENTS AND METHOD: In 20 patients with arch length deficiency and anterior crowding, pendulum and lingual arch appliances were inserted simultaneously in the upper and in the lower arch respectively to gain space. The patients were divided into two groups according to their dental eruption stage: ten children (six boys, four girls; mean age: 9 years, 6 months) were in the early mixed dentition, while an adolescent comparison group of the same size (three boys, seven girls; mean age: 12 years, 3 months) were in the permanent dentition at the beginning of treatment. AIM: The main purpose of the study was to investigate whether simultaneous therapy with pendulum and lingual arch appliances is to be recommended, i.e. whether this therapy should take place as interceptive treatment in the early mixed dentition or only in the permanent dentition in adolescence. Parameters were the extent and quality of dentoalveolar effects and the side effects (mesial movement of the incisors, protrusion of the incisors, tipping of molars). RESULTS: The treatment course was documented by means of study casts and lateral cephalograms. Assessment of the diagnostic records yielded the following findings: In the early treatment group the maxillary molars were distalized by the pendulum appliance by a mean distance of 4.0 +/- 1.46 mm, resulting in distal tipping by 6.1 +/- 2.18 degrees. The incisors were moved reciprocally by 1.08 +/- 1.06 mm to anterior and protruded by 7.65 +/- 4.84 degrees. In the comparison group molar distalization and molar tipping were less pronounced (2.86 +/- 1.54 mm/4.25 +/- 3.78 degrees ), while mesial movement of the incisors was comparably high at 1.62 +/- 0.99 mm. At only 3.8 +/- 2.9 degrees, incisor protrusion was significantly less pronounced than in the early treatment group (p = 0.045). The proportion of molar distalization in the total movement was higher in patients in the early mixed dentition: 79.83 +/- 15.38% vs 60.71 +/- 26.64%. During the early therapy with the lingual arch appliance in the lower arch, the molars were uprighted to the distal by 2.4 +/- 0.97 degrees and the incisors were tipped to labial by 5.0 +/- 1.83 degrees. In the adolescent control group, molar uprighting was less pronounced and the degree of incisor protrusion was significantly lower (2.75 +/- 1.11 degrees, p = 0.004). CONCLUSION: With the appropriate indication, the combined therapy with the two compliance-independent appliances described can be recommended for gaining sagittal arch length in the early mixed dentition.     

Efficiency of early and late Class II Division 1 treatment.

The aim of this study was to assess the efficiency of early and late Class II Division 1 treatment in the mixed and permanent dentition. Treatment efficiency was defined as a better result in a shorter treatment time. We examined 204 patients with Class II Division 1 malocclusions treated in the early mixed dentition (n = 54), late mixed dentition (n = 104), and permanent dentition (n = 46). The pretreatment and posttreatment dental casts were evaluated with the peer assessment rating (PAR) index. The duration of treatment decreased with progressing dental development: patients in the early mixed dentition (dental stage [DS] 2) were treated for 57 months, patients in the late mixed dentition (DS 3) for 33 months, and patients in the permanent dentition (DS 4) for 21 months. Patients treated exclusively with fixed appliances had a shorter treatment duration (19 months for Herbst and 24 months for multibracket) than did patients treated with functional appliances or a combination of appliances (38 months for functional appliances and 49 months for a combination). The PAR score reduction (improvement) increased with progressing dental development: DS 2 patients had a PAR score reduction of 64%, DS 3 patients had a reduction of 73%, and DS 4 patients had a reduction of 77%. Patients treated exclusively with fixed appliances had a greater PAR score reduction (77%) than did patients treated with functional appliances or a combination (60% for fixed appliances and 71% for functional or a combination). Based on the results of this investigation, we concluded that treatment of Class II Division 1 malocclusions is more efficient in the permanent dentition (late treatment) than it is in the mixed dentition (early treatment).     

Three-dimensional evaluation of facial asymmetry in association with unilateral functional crossbite in the primary,early, and late mixed dentition phases

Objective:To assess the degree of facial asymmetry associated with subjects with unilateral functional crossbite (CB) in the primary, early/intermediate, and late mixed dentition phases in comparison with a group of subjects without CB.Subjects and Methods:A group of 234 white subjects, 78 with CB (42 girls and 36 boys) and 156 without CB (73 girls and 83 boys), aged 3.9–11.9, grouped according to the dentition phase, were included. Three-dimensional laser scans of the subjects'' faces were used to assess facial asymmetry. For each part of the face two-way multivariate analysis of covariance was performed to assess differences among the subjects, and an independent sample t-test was used to assess the significance of the differences between data sets.Results:Within all dentition phases, the subjects with CB had statistically significantly greater facial asymmetry of the whole face than the subjects without CB, with the greatest values in the lower part of the face (P < .05). In the middle part of the face a significant difference was observed in the mixed dentition phases.Conclusions:Children with unilateral functional CB exhibited a greater facial asymmetry than children without this malocclusion in all the dentition phases herein investigated. The greatest differences were seen for the lower part of the face. Further, facial asymmetry in the middle part of the face became clinically relevant in combination with the transition from primary to mixed dentition phase.     

输液管在儿童替牙期含牙囊肿开窗术中的应用

目的:探讨输液管在儿童替牙期含牙囊肿开窗引流术中的作用。方法 :分析2003-12—2011-12我院口腔颌面外科收治的经病理证实为含牙囊肿的替牙期儿童病例22例,平均年龄11岁,所有病例术前均拍摄曲面断层片和局部小牙片,囊肿直径3～5 cm,其中含多生牙9例。术中拔除部分乳牙及多生牙,于拔牙创处开窗,切取部分囊壁,拔牙创口置直径0.4 cm、长约1.0～1.5 cm输液管,并固定于牙龈或邻近牙齿。每日冲洗,术后3个月、6个月、1年随访,同时拍摄曲面断层片检查。结果:所有病例在开窗术后早期局部轻度红肿疼痛,3个月后囊肿明显减小,6～7个月时骨质膨隆消失,10～11个月时X线检查囊肿低密度影像消失。13例恒牙自行正位萌出,4例出现尖牙与侧切牙错位萌出,5例恒牙未自行萌出。在开窗引流期间,无1例患者伤口感染,均引流通畅。结论:输液管在儿童替牙期含牙囊肿开窗引流术中,具有操作简单、患者术后依从性高、创伤痛苦小、复诊次数少、引流通畅、成本低廉、易于推广等特点,是治疗儿童替牙期含牙囊肿的较理想方法。     

Orthodontic Findings in the Deciduous and Early Mixed Dentition—Inferences for a Preventive Strategy

AIM AND METHOD: The aim of the present epidemiologic study was to obtain representative basic data on the frequency, extent and age-dependence of malocclusions in the deciduous and early mixed dentition. The developmental tendencies of specific malocclusions were investigated from the aspect of orthodontic prevention. The collective comprised 8,864 preschool and school-aged children, of whom 1,225 were in the deciduous dentition (mean age 4.5 years) and 7,639 in the mixed dentition (mean age 8.9 years). The orthodontic data were clinically assessed as sagittal, transversal, or vertical single-arch and occlusal findings. In addition, the malocclusions were classified according to their primary symptoms. Early infantile habits, tongue dysfunctions, speech defects and incompetent lip closure were registered separately. RESULTS: 57% of the children were found to have malocclusions, with the frequency rising statistically significantly in dependence on age from the deciduous to the mixed dentition (p < or = 0.001). The mean extent of excessive overjet increased significantly from the deciduous to the mixed dentition. Crossbite with mandibular midline discrepancies were observed significantly more frequently in the deciduous dentition. Although the frequency of anterior open bite underwent a significant decline from the deciduous to the mixed dentition, open bite was the malocclusion most frequently associated with dysfunction in both groups. The significant increase in traumatic deep bite in the mixed dentition indicates an unfavorable developmental tendency in this anomaly until after the eruption of the permanent incisors. CONCLUSION: The need for preventive orthodontic therapy and for the intensified application of interceptive and early treatment measures is stressed in view of the high number of malalignments and malocclusions in the deciduous and mixed dentition and the tendency for some forms of malocclusion to deteriorate as the dentition develops.     

Serial Extraction or Premolar Extraction in the Permanent Dentition? Comparison of Duration and Outcome of Orthodontic Treatment

Treatment outcome and duration of 2 different treatment approaches in 2 groups of comparable extraction cases were analyzed: Group I: serial extraction performed in the early mixed dentition followed by orthodontic treatment in the permanent dentition; group II: extractions as well as orthodontic treatment in the permanent dentition. The following conclusions were reached: 1. The treatment period with fixed appliances was highly significantly shorter in group I; however, the number of appointments was significantly higher and the total duration of treatment/observation time significantly longer. 2. In both groups the reduction in PAR score was either improved or greatly improved in all cases.     

Rapid maxillary expansion. Is it better in the mixed or in the permanent dentition?

The aim of this study was to compare the dentoskeletal effects of a modified acrylic-bonded rapid maxillary expansion (RME) device when it is used in the mixed and permanent dentitions. The study group consisted of 51 patients in the mixed and permanent dentition (26 girls and 25 boys) who underwent RME treatment. Group 1 was composed of 34 subjects in the mixed dentition (19 girls and 15 boys; mean age, 9.2 +/- 1.3 years). Group 2 consisted of 17 subjects in the permanent dentition (seven girls and 10 boys; mean age 12.7 +/- 1.2 years). Lateral and frontal cephalograms and upper dental casts were collected before treatment (T1), after treatment (T2), and after retention (T3). Intragroup and intergroup changes were evaluated by paired t-test and Student's t-test, respectively. In both groups after RME, the maxilla moved forward; mandible rotated posteriorly; facial height increased; nasal, maxillary, and maxillary intercanine and first molar widths increased; and the upper molars tipped buccally. Almost all these significant changes were stable at follow-up (T3). When overall (T1 - T3) differences were considered, upper molars tipped more, and the ANB angle increased less in the mixed dentition group compared with the permanent dentition group (P < .01). Within the limits of this study, the results suggest that the orthopedic effects of RME are not as great as expected at early ages, and it might be a better alternative to delay RME to early permanent dentition.     

山东地区汉族正常(牙合)少年儿童牙颌颅面特点的研究

目的:建立山东地区汉族少年儿童的X线头影测量正常值和标准差,分析其牙颌颅面形态特征,并建立面型模板。方法:选择156例山东籍8￣15岁正常牙合少年儿童,拍摄X线头颅侧位片,分为替牙期组和恒牙初期组。用WinCeph7.0进行图像处理和定点测量,选取38个硬组织标志点及118项硬组织项目,得出各项目的均值和标准差,进行男女之间、替牙期与恒牙初期之间两样本的t检验。结果:建立了山东地区汉族正常牙合少年儿童硬组织的X线头影测量的正常值和标准差,比较出性别差异,并建立了面型模板。结论:男性从替牙期到恒牙初期,前后面都有显著的生长,上颌向前下方生长明显,而下颌生长缓慢;女性从替牙期到恒牙初期,下颌生长明显,颏部前突。     

Relationship between Occlusal Findings and Orofacial Myofunctional Status in Primary and Mixed Dentition

AIM: The aim of this study is to provide basic data on the prevalence of malocclusions and orofacial dysfunctions in the primary and early mixed dentition, to examine occlusal relationships in their functional context, and to analyze the need for and potential of orthodontic prevention. SUBJECTS AND METHODS: Occlusal relationships and myofunctional status were evaluated in 766 children in the primary dentition and in 2,275 children in the early mixed dentition. Orthodontic findings in single jaws and intermaxillary occlusal relationships were clinically analyzed in all three dimensions. RESULTS: Normal occlusal relationships were found in 25.3% of children in the primary dentition. Frequency of children with normal dentitions fell significantly in the mixed dentition (7.3%). Prevalence of bilateral distoclusion increased significantly from the primary to the mixed dentition. Increased maxillary overjet was diagnosed in 49.3% and 59.0% of the children in the primary and mixed dentition, respectively. Prevalence of lateral crossbites increased significantly from primary to mixed dentition (7.2% vs. 12.0%). Deep bites and edge-to-edge bites were found significantly more often in the early mixed dentition. CONCLUSIONS: The significant increase in the prevalence of malocclusions between the primary and mixed dentition--distoclusion and lateral crossbite, and the impairment of vertical occlusal relationships in the mixed dentition in particular--reveal the need for orthodontic prevention. They highlight the absence of applied interceptive and early treatment measures in orthodontics. The indication system in current use for early orthodontic treatment here in Germany fails to fulfill the requirements for prevention-oriented dental care.