高角骨性Ⅱ类错牙合患者的临床特点及治疗对策

骨性Ⅱ类高角错牙合是临床上常见的错牙合畸形,主要表现为矢状向及垂直向的不调。学者们对其形成的病因、临床表现、X线及治疗方法等都有很多研究,其机制及治疗效果各不相同。该文就骨性Ⅱ类高角型错牙合畸形的特殊性,以及在治疗过程中需要注意的问题进行研究,为以后的正畸治疗的顺利进行和治疗后的长期稳定提供重要保证。     

前牙原发性牙根吸收患者功能(牙合)的特点分析

目的:探讨原发性牙根吸收患者的功能(牙合)特点,揭示功能(牙合)对前牙牙根吸收的影响.方法:对正畸治疗前的错(牙合)患者用曲面断层片、根尖片并结合临床确诊前牙原发性牙根吸收,从中选取2～3级牙根吸收患者15例,按年龄和性别配对,建立无牙根吸收对照组.对2组实验对象的功能(牙合)进行临床和Denar MarkⅡ(牙合)架检查,比较2组在侧方(牙合)及前伸(牙合)运动过程中功能(牙合)指标的差别,采用SPSS13.0软件包进行统计学处理.结果:侧方(牙合)运动时,实验组前牙(牙合)干扰的数量显著高于对照组,临床检查(P＜0.05)及(牙合)架检查(P＜0.05)均有统计学意义,后牙(牙合)干扰数量2组无显著差异.下颌后退位(RCP)滑向牙尖交错位(ICP)时在垂直向、前后向及侧向的距离及前伸运动时存在的后牙(牙合)干扰数2组无显著差异.结论:侧方运动中出现的前牙(牙合)干扰作为一种长期轻微的创伤,可能是诱发前牙原发性牙根吸收的原因之一.     

牙合架的发展简史

该文以历史时间为轴,详细讲述了牙合架从无到有、从简陋到完善的200多年发展过程。作者将牙合架发展史分为早期牙合架、近代牙合架和现代牙合架3个时期,详细讲解了牙合架的基本设计原理,并列举了髁导、切导等重要牙合架结构的演变由来。     

前牙覆牙合对安氏Ⅲ类错牙合牙合平面的影响

目的探讨安氏Ⅲ类错牙合畸形中牙合平面与前牙覆牙合的相关性,通过控制牙合平面的变化为不同前牙覆牙合安氏Ⅲ类错牙合患者的正畸、正颌治疗提供策略依据。方法选取90例安氏Ⅲ类前牙反成人正畸患者治疗前的头颅侧位片作为试验组,同时选取30例成人个别正常的头颅侧位片作为对照组。根据前牙覆牙合的大小将安氏Ⅲ类错牙合分为3组,即开组、反覆牙合组、反深覆牙合组,每组各测量14项指标。对各组间的差异进行方差分析和多重比较分析,同时对前牙覆牙合与前后牙合平面的相关性进行直线相关分析。结果安氏Ⅲ类错牙合中后牙牙合平面倾斜度（OP-P角）和前牙覆牙合呈负相关（r=-0.24,P<0.05）,前牙牙合平面倾斜度（OP-A角）与前牙覆牙合呈正相关（r=0.23,P<0.05）。结论 不同前牙覆牙合的牙合平面形态各有不同,在正畸治疗不同前牙覆牙合安氏Ⅲ类错牙合时,应重视后牙垂直高度的控制及后牙牙合平面的倾斜度改变。     

安氏Ⅱ2错牙合畸形治疗方法概述

安氏Ⅱ2错牙合畸形是口腔正畸临床上较为常见的错牙合畸形之一,从三维方向的软硬组织分析,安氏Ⅱ2错牙合有其独特的临床表现,且其错牙合畸形的程度往往较临床表现更加复杂。加之此类错牙合患者面型代偿常常掩盖了颌骨矢状向位置不调,因此在诊治安氏Ⅱ2错牙合病例时,正畸医生经常面临许多陷阱和尴尬。对于安氏Ⅱ2错牙合畸形的矫治方法,国内外学者均有不同的观点,目前尚无统一的治疗标准。现对近年来国内外文献中关于安氏Ⅱ2错牙合畸形治疗方法的研究和进展做一综述。     

临床观摩与规范化模拟牙合架实操在口腔本科正畸教学中的对比应用

目的: 利用分组教学及问卷调查的形式,对本科生正畸知识掌握程度进行考察,对比临床观摩与Typodont模拟牙合架实操两组不同教学方式在口腔本科正畸教学中的效果,同时撰写规范化Typodont实操流程,致力于全国本科教学推广。方法: 撰写规范化Typodont实操流程,将60名学生随机分为两组,分别进行临床观摩教学及Typodont模拟牙合架实操教学,设计问卷调查并评估结果。结果: Typodont教学法在正畸学习兴趣,正畸知识理解能力,正畸操作帮助等方面明显优于临床观摩法。结论: Typodont教学流程及方法值得在本科正畸教学中推广应用。     

T-扫描系统对平衡的研究

本文系统介绍了计算机咬合分析系统即T-扫描系统(T-scan system)的组成、工作原理、方法、应用范围及其优缺点和影响准确性的因素。同时就该系统对(牙合)平衡的研究状况作了详细综述。掌握该手段,必将促进(牙合)学、修复学及正畸学研究和临床检查的进一步发展。     

用简单(牙合)架制作全口义齿163例临床应用分析

目的探讨简单(牙合)架制作全口义齿的临床使用价值.方法用简单(牙合)架制作全口义齿163例进行调查分析.结果用简单(牙合)架制作全口义齿影响前伸(牙合)平衡与侧向(牙合)平衡.结论 使用简笛(牙合)架排牙,绝大多数通过选磨也能达到满意效果.     

儿童错畸形对其父母生活质量的影响

目的:研究儿童的错(牙合)畸形对其父母生活质量的影响和两者间的关系.方法:从正畸科临床就诊病人中选择155名儿童患者,对其错(牙合)畸形的严重程度采用常用的正畸治疗需要指数(IOTN-AC和DHC、ICON和DAI)进行评估;另外,儿童的家长填写一份关于儿童口腔健康对父母生活质量影响的问卷(family impact scale-FIS).结果:儿童的错(牙合)畸形会影响父母的生活质量,包括日常活动和家长情绪;需要正畸治疗的儿童的FIS分数明显高于不需要正畸治疗者.统计效应最小0.07、最大0.42.多元回归结果显示FIS分数与是否需要正畸治疗、儿童性别、家长文化程度、家长性别没有关系.结论:儿童错(牙合)畸形会影响家长的生活质量,但受影响程度与儿童错(牙合)畸形的严重程度相关性不大.     

颞下颌关节紊乱病患者正畸治疗前后骀接触点及[牙合]力变化的研究

目的利用电子咬合记录仪（TScan）研究颞下颌关节紊乱病（temporomandibulardisorders,TMD）患者正畸治疗前后,咬合接触的变化,从而评价正畸治疗前后各咬合指标的改善程度及T-scan电子咬合记录仪用于咬合研究的意义。方法经关节门诊确诊为TMD病例13例,男4例,女9例,年龄13~37岁,针对不同患者TMD情况,为每例病人制定个性化矫治方法及目标。治疗前后采用美国Tekscan公司的T-scan咬合记录仪,分别记录[牙合]力中心在前后向与左右向的位移,[牙合]力不对称指数,[牙合]接触点,[牙合]接触面积及咬合时间。记录结果从T-scansoftware4．02存贮并输出。结果TMD患者在正畸治疗后临床症状得到缓解,临床检查无疼痛、开口受限;5例弹响消失,7例有单侧轻度开口初、中期弹响,1例有双侧开口初弹响。主观上8例明显自觉咬合舒适程度明显改善。T-scan检查可见咬[牙合]力中心位移在前后向及左右向位移均减小（P〈0．05）,袷[牙合]布分更接近中心（Pdo．05）,治疗前后差异有显著统计学意义,治疗前后骀力不对称性有明显改善（P〈0．05）;但咬合接触点及接触面积在治疗前后差异无统计学差异。所有病例咬合时间治疗后较治疗前减小,但结果没有统计学差异。结论TMD患者的[牙合]治疗应针对患者个性处理,[牙合]力分布及咬合中心点可以作为TMD正畸治疗前后的评价指标。     

Vertical repositioning accuracy of magnetic mounting systems on 4 articulator models

Statement of problem

Research of the ability of a cast mounted on an articulator on maintaining the identical position of a cast mounted on an articulator after repeated repositioning is lacking, despite the possible effects this may have on the occlusion of a mounted cast.

Face-bow record without a third point of reference: theoretical considerations and an alternative technique.

Accurate mounting of dental casts is achieved by transferring the tridimensional spatial relationship of the maxillary arch to an articulator. A face-bow is used to transfer this relationship to the articulator, usually by relating the face-bow to a plane of reference. The most common reference plane is the Frankfort plane, which has been assumed to be horizontal when the patient is in the natural head position. The axis-orbitale plane has also been considered horizontal and used as reference. However, it has been shown that both planes are not horizontal, and mounting a maxillary cast according to these planes can result in an inaccurate mounting. This article describes an alternative procedure for face-bow transfer without a plane of reference, and uses the angular relationship between the occlusal plane and the condylar path to mount the maxillary cast on the articulator. The elimination of a reference plane, to which relate the functional determinants of occlusion, avoids an additional source of error during the mounting procedure.     

全口义齿实验教学中2种教学方法的应用比较

目的:比较全口义齿工艺技术实验教学过程中2种不同的义齿制作方法—精细步骤制作法和常规制作法,探讨在全口义齿实验教学中应如何合理应用2种方法来提高教学效果。方法:将46名学生随机分为常规制作组(n=23)和精细步骤制作组(n=23)。在3个实验教学阶段(初学时、11个月时、临床实训)中,针对3个重要的义齿制作环节,即托制作、上架、排列人工牙等,对2种义齿制作方法的效果进行比较。应用SPSS 18统计软件包对数据进行处理,统计方法包括独立样本t检验和单因素方差分析。结果:3个不同的实验教学阶段中,托制作和上架两个环节精细步骤制作法组成绩较常规制作法组高(P<0.05),平均高4.3%～7.3%;而在学习难度相对大一点的排列人工牙实验教学中,精细步骤制作法组实验成绩则低于常规制作法组(P<0.05),平均低5.6%。结论:在全口义齿工艺技术实验教学中,针对不同的学习环节和阶段,科学选择合理的教学方法,使学生在一定的实践训练时间内较快地提高自己的义齿制作技能,达到更好的教学效果,是完全可能的。     

Virtual Articulators and Virtual Mounting Procedures: Where Do We Stand?

A virtual articulator is a computer software tool that is capable of reproducing the relationship between the jaws and simulating jaw movement. It has gradually gained research interest in dentistry over the past decade. In prosthodontics, the virtual articulator should be considered as an additional diagnostic and treatment planning tool to the mechanical articulator, especially in complex cases involving alterations to the vertical dimension of occlusion. Numerous authors have reported on the available digital methodologies used for the assembly of virtual arch models in a virtual articulator, focusing their attention on topics such as the virtual facebow and digital occlusal registration. To correctly simulate jaw movement, the jaw models have to be digitalized and properly mounted on the virtual articulator. The aim of this review was to discuss the current knowledge surrounding the various techniques and methodologies related to virtual mounting in dentistry, and whether virtual articulators will become commonplace in clinical practice in the future. This review also traces the history of the virtual articulator up to its current state and discusses recently developed approaches and workflows for virtual mounting based on current knowledge and technological devices.     

A new articulator emphasizing centric occlusion and the anterior determinants.

A new articulator is described which has the advantages of the rigidity of a simple articulator in the upper member and the flexibility of an adjustable articulator in the lower member. A link between the members and the frame along with the posterior controls establishes a full range of functional chewing movements and defines the extreme lateral or border paths. The articulator has condylar element controls which permit releasing and remounting the mandibular cast in a manner that serves the same function as the split-cast technique, but this method is faster and shows the amount of discrepancy. The condylar element control is an improvement over existing devices for comparing interocclusal records in that it not only indicates differences in position but it also provides quick remounting of the casts in a working articulator. Other features of the articulator are: (1) a condylar lock mechanism which is activated by only a half turn, (2) adjustable spring tension, (3) precise long centric and wide centric controls, (4) an incisal pain which can be removed and replaced on the articulator without changing its setting, (5) a Bennett movement carefully selected to avoid the complication of a pantograph type of face-bow, and (6) a new sponge wall type of mounting plate which supports both casts for simultaneous mounting.     

A reevaluation of the axis-orbital plane and the use of orbitale in a facebow transfer record.

A fundamental assumption in prosthetic dentistry is that the axis-orbital plane usually will be parallel to the reference horizontal. Most articulator systems have incorporated this concept into their designs and use orbitale as the anterior reference point for transferring the vertical position of the maxillae to the articulator. The position of the maxillary cast is expected to be in the same vertical position as the maxillae with the subject's head oriented in the esthetic reference position. However, the use of orbitale in conjunction with an articulator whose design assumption places the axis and orbital indicator parallel to the horizontal reference will result in a substantial mounting error. This article examines the cause and correction of the mounting error that results from the use of orbitale as the anterior reference point of a facebow transfer record made to an axis-orbital designed articulator.     

Fabrication Method for a Mounting Jig and Cast Support for Mounting Complete Dentures

In complete denture fabrication, the definitive maxillary cast is mounted on an articulator using a facebow transfer or mounting jig, and the mandibular cast is mounted using an interocclusal record. The technique presented describes an easy and inexpensive method for fabrication of a mounting jig and rigid cast supports for mounting complete dentures.     

Accuracy of face-bow transfer: effect on surgical prediction and postsurgical result.

One of the most common errors in model surgery for orthognathic surgery is in the mounting of the models on the articulator. This study assessed the ability of one type of face-bow to transfer the maxillary model to the articulator. Twenty-five consecutive mountings were evaluated by calculating the angle made between the maxillary occlusal plane on the cephalogram and comparing it with the maxillary occlusal plane angle on the articulator. An accurate face-bow transfer should transfer this angle, making the two similar. It was found that a significant difference between the maxillary occlusal plane angle on the cephalogram and the articulator was found in the average case. The implications of such errors and a technique to avoid them are presented.     

A study on the use of the dentatus AEB face bow and its modification as an ear bow

This study investigated the siting of the earbow mounting pins on the Dentatus ARL articulator relative to the condylar axis. Further, it showed the repeatability of registrations using the Dentatus AEB face bow and its modification as an earbow. Three face bow and three earbow recordings were made of 35 subjects. Registrations were fitted onto the subject's cast mounted on the articulator to show differences in the recording of the condylar axis. The mean horizontal relationship between the earbow and face bow registrations approximated to the relationship of the earbow mounting pin to the opening axis of the articulator. The mean diameter of the spread of registrations was less for the earbow than the conventional face bow. The use of the earbow modification to the Dentatus face bow is supported.     

Functional occlusion: II. The role of articulators in orthodontics

Opinion is divided on whether there is a place for the use of semi-adjustable dental articulators in orthodontics. In this review we explore the validity and reproducibility of the techniques involved in mounting study models on a semi-adjustable dental articulator. We also look at the role of articulated study models in orthodontic diagnosis and treatment planning, in the finishing stages of orthodontics and in planning for orthognathic surgery. We report that each of the many stages involved in mounting study models on a semi-adjustable articulator is a potential source of error and that only if the technique is carried out with a high degree of accuracy is it worth the additional chairside time.