颌骨前后向不调指数与骨性安氏Ⅲ类骨性错矢状关系的分析

目的:探讨颌骨前后向不调指数(APDI)与上、下颌骨矢状向的位置关系,以利于骨性安氏Ⅲ类错的诊断及治疗。方法:测试对象共100例,其中正常成人组20例,正常青少年组20例,骨性安氏Ⅲ类错成人组28例,早期骨性安氏Ⅲ类错治疗组24例,早期骨性安氏Ⅲ类错治疗失败组8例。头颅侧位定位片测量指标为,腭平面角、面角、AB平面角及APDI值。采用SAS6.12软件包对数据进行t检验。结果:正常人群的APDI均值在85°以下,骨性安氏Ⅲ类错APDI均值在90°以上,青少年的各项测量值相对成人小,需行正颌外科的患者,APDI均值超过100°。APDI值各组间均有显著性差异,P<0.01。结论:APDI均值超出正常标准值越多,上、下颌骨骨性矢状向畸形就越严重。APDI值是评价骨性安氏Ⅲ类上、下颌骨矢状向关系较为有效的指标。     

安氏Ⅱ~1类错不同骨面型的牙颌垂直向形态特征分析

目的:探讨安氏Ⅱ1类错牙合不同骨面型牙颌垂直向形态特征。方法:选取恒牙初期的正常牙合,Ⅱ1类错牙合均角型、高角型、低角型的X线头颅侧位片各30张,男女各半,进行X线头影测量分析,通过多组间单因素方差分析及两两比较,明确Ⅱ1类错牙合3种骨面型和正常牙合的牙颌垂直向形态变化。结果:(1)所有Ⅱ1类错牙合总体上颌复合体的前部相对于后部垂直向发育过度。均角组上颌复合体整体相对发育过度,颅底一下颌支复合体发育不足;高角组上颌复合体前部发育过度,后部和颅底-下颌支复合体发育不足;均角组和高角组下颌有后下旋转的趋势。低角组颅底一下颌支复合体的垂直生长相对于上颌复合体的后部发育过度,上颌复合体前部发育正常。下颌有前上旋转的趋势。(2)Ⅱ1类错牙合L6的垂直高度降低,U6远中倾斜。高角组、均角组U6垂直高度未增加,功能牙合平面(FOP)前下倾斜,高角组U6及功能牙合平面倾斜的程度最大;低角组U6垂直高度降低,远中倾斜程度最小,功能牙合平面未见异常。结论:Ⅱ1类错牙合不同骨面型牙颌形态表现出不同的垂直向特征,治疗时垂直向控制应采取不同的措施。     

安氏Ⅱ~1错的颅颌特征因素分析

目的:研究安氏Ⅱ1错牙合的颅颌结构特征。方法:53例恒牙初期安氏Ⅱ1错牙合病例。测量8项X线头影测量线距指标,运用逐步回归法做因素分析。结果:男性安氏Ⅱ1错牙合有效下颌长度减小、上切牙突距增加、上颌突度减小、有效上颌长度增加是导致安氏Ⅱ1错牙合颌面结构改变的主要因素。女性安氏Ⅱ1错牙合上下颌长度差减小及下面高增加是导致安氏Ⅱ1错牙合颌面结构改变的主要因素。结论:安氏Ⅱ1错牙合不同性别表现出不同的颅颌结构改变特征,下颌骨长度减小,上颌位置后缩,上切牙唇倾度增加,上颌骨长度增加是男性安氏Ⅱ1错牙合颅颌结构改变的主要因素。上下颌骨长度差减小及下颌顺时针旋转是女性安氏Ⅱ1错牙合颅颌结构改变的主要因素。     

安氏Ⅱ~1类和Ⅲ类错Tweed分析法的比较研究

目的 :对两种临床表现截然不同的错畸形作一形态学方面的比较研究。方法 :用Tweed分析法对 60名恒牙初期 ( 3 0名安氏 Ⅱ1类、3 0名安氏Ⅲ类 )患者进行X线头影测量分析。结果 :处于生长发育阶段的安氏 Ⅱ1类和 Ⅲ 类错患者其FMA角可以表现为接近而无明显差异 ,而两者的FMIA角和IMPA角表现为高度显著性差异。结论 :本研究认为下切牙倾斜度的变化是两者FMIA角和IMPA角显著性差异的主要原因。     

安氏Ⅱ类1分类错的三维X线头影测量研究

本文利用三维Ｘ线头影测量系统对５０名恒牙早期的安氏Ⅱ类１分类错进行了研究，发现此类错的发病机制错综复杂，其颅面结构在长宽高三个方面都存在有不同程度的异常，本文对其进行了深入的探讨，并结合其颅面三维结构特点，将此类错进行了分型，提出了各自的治疗原则     

安氏Ⅰ类错与安氏Ⅱ~1错患者颅面关系的研究

目的 :探讨安氏Ⅰ类错牙合与安氏Ⅱ1错牙合患者颅面结构的差异。方法 :随机选取 11～ 14岁的年轻恒牙列病例 45例 ,其中安氏Ⅰ类错牙合2 4例 ,安氏Ⅱ1错牙合 2 1例 ,在正中咬合位时拍摄X线头颅定位侧位片 ,比较两者颅面结构的差异。结果 :安氏Ⅱ1错牙合患者SNB、ANB、SNPg、FMA的测量值大于安氏Ⅰ类错牙合患者 (P <0 .0 5 ) ,而SNA、PP SN、OP SN、GoGn SN的测量值两者间无显著差异。结论 :安氏Ⅰ类错牙合与安氏Ⅱ1类错牙合X线头影测量的主要差异是下颌位置的异常。     

应用颌骨垂直向不调指数评价骨性安氏Ⅲ类错[牙合]的垂直向关系

目的：探讨颌骨垂直向不调指数（ODI）与上、下颌骨垂直向的位置关系,以利于骨性安氏Ⅲ类错[牙合]诊断及早期治疗。方法：100例成人及青少年分成5组,正常成人组20例,正常青少年组20例,骨性安氏Ⅲ类错[牙合]成人组28例,早期骨性安氏Ⅲ类错[牙合]治疗组24例,早期骨性安氏Ⅲ类错[牙合]治疗失败组8例。头颅侧位定位片测量指标为腭平面角、下颌-AB平面角、ODI值,采用SAS6.12软件包对数据进行团体t检验。结果：正常人群的ODI均值在70°以上,骨性安氏Ⅲ类错[牙合]ODI均值在63°以下,青少年的各项测量值较成人小,需行正颌手术的患者ODI均值小于53°。ODI值各组间均有显著性差异,P〈0.001。结论：ODI均值小于正常标准值越大,上、下颌骨骨性垂直向畸形就越严重。ODI值是评价骨性安氏Ⅲ类错[牙合]上、下颌骨垂直向关系较为有效的指标。     

口外弓推磨牙远移矫治安氏Ⅱ类错12例临床分析

目的　研究口外弓推上颌磨牙远移矫治安氏Ⅱ类错牙合后的组织变化。方法　用口外弓推磨牙远移治疗 12例安氏Ⅱ类错牙合。通过治疗前后X线测量及模型测量进行分析比较。结果　磨牙关系均被纠正至安氏Ⅰ类关系。结论　口外弓推磨牙远移配合方丝弓矫治器是矫治安氏Ⅱ类错牙合简便有效的方法之一     

活动翼托槽与直丝弓矫治器矫治安氏Ⅱ类1分类错临床疗效比较

目的探讨活动翼托槽矫治器与直丝弓矫治器矫治安氏Ⅱ类1分类错患者临床疗效的差异。方法选择25例患者,随机分成2组,分别采用以上2种矫治器进行矫治,对2组各治疗阶段所需时间以及治疗前后牙颌组织头影测量数据进行比较分析。结果与直丝弓矫治器组相比,活动翼托槽组在排齐、整平牙列和关闭间隙阶段所用时间明显减少,而在精细调节阶段时间增加,差异有统计学意义（P〈0.05）;磨牙前移量减少,上下前牙更为直立,差异有统计学意义（P〈0.05）;两组颌骨关系变化差异无统计学意义（P〉0.05）。结论与传统直丝弓矫治器相比,活动翼托槽矫治器可以缩短整体治疗时间,但其对前牙转矩的控制及牙列的精细调节不足。     

应用Herbst矫治器矫治恒牙期安氏Ⅱ~1类错

目的研究Herbst矫治器矫治恒牙期安氏Ⅱ1类错牙合的疗效。方法用Herbst矫治器矫治20例安氏Ⅱ1类错牙合患者,并对治疗前后的X线头颅侧位定位片进行分析比较。结果Herbst矫治器矫治恒牙期安氏Ⅱ1类错牙合,Ⅱ类关系的改善是上下颌综合作用的结果,其促进下颌骨生长及下颌牙前移的效应占主要因素。其中SNB增加(+4.1°),ANB减小(-4.6°),下颌骨的长度增加,上切牙舌倾,下切牙唇倾,下磨牙前移升高,前后牙垂直方向变化导致上下牙合平面顺时针旋转,软组织侧貌明显改善。结论应用Herbst矫治器治疗安氏Ⅱ1类错牙合,通过对牙、颌作用后产生综合效应,能在较短的时间内达到良好的效果。     

Treatment outcomes of growing Class II Division 1 patients with varying degrees of anteroposterior and vertical dysplasias, Part 1. Cephalometrics.

The purpose of this retrospective study was to evaluate the differences in orthodontic treatment outcomes for 5 groups of growing Class II Division 1 patients with various anteroposterior and vertical skeletal dysplasias. Pretreatment and posttreatment cephalograms of 100 patients were evaluated for soft and hard tissue treatment effects and differences between groups. Changes from pretreatment to posttreatment differed between groups in correction of overjet and change in ANB angle (P <.05). Those with the largest skeletal dysplasias had the greatest skeletal correction but also retained the largest ANB angles posttreatment. Additional correction was achieved through dentoalveolar change with the greatest uprighting of maxillary incisors occurring in patients who initially were the most severely affected (P <.05); this effect was accompanied by an increase in nasolabial angle. All groups had similar changes in mandibular incisor positions, and final positions of the mandibular incisors did not differ between groups. Compared with norms, Z angles and facial contour angles showed discrimination between the most and least severely affected patients based on combined anteroposterior and vertical dysplasias (P <.05). However, there were no clear-cut divisions between the groups, especially with regard to soft tissue cephalometric outcomes. Further evaluation of profile esthetics follows in Part 2. We conclude that conventional orthodontic therapy successfully corrects Class II Division 1 malocclusions in growing patients through a combination of skeletal and dentoalveolar changes, with the greatest changes occurring in patients who initially have the most severe skeletal dysplasias.     

Treatment outcomes of growing Class II Division 1 patients with varying degrees of anteroposterior and vertical dysplasias, Part 2. Profile silhouette evaluation.

The purpose of this study was to evaluate pretreatment and posttreatment soft tissue profiles of 4 groups of growing Class II Division 1 patients treated with fixed orthodontic appliances and headgear. One hundred patients were grouped according to the severity of their initial retrognathia and vertical skeletal status. Standardized pretreatment and posttreatment profile silhouettes of each patient were randomized and projected for scoring by panels of lay persons and orthodontic residents. Statistical analysis consisting of nonparametric procedures showed that (1) as the initial skeletal discrepancies between the 4 groups worsened, the initial profiles were judged to be more unattractive (P <.001); (2) there was no perceived difference in the final profiles between the 4 groups; and (3) significantly greater improvement was measured for those with greater initial skeletal discrepancies (P <.05). This study demonstrated that, with appropriate and timely treatment with fixed orthodontic appliances and headgear, growing Class II Division 1 patients can undergo significant profile improvement, and, on average, even those more severely affected can achieve profile improvement so that they can be judged as attractive as those initially less severely affected.     

Orthodontic relapse in subjects with varying degrees of anteroposterior and vertical dysplasia.

Fifty seemingly well-treated orthodontic cases were studied by means of pretreatment, posttreatment, and postretention dental casts, lateral cephalograms, and other orthodontic records. The sample was restricted to cases exhibiting anteroposterior and/or vertical dysplasia as revealed by pretreatment dental casts. The sample was divided into a stable group and a relapse group. Each group contained twenty-five cases. A double-blind design was used. The raw data were analyzed by the stepwise discriminant analysis and by the multivariate analysis of variance. On the basis of the results obtained from this study, the following conclusions can be drawn: 1. In seemingly well-treated orthodontic cases, relapse or stability can neither be predicted nor judged from one set of records alone. 2. Relapse or stability of an orthodontic case can be predicted by comparing the posttreatment variables with the pretreatment variables. 3. Relapse or stability of an orthodontic case can be judged by comparing the postretention variables to the posttreatment variables. 4. The PP-GoGn angle and the mandibular intercanine width are the two most important variables associated with orthodontic relapse. 5. Changing the PP-GoGn angle, either by treatment or by growth, was associated with relapse. In other words, changes in the PP-GoGn angle tended to be unstable. This suggests that decreasing the PP-GoGn angle should be avoided. 6. In both the stable and the relapse groups, the mandibular intercanine width decreased postretention. This decrease was associated more with the relapse group than with the stable group. 7. The mandibular intercanine width tended to relapse toward its original pretreatment value. This suggests that, at the end of active treatment, the mandibular intercanine width should be maintained as originally presented. 8. There was no significant interaction between orthodontic relapse (or stability) and Angle Class I and II cases. 9. There was no significant interaction between relapse (or stability), of an orthodontic case, and the sex of the patient. 10. There was no significant interaction between orthodontic relapse (or stability) and whether or not extraction was included as a part of the mechanotherapy. Thus, the pretreatment deep overbite is not necessarily a contraindication to extraction.     

Treatment of Class II malocclusions with removable appliances. Part 2. Class II division 1 treatment

It is possible, with careful case selection, to achieve good orthodontic results using removable appliances, provided that they are well designed and properly adjusted. The best way to measure progress is to divide the treatment plan into stages, with each stage having recognisable objectives that must be achieved before moving on to the next stage.     

上颌单颌拨牙矫治安氏Ⅱ类1分类错He

目的 探讨上颌单颌拨牙矫治安氏Ⅱ类１分类错Ｈｅ的疗效、适应证和临床意义。方法 对１４例安氏Ⅱ类１分类错Ｈｅ患者采用上颌单颌拔牙模式进行矫治,将矫治前后的Ｘ线头影测量数据进行对比。结果 ①１－ＦＨ角减少１１．０３＾。,＾－１－ＭＰ角增加３．０７＾。;②下颌综合长度增加３．３０ｍｍ;③上、下唇突度分别减小２．６５ｍｍ和１．６４ｍｍ。上述测量项目矫治前、后的均值之间,差异具有显著性（Ｐ〈０．０５～０．０     

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.     

Treatment of a Class II division 1 anterior open bite malocclusion.

A case report of an 11-year-old Caucasian female who presented with a Class II div I anterior open bite malocclusion. Overjet is 6 mm and the anterior open bite 2 mm. There was a history of digit sucking till she was eight years old. She was successfully treated by non-extraction with pre-adjusted Edgewise appliances and high-pull headgear for a period of 27 months.     

Treatment of adult Class II division 2 patient with metal hypersensitivity

This case report describes the orthodontic treatment of an adult female with an Angle Class II division 2 malocclusion with a severe deep bite and a congenitally missing lower incisor. The use of available orthodontic devices and materials was limited because the patient had metal allergies. Following a careful examination and case analysis, the preadjusted edgewise appliances and the microscrew implants were placed after the upper first premolars were extracted. After active treatment, a good facial profile and occlusion were achieved. These results have been maintained for 2 years following completion of the active treatment.     

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.