Twin-block矫治器治疗早期骨性II类错牙合的X线头影测量分析

目的:分析Twin-block矫治器治疗早期骨性II类错牙合的牙颌形态变化,并探讨其适应证。方法:21例早期骨性II类错牙合患者(5°相似文献   

Bionator和Twin-block矫治器治疗Ⅱ类错疗效比较

目的比较Bionator与Twin-block两种功能性矫治器治疗下颌后缩Ⅱ类错颌骨及牙的变化。方法选择替牙期、恒牙早期Ⅱ类错患者20例(男7例,女13例),平均年龄11岁2个月,随机分成两组,每组10例,第1组采用Bionator治疗,第2组采用Twin-block治疗,分别对治疗前后头颅侧位定位片进行分析比较。结果Bionator对Ⅱ类错上颌骨的抑制作用大于Twin-block(P<0.05);两者对下颌骨均有刺激生长作用,两组间无显著性差异;两者均产生上前牙舌倾、下前牙唇倾作用,但Bionator产生的上前牙舌倾较Twin-block更明显(P<0.05);Bionator产生上颌第一磨牙远中移动效应,Twin-block产生较明显的下颌第一磨牙垂直向的伸长及水平向的近中调整,这些变化两组间差异均有显著性(P<0.05)。结论Bionator与Twin-block两种功能性矫治器均能有效地矫治Ⅱ类错,刺激下颌骨向前生长,Bionator抑制上颌骨向前生长更有效,其产生的上前牙舌倾、下前牙唇倾明显,Twin-block产生明显的下颌第一磨牙垂直向及水平向的调整。     

Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions

Objectives:The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group.Materials and Methods:Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models.Results:Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = −1.925°, P < .0001; FH-NA = −3.042°, P < .0001; linear measurement A-point to Vertical Reference = −3.859 mm, P < .0001) and reduction of the ANB angle (−1.767°, P < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term.Conclusions:One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.     

Twin-block矫治器对骨性Ⅱ类错儿童早期矫治的疗效分析

目的 分析Twin-block矫治器治疗生长发育期骨性Ⅱ类错儿童的临床疗效,探讨其机制。方法 选择生长发育期骨性Ⅱ类患者20例（男9例,女11例）,进行Twin-block功能矫治。所有患者治疗前后拍摄X线头颅侧位片,应用Pancherz分析法测量患者治疗前后硬组织指标变化情况,同时,测量治疗前后的上气道线距变化,采用配对t检验检测治疗前后各指标差异。结果 Twin-block治疗前后,ss/OLP、pg/OLP明显增大, Co/OLP和前牙覆盖明显减小, Go-Me长度明显增加,磨牙关系明显改善,有统计学意义（P<0.05）,其余各参数无统计学差异。气道测量值Adl-PNS、Ad2-PNS、Mcnamara线、U-MPW、TB-TPPW治疗后均有增大,差异有统计学意义（P<0.05）。结论 Twin-block功能矫治器能有效地改善骨性Ⅱ类患者的咬关系和侧貌,可以有效增加上气道各段前后径长度,这些变化主要由髁突前移导致的下颌骨生长发育所致。     

Twin-block矫治器矫治青少年安氏Ⅱ类1分类错(牙合)疗效的系统评价

目的:评价Twin-block矫治器治疗青少年安氏II类1分类错(牙合)畸形的有效性.方法: 计算机检索PubMed(1966～2008.9)、Cochrane library(2008 年第3 期)、Embase(1984～2008.9.);中国生物医学文献数据库(CBM)(1978～2008.9)、中国期刊全文数据库(CNKI)(1994～2008.9)、中文科技期刊数据库(VIP)(1994～2008.9).手工检索中华口腔医学杂志(1994～2008)等5 种中文期刊.纳入Twin-block矫治器治疗青少年安氏II类1分类错(牙合)畸形的随机对照试验(RCT).纳入研究按照Cochrane Reviewer's Handbook 4.2.6随机对照试验的质量标准评价.统计分析采用RevMan5.0.0版软件.结果:共纳入4个RCT,289 例受试者.Meta分析显示和对照组相比,治疗组患者的覆(牙合)、覆盖、ANB角、Ls-E有明显减小;SNB、Ar-Gn、鼻唇角、颏唇角有明显增大,差异在2 组之间有统计学意义,但在SNA、Li-E变化方面,尚无差别.结论:Twin-block矫治器治疗青少年安氏II类1分类错(牙合)畸形,能明显减小覆盖、覆(牙合),促进下颌生长,而对上颌发育的抑制作用不明显.尚需要更多高质量、大样本的RCT进一步验证Twin-block矫治器的疗效.     

固定式Twin-block矫治青春期骨性II类错的临床效果评价

目的: 评价固定式Twin-block矫治器的固位效果及治疗青春期骨性Ⅱ类错的临床疗效。方法: 选取26例（男12例,女14例）青春期骨性Ⅱ类1分类错畸形患者（年龄11~13岁,平均11.8岁）,采用固定式Twin-block矫治器引导下颌骨前伸,疗程1年。治疗前、后拍摄头颅定位侧位片,观察患者的骨性、牙性及软组织变化。采用Graphpad Prism 6.0软件对治疗前、后数据进行配对t检验。结果: 治疗中未出现矫治器松动、破坏,所有病例侧貌获得明显改善。发生显著变化的指标有:下颌骨长度和位置（Co-Gn、SNB、ANB、Pog-VL、Pos-VL）,上前牙位置和倾斜度（U1-VL、U1-SN）,下牙列矢状向位置（L1-VL、L6-VL）（P<0.05）;变化不显著的指标有:下颌平面角（MP-SN）,上颌骨位置和长度（SNA、A-VL）,上前牙垂直向位置（U1-HL）,上后牙位置（U6-VL、U6-HL）,下前牙倾斜度（IMPA）,下牙列垂直向位置（L6-MP、L1-MP）（P>0.05）。结论: 固定式矫治器Twin-block可增强下颌支抗,有效促进下颌骨生长,改善患者侧貌。     

下颌前导矫形与单纯拔牙矫治对骨性Ⅱ类错颌畸形的疗效评价

目的：通过X线头影测量分析,评价前导矫形联合固定矫治器矫治和单纯拔牙固定矫治对生长发育期安氏Ⅱ类骨性错颌畸形的临床疗效。方法 选取31例生长发育期安氏Ⅱ类错颌畸形伴下颌后缩的病例。其中,18例采用Ⅰ期固定式Twin-block矫治器联合Ⅱ期固定矫治;13例采用传统的单纯拔牙后使用直丝弓矫治器进行治疗。在治疗前、Twin-block矫治完成后以及全部固定矫治结束后拍摄X线头颅侧位片,利用Pancherz测量分析法进行分析,使用SPSS15.0软件包分别比较前导矫形组、单纯拔牙组治疗前后的组内差异以及2组的组间差异。结果 前导矫形组下颌骨长度增加并向前移动,上切牙相对于上颌骨的位置向后方移动,下切牙、下颌第一恒磨牙相对于下颌骨的位置均向前方移动,覆盖减小（P<0.05）。单纯拔牙组上、下颌骨的位置、髁突位置及下颌骨的长度治疗前后均无显著变化。在前牙覆盖的纠正中,前导组牙性因素占39.5%,骨性因素占60.5%,拔牙组牙性因素占86.9%,骨性因素占13.1%;在磨牙关系的纠正中,前导组牙性因素占44.9%,骨性因素占55.1%,拔牙组牙性因素占90.3%,骨性因素占9.7%。结论 前导矫形联合固定矫治与单纯拔牙固定矫治相比,在治疗生长发育期骨性Ⅱ类下颌后缩的患者中,疗效近似,但能更显著地改善患者的骨性侧貌。     

Twin-block矫治器治疗安氏Ⅱ类1分类错的软硬组织变化

目的探索安氏Ⅱ类1分类错畸形在应用Twin-block矫治器治疗后软硬组织侧貌的变化。方法将50例处于生长发育高峰前期或高峰期的安氏Ⅱ类1分类错患者分为2组,治疗组（27例）接受Twin-block矫治器治疗,对照组（23例）不进行治疗,随访观察。对2组治疗（观察）前后的X线头影测量数据进行统计学分析。结果软组织指标中治疗组Ls-E、Li-E、U1-Stms、Stms-Stmi、NsLs-FH、LsNsLi、LsNsPg’、H角减小;Sn-Stms、Stmi-Me’、Ns-Me’、Sn-Me’、NsLi-FH、NsPg’-FH、A’Ls-FH、B’Li-FH、LiB’Pg’、CmSnLs、GSnPg’、Z角增大,与对照组比较有统计学差异（P<0.05）。硬组织指标中治疗组SNB、L1-NB、IMPA增大;ANB、U1-SN、U1-NA、FMIA减小,与对照组比较有统计学差异（P<0.05）。结论Twin-block矫治器可显著改善下颌后缩患者上下颌骨的矢状关系,促进面下1/3高度的生长,使软组织侧貌趋于直面型。     

Twin-block矫治器治疗安氏Ⅱ类骨性错后的软、硬组织变化

目的:探讨Twin-block矫治器早期矫治对安氏Ⅱ类骨性错患者软、硬组织的影响。方法:前瞻性选择60例安氏Ⅱ类骨性错患者为研究对象,应用随机数字表法将患者分为2组,每组各30例。实验组采用Twin-block联合直丝矫治器治疗,对照组采用直丝矫治器治疗。观察2组矫治前、矫治后12个月、36个月硬组织指标（SNA、SNB、ANB、U1-NA夹角、U1-NA距离、L1-NB距离、L1-NB夹角、U1-L1夹角）和软组织测量指标[UL-U1、LL-L1、覆盖（over jet）、覆（overbite）、上唇突点至E 线的垂直距离（E-upper-lip）、下唇突点至E 线的垂直距离（E-lower-lip）、颏沟倾角、颏软组织厚度]的变化。采用SPSS 25.0软件包对数据进行统计学分析。结果:实验组矫治后12个月、36个月U1-NA、U1-NA、L1-NB、L1-NB、覆盖、覆、E-upper-lip、E-lower-lip显著小于对照组（P<0.05）,U1-L1、鼻唇角、颏沟倾角、颏软组织厚度显著大于对照组（P<0.05）。结论:Twin-block联合直丝矫治器可显著改善安氏Ⅱ类骨性错患者口颌以及面部软、硬组织关系,远期效果良好。     

Comparison of oropharyngeal airway dimensional changes in patients with skeletal Class II and Class III malocclusions after orthognathic surgery and functional appliance treatment: A systematic review

ObjectiveTo compare the dimensional changes in the oropharyngeal airway in patients with skeletal Class II and Class III malocclusion before and after orthognathic surgery and treatment with a functional appliance.MethodsThe protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and was registered to the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42020170901. Furthermore, the reporting of the present SR was performed based on the PRISMA checklist.ResultsThe use of removable functional appliances increased the volume of the oropharyngeal airway in patients with skeletal Class II malocclusion. Furthermore, the increase in the volume of the oropharyngeal airway following the removable functional appliance treatment was more than that observed after fixed functional appliance treatment in growing patients. For patients with skeletal Class III malocclusion, who underwent the bimaxillary orthognathic surgery, resulted in no change in the dimensions of the oropharyngeal airway.ConclusionGrowing patients who receive removable functional appliance treatment have a more favorable long-term prognosis with regard to the oropharyngeal airway when compared with those who receive fixed functional appliance. Alternatively, in patients aged from (18–22) years with skeletal class III malocclusion Bimaxillary orthognathic surgery was found to be the recomended and superior method of treatment.     

Twin-block功能矫治联合固定矫治对安氏II类患者骨性指标及牙（牙合）指标的影响

目的 探究Twin-block功能矫治联合固定矫治对安氏Ⅱ类患者骨性指标及牙(牙合)指标的影响。方法 选取我院自2017年6月至2020年12月期间收治的53例安氏Ⅱ类患者为研究对象，按照随机数字表法分为观察组和对照组，对照组（n=26）给予常规固定矫治治疗，观察组（n=27）在对照组基础上加以Twin-block功能矫治治疗，比较两组的面颌骨组织矫治效果、牙(牙合)矫治效果、气道改善效果、矫治时间及随访复发情况。结果 两组患者FH-NPo、Go-Me、Ar-Go、N-Me、S-Go、SNB、IMPA、NLA值均显著增大（P <0.05）,SNA、ANB、U1-NA、L1-MP值均显著减小（P <0.05），患儿PAR指数各指标评分及总分均显著降低（P <0.05），气道体积与气道横截面积均显著增加（P <0.05），且观察组上述矫治指标改善显著优于对照组（P <0.05）；观察组平均矫治时间显著低于对照组（t=3.925,P <0.05）。结论Twin-block功能矫治联合固定矫治可显著改善安氏Ⅱ类患者面颌部骨组织发育，促进牙齿正常建(牙合)，扩...     

A prospective controlled evaluation of Class II division 1 malocclusions treated with fixed lingual mandibular growth modificator

Objective: To assess the net dentofacial effects of the fixed lingual mandibular growth modificator (FLMGM).Materials and Methods:The study sample comprised 38 patients with Class II/1 malocclusion and retrognathic mandible. All were in the pubertal growth spurt. Whereas FLMGM was applied to the treatment group (n  =  21, mean age  =  13.2 years), no treatment was performed on the control group (n  =  17, mean age  =  12.5 years). Skeletal and dentoalveolar changes were assessed on digital lateral cephalograms obtained at the beginning and end of the treatment/observation period of 8 months. Paired and independent t-tests were used to assess the differences within and between groups.Results:Maxillary growth was not affected by FLMGM treatment, which resulted in a significant overjet reduction of 4.1 mm, an increase in total mandibular length (Co-Gn) of 2.3 mm, chin advancement of 1.6°, and upper incisor retroclination of 4.0°. A reduction of 2.4° in ANB was largely due to an increase of 1.8° in SNB. Favorably, the lower incisors were obviously retroclined by 4.5°. The changes in the vertical skeletal relationships were negligible.Conclusion:FLMGM was effective in treating growing Class II/1 patients and produced favorable dentofacial effects, with the matched untreated sample showing minimal changes. Lower incisor retroclination was a benefit of FLMGM treatment.     

Class II malocclusion treatment effects with Jones Jig and Distal Jet followed by fixed appliances

Objectives:To compare the skeletal, dentoalveolar, and soft tissue changes in Class II malocclusion patients treated with Jones Jig and Distal Jet distalizers followed by fixed appliances.Materials and Methods:The experimental groups comprised 45 Class II malocclusion subjects divided into two groups. Group 1 consisted of 25 patients treated with the Jones Jig, and group 2 consisted of 20 patients treated with the Distal Jet. Group 3 comprised 19 untreated Class II subjects. Cephalograms were analyzed before and after orthodontic treatment. For intergroup comparisons, one-way analysis of variance and post hoc Tukey tests were performed.Results:During treatment, the experimental groups exhibited significant increases in occlusal plane inclination and maxillary second molar mesial tipping. Additionally, the molar relationship improved and overjet decreased significantly in the experimental groups. The Jones Jig group showed greater mandibular incisor proclination and greater overbite reduction than the control group. No significant intergroup differences in nasolabial angle changes were found.Conclusions:Treatment protocols using the Jones Jig and Distal Jet followed by fixed appliances were effective in correcting Class II malocclusion by means of dentoalveolar changes without significant skeletal and soft tissue changes. The experimental groups showed occlusal plane clockwise rotation and greater mesial tipping of maxillary second molars when compared to the untreated group.     

安氏Ⅱ类1分类拔牙病例正畸治疗后后牙关系的稳定性研究

目的　探讨安氏Ⅱ类1分类患者正畸治疗前、后后牙关系的变化趋势,分析可能影响后牙关系复发的因素。方法　选取采用拔牙治疗的安氏Ⅱ类1分类患者29例,其中男12例,女17例。根据ANB角进一步分为牙性Ⅱ类14例,骨性Ⅱ类15例。分别对其正畸治疗前、后进行模型测量和X线头影测量。结果　所有患者的Ⅱ类磨牙关系在治疗后均得到明显改善,随访时仅有少量复发。牙性Ⅱ类患者治疗后下磨牙近中移动量(4·52±2·15) mm,大于上磨牙移动量(3·62±2·62)mm,而骨性Ⅱ类患者上下磨牙近中移动量相似,但ANB角由治疗前的(6·27± 1·08)°明显减小为(4·64±1·17)°。随访时两类错患者上下颌磨牙均近中移动,且上颌磨牙移动量大于下颌磨牙。多元回归分析提示下颌骨水平向生长和上前牙不齐指数与磨牙关系复发有关。结论　Ⅱ类错患者正畸治疗后磨牙关系较为稳定。牙性Ⅱ类错磨牙关系的解除有赖于上下颌磨牙相对移动调整,骨性Ⅱ类错则依靠上下颌骨间位置关系的改变。有利的下颌生长型和上颌前牙不齐程度等与磨牙关系的保持有密切关系。     

Treatment effects produced by the Twin-block appliance vs the Forsus Fatigue Resistant Device in growing Class II patients

Objective:To compare the dentoskeletal changes produced by the Twin-block appliance (TB) followed by fixed appliances vs the Forsus Fatigue Resistant Device (FRD) in combination with fixed appliances in growing patients having Class II division 1 malocclusion.Materials and Methods:Twenty-eight Class II patients (19 females and 9 males; mean age, 12.4 years) treated consecutively with the TB followed by fixed appliances were compared with a group of 36 patients (16 females and 20 males; mean age, 12.3 years) treated consecutively with the FRD in combination with fixed appliances and with a sample of 27 subjects having untreated Class II malocclusion (13 females and 14 males; mean age, 12.2 years). Mean observation interval was 2.3 years in all groups. Cephalometric changes were compared among the three groups by means of ANOVA and Tukey''s post hoc tests.Results:The FRD produced a significant restraint of the maxilla compared with the TB and control samples (SNA, −1.1° and −1.8°, respectively). The TB sample exhibited significantly greater mandibular advancement and greater increments in total mandibular length than either the FRD or control groups (SNB, 1.9° and 1.5°, respectively; and Co-Gn, 2.0 mm and 3.4 mm, respectively). The FRD produced a significantly greater amount of proclination of the mandibular incisors than what occurred with the TB or the control samples (2.9° and 5.6°, respectively).Conclusion:The TB appliance produced greater skeletal effects in terms of mandibular advancement and growth stimulation while the Forsus caused significant proclination of the mandibular incisors.     

功能和固定矫治器联合矫治安氏Ⅱ类1分类骨性错畸形

目的 通过对功能和固定矫治器联合矫治恒牙列早期安氏Ⅱ类1分类骨性错(牙合)畸形的研究,探讨发育期骨性错(牙合)畸形一期矫治的优越性。方法 应用双(牙合)垫矫治器或斜面导板结合方丝弓矫治器对12例恒牙列早期安氏Ⅱ类1分类骨性错(牙合)联合矫治,对治疗前后头颅侧位定位片进行分析。结果 SNB角增加1.28°,FMA角无明显改变,OP-SN值变大,Go-Pog、Go-Ar都呈显著性增大,前牙覆盖减少7.26mm,上下唇至审美平面距离显著减小。结论 利用功能矫治器和固定矫治器联合一期矫治恒牙列早期安氏Ⅱ类1分类骨性错(牙合),,同样可收到双期矫治的效果。     

骨性安氏Ⅲ类错下颌单颌手术后软硬组织的变化

目的:探讨正畸-正颌联合治疗成人骨性安氏Ⅲ类错,上、下颌软、硬组织的变化及其变化的相关性。方法:选取骨性安氏Ⅲ类错患者20例,手术前、后拍摄X线头颅侧位片,手术方式为双侧下颌骨矢状劈开截骨术(BSSRO)。采用SPSS13.0软件包对数据进行配对t检验。结果:治疗后SNB、B点和Pog点到Y轴的距离变小,ANB变大;软组织颏唇角、TLL点、SB点和TC点到Y轴的距离均变小,且均有显著差异(P<0.01)。SB点到Y轴的距离与B点到Y轴的距离存在线性关系,比值为1∶1,决定系数R2=0.96;TC点到Y轴的距离与Pog点到Y轴的距离比为0.84,决定系数R2=0.97。结论:单纯下颌前突患者经正畸和BSSRO治疗后,上颌软组织无明显变化,上、下唇长度不受影响。颏前点软组织与骨组织变化比值为0.84,颏唇沟点为1:1,相关强度均在0.9以上。     

Twin-block矫治下颌后缩患者前、后的气道变化

目的: 探讨安氏Ⅱ类1分类下颌后缩患者Twin-block矫治前、后上气道的变化,观察不同舌位置患者矫治前、后气道的变化。方法: 选择下颌后缩的安氏Ⅱ类1分类患者33例,平均年龄（11.3±0.89）岁,分为对照组（12例）和试验组（21例）,试验组按锥形束CT（CBCT）显示的舌位置又分为舌低位组及舌高位组。试验组使用Twin-block矫治器进行治疗,对照组不矫治。试验组于治疗前及治疗8个月后拍摄CBCT,对照组在第1个月和第8个月拍摄CBCT。利用Dolphin软件对收集的数据进行三维重建,并测量口咽处气道体积以及最小横截面积的变化。采用SPSS 24.0软件包对数据进行配对t检验和单因素方差分析。结果: 8个月后,对照组口咽处气道体积及最小横截面积均无显著变化,而试验组口咽处气道体积及最小横截面积均显著增大（P<0.001）。舌高位组气道体积及最小横截面积比治疗前显著增加（P<0.01）,舌低位组气道体积及最小横截面积与治疗前相比也显著增加（P<0.05）。结论: Twin-block能够显著增加安氏Ⅱ类1分类下颌后缩患者口咽处气道体积及最小横截面积;下颌前移与气道改善不呈正相关,但在前移过程中,舌位正常有助于气道开放。     

Bionator矫治器矫治Ⅱ类1分类错(牙合)的软硬组织变化

目的：研究Bionator矫治器治疗安氏Ⅱ类1分类下颌后缩骨性错[牙合]的效果。方法：对12例患儿矫治前后软硬组织变化行x线头影测量分析。结果：①Bionator矫治器对上颌骨生长无明显的抑制作用；②使用Bionator矫治器可使下颌体及下颌升支长度明显增长，使下颌生长方向有利于软硬组织侧貌面型的改善；③Bionator矫治器可减少安氏Ⅱ类1分类骨性错[牙合]患者的上前牙唇向倾斜，上下前后牙槽高度均增加。结论：Bionator矫治器对安氏Ⅱ类1分类下颌后缩的骨性错[牙合]有较好的治疗效果。     

成人轻度骨性Ⅲ类错牙合不同拔牙模式矫治的侧貌分析

目的：比较不同拔牙模式矫治的轻度骨性Ⅲ类错牙合成人患者的侧貌变化。方法：选择40例诊断为设计拔除4个前磨牙或第三磨牙矫治的轻度骨性III类错牙合的成人病例,分为两组,每组各20例。用头影测量分析法比较矫治前后的变化以及软硬组织的相关性。结果：拔除前磨牙组变化主要在于内收上下前牙。拔除第三磨牙组在于唇倾上前牙,软组织改变分别是内收下唇和唇倾上唇代偿（P<0．05）。软硬组织的变化具有一定相关性（P<0．05）。结论：不同拔牙模式对轻度骨性Ⅲ类错牙合患者矫治后侧貌的改变是有差别的,但在一定程度上都能改善凹面型和颏部形态。