平面与错畸形的关系

平面是颅面部错畸形矫治的基础,平面倾斜度将影响颌骨的生长发育、口腔功能、上下颌骨关系、牙齿咬合以及面部美观。各类错均存在不同程度的平面偏斜,本文就平面与错畸形检查、诊断、治疗计划设计关系的研究进展作一综述。     

Changes in occlusal force and occlusal contact area after active orthodontic treatment: a pilot study using pressure-sensitive sheets

The aim of this study was to investigate functional changes in occlusion during retention. Data on occlusal force (OcFr) and occlusal contact area (OcAr) was obtained using the pressure-sensitive sheet, from a treated group (20 female patients) who had had four premolar extractions and treatment with standard edgewise appliances, and a control sample who matched the treated group of retainer for sex, age and Angle classification at 1 year after removal. A repeated measures analysis of variance showed that the mean values of total OcFr and OcAr in the treatment group gradually increased during retention and were 669.3 N and 15.1 mm2, respectively, at 1 year after removal of retainer. The increases of OcFr and OcAr were larger in the molar region, especially at the second molar. At 1 year after removal of retainer, OcFr and OcAr in the second molar were significantly larger in the treatment group than in the control sample, and a similar distribution pattern of OcFr and OcAr to those in normal occlusion was seen. These results suggested that balanced OcFr and OcAr might be obtained during and after retention, due to the settling of molars that had been discluded by active orthodontic treatment.     

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咬合是口颌系统的重要功能,对引导口颌系统完成生理功能活动及维持全身健康具有重要作用。各种的畸形与紊乱,如错、牙体磨耗、牙体缺损、不良修复等均可引发咬合疾病,干扰作为临床上常见的咬合紊乱,被多数学者认为是导致口颌系统异常的因素之一。本文就干扰对口颌系统及全身健康的影响进行综述。     

Concern for dental appearance among Norwegian young adults in region with low uptake of orthodontic treatment

Abstract – The purpose of the present study was to examine orthodontic concern among orthodontically untreated young adults living in an area where the relative number of children receiving treatment was only 15–20% and to compare orthodontic concern among these individuals with that of untreated persons from an area with a higher treatment frequency. All the subjects were clinically examined and impressions for dental study casts, radiographs and photographs were taken. The subject's occlusion was classified according to two methods: 1) allocation to one of four groups according to the national Need for Orthodontic Treatment Index (NOTI), and 2) allocation to one of three groups according to presence or absence of six Anterior Occlusal Traits (AOT). Frequencies of NOTI scores demonstrated that in the study group more individuals were in need of treatment relative to the comparison group. Reported concern was at the same level in both groups, and significantly related to NOTI and AOT scores. The individuals in the area with the low treatment frequency were generally less aware of their anterior traits compared to the individuals in the area with a higher treatment frequency. The results indicated that a long-term low uptake of orthodontic treatment among children in the particular area was not accompanied by a similar increase in concern about own dental appearance in early adulthood.     

垫式舌侧矫治器矫治前牙反

目的：对舌侧矫治器进行改良,应用于前牙反的矫治,疗效好,临床操作简化。方法：制作＂联冠垫＂粘固在后牙牙冠上,成为＂固定垫＂,磨牙舌面管和前磨牙托槽埋于垫中和＂联冠垫＂合为一体,成为＂垫式舌侧矫治器＂。结果：6例患者治疗后磨牙关系中性,前牙覆覆盖正常,牙列整齐。结论：垫式舌侧矫治器矫治假性前牙反效果良好,椅旁操作时间减少。     

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目的探讨对于后牙缺失时间长,对颌牙伸长,垂直间隙过小病例的前期正畸治疗。方法对2004—2007年于西北民族大学医学院口腔科就诊的后牙缺失伴垂直间隙过小的修复患者8例,先采用正畸治疗方法压低伸长的对颌牙,调整咬合关系,恢复正常颌间距离,待时机成熟再做修复治疗。结果8例后牙间隙过小患者均得到了有效治疗,达到良好的咬合关系,治疗效果满意。结论对后牙间隙过小的病例,先通过正畸治疗压低伸长的对颌牙,再行修复治疗,能够取得满意的临床效果。     

Relationship between the flow of bolus and occlusal condition during mastication--computer simulation based on the measurement of characteristics of the bolus

The purpose of the present study was to clarify the relationship between the flow of a bolus and occlusal condition during mastication. First, the characteristics of a bolus under mastication was measured in subjects having different occlusal conditions. Secondly, the flow of a bolus between the upper and lower first molars under mastication was simulated using finite element non-linear dynamic analysis. Measurement of the elasticity of the bolus clarified the phenomenon of its communition. The measurement of the viscosity of the bolus clarified the phenomenon of its mixing with saliva. In addition, a relationship between the elasticity and the viscosity of the bolus at the point of just before swallowing was investigated. The flow of the bolus under mastication was revealed to vary according to the occlusal condition. These results suggest a close relationship between the occlusal condition, the flow of the bolus and its characteristics.     

An investigation of some factors associated with occlusal tooth wear in a selected high-wear sample

The aim of the present study was to investigate the influence of some factors associated with occlusal tooth wear in a selected high-wear Swedish sample. The material comprised 59 persons having a mean age of 35 yr within the range 16–70 yr, the criteria for selection being a full or near-full complement of natural teeth, and the presence of definite clinical signs of occlusal wear. A dentition wear index, in addition to anterior, posterior, and arch subindices, was derived from a tooth-by-tooth evaluation of casts. Factors which were found to correlate significantly with increased occlusal wear were age, sex, self-perception of wear, number of teeth, and general health, as well as a number of variables from study-cast analysis. On the basis of the findings, not only is the multifactorial etiology of occlusal tooth wear a reality, but so, too, is the complex interdependence of these factors in the severity of wear.     

Relationship between occlusal curvatures and mandibular deviation in orthodontic patients with temporomandibular disorders

The aim of this study was to investigate the relationships between occlusal curvature (OC) and frontal craniofacial morphology in patients with and without temporomandibular disorders (TMD), using frontal cephalograms and a sophisticated measuring device (XYZAX S400A). Thirty-seven female orthodontic patients (mean age 24.0 years) were divided into a TMD group (n = 25) and no-TMD group (n = 12). In the TMD group, the lateral OCs of the mandibular second premolar, and first and second molars were significantly deeper on the deviated side than on the non-deviated side, and the anteroposterior OCs of the mandibular second premolar and first molar were also significantly shallower on the deviated side. In the no-TMD group, however, there were no significant differences in OCs between deviated and non-deviated sides. The differences between right and left lateral OCs in the mandibular second premolar and first and second molars, as well as the anteroposterior OCs in the mandibular first and second molars, showed significant correlations with mandibular deviation in the TMD group. On the other hand, in the no-TMD group, there was no significant correlation between OCs and mandibular deviation. The above results suggest that OCs might try to compensate for mandibular deviation in patients with TMD.     

Psychological factors and perceptions of pain associated with dental treatment

Although pain during dental treatment has been identified as playing a major role in the onset of dental anxiety and is a major concern of patients when seeking dental care, there have been very few studies of the prevalence of pain during dental treatment and the factors associated with patients' perceptions of pain. This study used data from a longitudinal population-based study to assess the proportion of dental attenders who experienced pain while having dental treatment and the psychological characteristics which predisposed them to experience pain. Of 1422 subjects who completed questionnaires at baseline and five-year follow-up, 96.4% had visited a dentist over the observation period. Two fifths, 42.5%, reported having pain during treatment and one-fifth, 19.1%, had pain that was moderate to severe in intensity. Reports of pain were associated with the types of treatment received, and a number of baseline sociodemographic and psychological factors. In a logistic regression analysis predicting the probability of pain, a variable documenting the number of types of invasive treatment received (restorations, extractions, crowns/bridges, root canal therapy and periodontal treatment/surgery) had the strongest independent effect. Pain was also more likely to be reported by those with previous painful experiences and those who were anxious about dental treatment, expected treatment to be painful and felt that they had little control over the treatment process. Pain was less likely to be reported by those who said they were unwilling to accept or tolerate pain. Younger subjects and those with higher levels of education were more likely to report pain than older subjects and those with a lower educational level. These results indicate that pain is as much a cognitive and emotional construct as a physiological experience. They also have implications for dentists' behaviour when providing dental care.     

老年病人磨牙缺失后前磨牙楔形缺损和面磨耗的临床研究

目的:研究前磨牙楔形缺损和面磨耗在磨牙缺失老年病人的发生情况。方法:收集磨牙缺失而前磨牙保留完整的老年病人22例,共174个前磨牙,观察并记录前磨牙楔形缺损和面磨耗的情况。研究设置对照组,即双侧后牙牙弓完整的老年病人20例,共160个前磨牙。比较两组楔形缺损和面磨耗的发生情况并进行统计学分析。结果:磨牙缺失组中,前磨牙2度以上楔形缺损144个,检出率83%,面磨耗至牙本质暴露112个,检出率64%。对照组中,2度以上楔形缺损的前磨牙81个,检出率为51%,牙合面磨耗至牙本质暴露66个,占检出率41%。统计结果显示:磨牙缺失组前磨牙楔形缺损和面磨耗的检出率明显高于对照组(P<0.05)。结论:老年病人磨牙缺失发生楔形缺损和面磨耗较后牙牙弓完整者可能性高。力过大可能是导致前磨牙楔形缺损和面磨耗加重的一个重要原因。     

对伴有牙列拥挤牙周病的治疗体会

目的:探讨牙周炎伴牙列拥挤病人在常规牙周治疗和正畸治疗后的牙周改善情况。方法:对55例伴牙列拥挤、创伤等的牙周炎病人进行常规牙周治疗和正畸治疗,比较治疗前后病人的菌斑指数、软垢指数和牙石指数。结果:菌斑指数、软垢指数和牙石指数在单一牙周治疗后6个月与治疗前无显著性差异(P>0.05),而正畸治疗和牙周治疗6个月后与治疗前比较有非常显著性差异(P<0.05)。结论:对伴有牙列拥挤的牙周病,必须通过正畸来改善牙周环境,才能有效治疗。     

Talon cusp causing occlusal trauma and acute apical periodontitis: report of a case

Abstract  – The talon cusp, or dens evaginatus of anterior teeth, is a relatively rare dental developmental anomaly characterized by the presence of an accessory cusp-like structure projecting from the cingulum area or cemento–enamel junction. This occurs in either maxillary or mandibular anterior teeth in both the primary and permanent dentition. One of the main problems caused by accessory cusps are occlusal interferences. The anomalous cusp even can generate occlusal trauma and reversible acute apical periodontitis of the opposing tooth. This article reports a case of talon cusp affecting the permanent maxillary left lateral incisor that caused clinical problems related to occlusal trauma and apical periodontitis caused by a premature contact. The treatment of the occlusal interference produced by the taloned tooth is described.     

重度磨耗牙垂直距离评估与固定修复

目的:探讨重度磨耗牙垂直距离的变化与固定修复方法的选择.方法:对65例129颗重度磨耗牙,根据垂直距离有无变化,分为三类修复:①重度磨耗牙,垂直距离未减小,(牙合 )龈距离尚能进行常规固定修复;②重度磨耗牙,垂直距离未减小,(牙合)龈距离不足进行常规固定修复;③重度磨耗牙伴有垂直距离减小,(牙合)龈距离不足进行固定修复...     

牙列缺损伴重度磨耗的咬合重建序列治疗体会

目的：评价牙列缺损伴重度磨耗的咬合重建序列治疗的效果。方法：选取牙列缺损伴重度磨耗患者36例,采用固定-活动联合修复方法实施咬合重建,通过3年随访,观察临床修复效果。结果：咬合重建后36例患者取得较满意疗效。结论：有序、合理的咬合重建治疗可以恢复患者正常的咀嚼功能,缓解颞下颌关节紊乱病及牙齿敏感,改善美观。     

垫式舌侧矫治器矫治前牙反的疗效观察

目的:将舌侧矫治器进行改良,以达到简化临床操作提高治疗前牙反疗效的目的。方法:制作联冠垫作为固定垫,磨牙舌面管和前磨牙托槽埋于垫中与联冠垫合二为一,成为垫式舌侧矫治器。选择假性前牙反病人30例,统计病人主动治疗时间和反解除时间,治疗前后摄头颅侧位定位片进行头影测量分析,并对软硬组织变化情况进行配对t检验。结果:30例病人治疗后磨牙关系中性,前牙覆覆盖正常,牙列整齐,反解除时间2~5个月,平均3.13个月。X线头影测量数据显示上下颌骨和上下前牙有一定的改变。结论:垫式舌侧矫治器矫治假性前牙反效果良好,并缩短了椅旁操作时间。