上下颌唇挡对替牙晚期儿童牙(牙合)的影响

目的研究上下颌唇挡同时应用对替牙晚期儿童牙(牙合)的影响.方法选择替牙晚期上下牙列轻度或中度拥挤患儿12例,上下颌均采用唇挡治疗8个月,进行治疗前后X线头影测量分析和模型测量分析,并对治疗前后的测量值变化进行配对t检验.结果唇挡治疗后,SNA、SNB分别增加1.02°和0.97°(P＜0.05),上下切牙前移均是牙冠向近中倾斜,而根尖相对固定的控制性倾斜,旋转中心接近根尖.上下磨牙远中倾斜效果不同,上磨牙远中倾斜直立,旋转中心接近牙冠;下磨牙远中倾斜移动,旋转中心接近阻抗中心;上颌磨牙间牙弓宽度、牙弓周径分别增加4.12mm和5.09mm(P＜0.01),下颌磨牙间牙弓宽度、牙弓周径分别增加4.07mm和6.86mm(P＜0.01).结论在儿童生长发育高峰期,唇挡可有效地引起上下颌牙弓横向和纵向变化,减轻或解除上下牙弓拥挤.     

正常he儿童软组织侧貌X线头影测量研究

目的 建立长春市正常he少年儿童软组织X线头影测量正常值标准，研究软组织侧貌发育的特征。方法 对104例正常he样本做X线头影测量分析，得出其正常值。对其颌面部软组织侧貌做性别上的特征性分析。结果 得出Holdaway、Burstone、Bishara三种分析法的正常值及其他测量项目的正常值。结论 虽然男女软组织侧貌发育特征很相近，但仍存在一定差异。了解正常he人群软组织侧貌的发育特征，有助于临床诊断及矫治计划的制定。     

正常儿童软组织侧貌X线头影测量研究

目的　建立长春市正常牙合少年儿童软组织X线头影测量正常值标准 ,研究软组织侧貌发育的特征。方法　对 10 4例正常牙合样本做X线头影测量分析 ,得出其正常值。对其颌面部软组织侧貌做性别上的特征性分析。结果　得出Holdaway、Burstone、Bishara三种分析法的正常值及其他测量项目的正常值。 结论　虽然男女软组织侧貌发育特征很相近 ,但仍存在一定差异。了解正常牙合人群软组织侧貌的发育特征 ,有助于临床诊断及矫治计划的制定。     

正常藏族人软组织侧貌分析

本研究对１００名正常藏族人的软组织侧貌进行了计算机—Ｘ线头影测量分析研究，建立了藏族人软组织Ｘ线头影测量的正常值和标准差，并对其形态结构特征进行了分析。结果表明：正常藏族人男女之间软组织侧貌有较大差异，面部厚度和高度男性大于女性，藏族人男性唇部和面中部软组织侧貌比女性明显突出     

腭裂术后患者软组织侧貌特征研究

目的 :研究于幼年接受腭裂修复术患者的软组织侧貌的形态特征。方法 :采用X线头影测量方法 ,对 5 5例患者进行测量 ,并与正常人测量值比较分析。结果 :研究对象的上、下面高度比值增大 ,上唇短小 ,上唇突度减小 ,颏底软组织厚度增大。结论 :腭裂术后患者软组织侧貌呈现明显畸形 :上、下面高度比失调 ,上唇短小、后移 ,颏底软组织臃肿     

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.     

正常(牙合)儿童软组织侧貌X线头影测量研究

目的建立长春市正常(牙合)少年儿童软组织X线头影测量正常值标准,研究软组织侧貌发育的特征.方法对104例正常(牙合)样本做X线头影测量分析,得出其正常值.对其颌面部软组织侧貌做性别上的特征性分析.结果得出HoIdaway、Burstone、Bishra三种分析法的正常值及其他测量项目的正常值.结论虽然男女软组织侧貌发育特征很相近,但仍存在一定差异.了解正常(牙合)人群软组织侧貌的发育特征,有助于临床诊断及矫治计划的制定.     

成年胯裂患者软组织侧貌X线头影测量研究

目的 研究成年时尚未接受手术治疗的腭裂患者软组织侧貌的形态特征。方法 采用X线头影测量方法，对49例成年腭裂患者软组织侧貌进行测量，并与正常人进行比较分析。结果 腭裂患者的上、下面高度比例协调，接近正常，上唇长度、唇间隙减小，下唇增长，颏唇沟深度无明显变化。结论 未手术成年腭裂患者软组织侧貌的畸形主要表现在面下部，即上、下唇长度比例失调。     

腭裂术后患者软组织侧貌特征研究

目的：研究于幼年接受腭裂修复术患者的软组织侧貌的形态特征。方法：采用X线头影测量方法,对55例患者进行测量,并与正常人测量值比较分析,结果：研究对锡的上、下面高度比值增大,上唇短小,上唇突度减小,颏底软组织厚度增大。结论：腭裂术后患者软组织侧貌呈现明显畸形：上、下面高度比失调,上唇短小、后移、颏底软组织臃肿。     

多曲钢丝唇挡对替牙期和恒牙初期上颌牙弓的影响

目的 研究多曲钢丝唇挡矫治器对上颌牙弓的影响。方法 选择安氏Ⅱ类错(牙合),第二恒磨牙未萌出,前牙拥挤Ⅰ～Ⅱ°患者15例,采用多曲钢丝唇挡治疗并对其矫治前后X线头颅侧位定位片和模型进行测量分析。结果 上颌牙弓长度增加3.43mm。磨牙向远中移动,切牙唇向移动。牙齿移动主要为倾斜移动。上颌磨牙区、第一前磨牙区、尖牙区的牙弓宽度均增加,平均分别达5.87mm、2.71mm和1.92mm。结论 多曲钢丝唇挡是一种有助于解除轻中度牙列拥挤的口内装置之一。     

配合上颌前牙微种植体支抗矫治开唇露齿的临床研究

目的：探讨配合上颌前牙微种植体支抗治疗开唇露齿的临床效果。方法：选取18例开唇露齿正畸治疗患者,分为实验组A（前后3枚种植支抗）9例和对照组B（传统Nance托支抗）9例。测量治疗前后头颅定位侧位片的相关软硬组织指标,使用SPSS15.0进行统计分析。结果：1）牙齿位置：A组前牙切端内收量及切牙显露程度的减少显著大于B组（P〈0.01）,切牙根尖（P〈0.05）及磨牙前移量（P〈0.01）显著小于B组。垂直向A组前牙被明显压低,B组升长,P〈0.01;后牙A组保持,B组升高,P〈0.05。2）骨组织：A组上齿槽缘点处骨吸收改建显著大于B组（P〈0.05）。结论：使用前后牙区3枚微种植体支抗,对上前牙内收、压低及控根作用均强于传统强支抗,能有效改善开唇露齿。     

多曲唇挡的设计、作用及临床应用

目的：探讨多曲唇挡的设计原理、制作、适应证和功能。方法：①介绍多曲唇挡的设计原理和制作。②通过对两例使用多曲唇挡典型病例的介绍,总结多曲唇挡的适应证和功能。结果：多曲唇挡可以起到缺隙保持器、Ｆｒａｅｎｋｅｌ矫治器和增强支抗或推磨牙向后等作用。结论：多曲振挡适应范围广,可以２４ｈ戴用,制作简便,并可预成,患者戴用舒适、隐蔽。     

Karapandzic Flap in Reconstruction of Post-traumatic Lower Lip Defects: Report of Two Cases

Reconstruction of lower lip is a challenge to the surgeon who seeks excellence in restoration of both aesthetics and functions. The defects may arise either due to trauma, developmental anomaly or post-excision of malignant conditions. The reconstruction of rectangular shaped full thickness defects of lip may be achieved with bilateral advancements of the remaining lip segments. We report two cases with post-traumatic full thickness avulsion of central two third of lower lip, reconstructed with Karapandzic flap.     

Reproducibility of maxillofacial landmark identification on three-dimensional cone-beam computed tomography images of patients with mandibular prognathism: Comparative study of a tentative method and traditional cephalometric analysis

Objective:To clarify the reproducibility of a tentative method for identifying maxillofacial landmarks on three-dimensional (3D) images obtained with cone-beam computed tomography (CBCT) for dental use in patients with mandibular prognathism. Also, the influence of level of experience of dentists applying the method was investigated by dividing them into two groups according to experience.Materials and Methods:Dentists with less (group A) or more (group B) than 3 years of experience of cephalometry and 3D image manipulation analyzed CBCT data from 10 patients using two different landmark identification methods: method 1 used conventional cephalometric definitions and method 2 used detailed landmark identification definitions developed for each cross-sectional plane. The plotting of nine landmarks was performed twice, and 10 coordinate values were obtained for each landmark. To assess reproducibility, the 95% confidence ellipse method was used.Results:Comparative analysis showed that method 2 was highly reproducible. Group B subjects attained smaller ellipsoid volumes than group A subjects, regardless of the landmark identification method used. With method 1, except for condyle and coronoid process, all landmarks showed a higher level of reproducibility in group A subjects than in group B subjects. With method 2, however, five landmarks showed no differences between the methods.Conclusion:The method proposed here may be highly reproducible regardless of the evaluators'' experience.     

唇腭裂术后患者牵引成骨术X线头影测量分析

目的:通过对唇腭裂术后继发上颌骨发育不足患者进行口外支架式前牵引治疗术后6～24个月随访,探讨术后复发程度及可能存在的复发因素,并提出初步预防复发的办法。方法:1998～2002年我院进行牵引成骨治疗的39例唇腭裂患者中选出14例资料齐全者进行术后随访分析,随访期分别为术后3月、6月、1年、2年,分别将其头颅定位侧位片用CASSOS系统描迹、定点,进行矢状向和垂直向分析。结果:14例患者在牵引成骨术后6月内均有不同程度的复发,尤其是牵引器拆除后未进行正畸治疗者。而6月以后患者上颌骨在垂直向及矢状向基本无明显改变。结论:(1)唇腭裂术后上颌骨发育不足患者进行牵引成骨治疗后6月内较不稳定,尤其是未进行正畸治疗者;(2)6月后上颌骨矢状向和垂直向基本稳定。复发因素可能与局部疤痕、肌肉牵拉、软组织张力及适应性改建有关。     

Long-Term Dentoskeletal Effects and Facial Profile Changes Induced by Bionator Therapy

Objective:To evaluate the long-term skeletal and soft tissue changes induced by the bionator in Class II subjects.Materials and Methods:The treatment sample consisted of 20 Class II patients (6 males and 14 females) treated consecutively with the bionator. The sample was evaluated at T1, start of treatment; T2, end of bionator therapy; and T3, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T1); at posttreatment, 12 years 4 months (T2); and at long-term follow-up, 18 years 11 months (CS 6). The control group consisted of 20 subjects (8 males and 12 females) with untreated Class II malocclusions. Lateral cephalograms were analyzed at the three time points for all groups. Student''s t-tests were used for comparisons of starting forms, and of the T1–T2 and T1–T3 changes between groups.Results:The bionator group showed significant, favorable T1–T2 changes both at the skeletal and dentoalveolar levels. The vertical dimension was increased. Significant modifications were assessed for the soft tissues as well. The treated group showed a final improvement in soft tissue pogonion of about 2.5 mm. Significant mandibular changes were noted in the treated group, with a net average 3.3 mm long-term increase in mandibular length compared with untreated Class II controls.Conclusions:This study suggests that bionator treatment of Class II malocclusion maintains favorable results over the long-term with a combination of skeletal, dentoalveolar, and soft tissue changes.     

The Clinical Standards Advisory Group (CSAG) Cleft Lip and Palate Study.

Abstract

A national study of care and outcomes in children born with a unilateral cleft lip and palate (UCLP) was performed over a 15-month period. Two cohorts of children ('5-year-olds' and '12-year-olds') were examined. There were 57 active cleft teams in the U.K. with 105 consultant orthodontists involved in the care of these children. Only 36 teams could provide basic data such as patients names. Of the patients, 47-51 per cent had neonatal appliances. The dental arch relationships were measured with the Goslon Index and a Five-Year-Old Index, 37-39 per cent of both age groups were either 'poor' or 'very poor'. Seventy per cent of the 12-year-old patients had a Skeletal III relation and 42 per cent of bone grafts were seriously deficient or failed. Dental treatment for active caries was needed by 40 per cent of 5-year-olds and 20 per cent of 12-year-olds. In addition, the training of recently appointed consultant orthodontists involved in the care of these children was scrutinized. As a whole, the results were disappointing with standards of care not significantly raised in the last decade. Recommendations have been made to the Department of Health and the implications for the orthodontic profession are explored. Overall, it seems that fewer orthodontists will need to be involved in a centralized care model for these children.     

4～6岁幼儿乳前牙重度内倾型深覆颌骨生长发育特征的研究

目的：探讨4～6岁乳前牙重度内倾型深覆幼儿上下颌骨生长发育特征。方法：对15名4～6岁乳前牙重度内倾型深覆患儿进行头影测量分析,与正常值对照并行统计学检验。结果：内倾型深覆患儿下颌骨明显后缩,且有发育不足,但上颌骨生长基本正常;患儿上下面高比例失调。结论：重度内倾型深覆在乳牙期即能引起幼儿颌骨生长发育障碍。