颈牵引装置矫治替牙期安氏Ⅱ类1分类错(牙合)矫治时机的临床探讨

目的:比较替牙早期及替牙晚期骨性安氏Ⅱ类1分类错(牙合)行口外颈牵引治疗的疗效,探讨合适的矫治时机.方法:样本包括11例替牙早期患者及15例替牙晚期患者,均为骨性安氏Ⅱ类1分类错(牙合),ANB≥5°,分别予以口外颈牵引治疗.治疗前后摄取X线头颅侧位定位片,进行头影测量及统计学分析.2组治疗前后比较采用配对t检验,2组之间采用团体t检验.结果:2组上颌骨生长均受到了抑制,SNA角、上颌骨长度(A-Ptm)及ANB角均有减小.U1-SN角减小,上前牙前突得到改善.2组比较,替牙晚期组变化更明显,2组之间有显著性差异(P＜0.01).而上颌第1恒磨牙远移距离在2组间则无显著性差异(P＜0.01).结论:在替牙晚期对骨性安氏Ⅱ类1分类错(牙合)患者行口外颈牵引治疗较为合适,有利于恒牙期的二期矫正治疗.     

颈牵引装置矫治替牙期安氏Ⅱ类1分类错矫治时机的临床探讨

目的:比较替牙早期及替牙晚期骨性安氏Ⅱ类1分类错行口外颈牵引治疗的疗效,探讨合适的矫治时机。方法:样本包括11例替牙早期患者及15例替牙晚期患者,均为骨性安氏Ⅱ类1分类错牙合,ANB≥5°,分别予以口外颈牵引治疗。治疗前后摄取X线头颅侧位定位片,进行头影测量及统计学分析。2组治疗前后比较采用配对t检验,2组之间采用团体t检验。结果:2组上颌骨生长均受到了抑制,SNA角、上颌骨长度(A-Ptm)及ANB角均有减小。U1-SN角减小,上前牙前突得到改善。2组比较,替牙晚期组变化更明显,2组之间有显著性差异(P<0.01)。而上颌第1恒磨牙远移距离在2组间则无显著性差异(P<0.01)。结论:在替牙晚期对骨性安氏Ⅱ类1分类错患者行口外颈牵引治疗较为合适,有利于恒牙期的二期矫正治疗。     

用新型组合式矫治装置早期矫治安氏Ⅱ~1错

目的:用新型组合式矫治装置治疗替牙期及恒牙初期安氏Ⅱ1错牙合。方法:采用由口外弓、下颌唇挡及上颌斜面导板组成的矫治装置,治疗替牙期及恒牙初期安氏Ⅱ1错牙合66例(男3 0例,女3 6例) ,治疗前后进行X线头影测量分析。结果:66例患者的覆牙合、覆盖及颌关系调整时间为3～13个月,平均7.6个月。治疗后覆牙合平均减小2 .5mm ,覆盖减小4.3mm ,SNB角增加1.8°,ANB角减小1.9°,U 1 NA角减小8.8°,L1 NB角增加6.4°,IMPA角增加5 .7°,Z角增加4.5°,Wits值减小1.6,ANS Me增加4.0mm。结论:该组合式矫治装置对替牙期及恒牙初期安氏Ⅱ1错牙合具有良好的矫治效果。     

口外颈牵引装置早期矫治安氏Ⅱ类1分类错牙合的疗效研究

目的 评价口外颈牵引装置对生长发育期的安氏Ⅱ类1分类错(牙合)患者的疗效。方法 采用侧位X线头影测量,对15例患者进行观察分析。结果 上颌骨向前生长受到抑制,下颌骨生长得到充分表达,上下颌骨矢状不调得以改善。上颌第一恒磨牙伸长并向远中移动,上颌切牙唇倾角度减小,第一恒磨牙关系恢复至中性(牙合),覆(牙合)、覆盖有不同程度的减小。同时发现,腭平面角、(牙合)平面角、下颌平面角均无显著性变化。结论 口外颈牵引装置对生长发育期安氏Ⅱ类1分类错(牙合)有明显的矫形效果。     

口外颈牵引装置矫治替牙期安氏Ⅱ类1分类错的临床研究

目的 :比较替早期及替牙晚期行口外颈牵引治疗的疗效 ,探讨合适的矫治时机。方法 :对 11例替牙早期患者及 15例替牙晚期患者行口外颈牵引治疗 ,采用侧位X线头影测量进行统计分析。结果 :替牙晚期组上颌骨受到较明显抑制 ,SNA和ANB减少较明显 ,上中切牙有较大程度内收。上颌第一恒磨牙远移距离两组无明显差异。结论 :替牙晚期行口外颈牵引较为合适 ,同时有利于恒牙期的综合性治疗。     

上颌前方牵引矫治器在骨性Ⅲ类错(牙合)矫治中的作用

目的探讨上颌前方牵引矫治器在骨性Ⅲ类错牙合矫治中的作用机理.方法应用上颌前方牵引矫治12例安氏Ⅲ类骨性错牙合的患者,比较矫治前后的临床表现及X线头影测量的结果.结果患者矫治前后的侧貌得到改善,并建立了正常前牙覆牙合、覆盖关系和后牙中性关系.治疗前后的SNA角、 ANB角、 1-SN角、 MP-SN角有显著性的差异.结论上颌前方牵引矫治器有促进上颌骨向前发育、抑制下颌骨向前发育的效果,从而调整上下颌骨的相对位置关系,使骨性Ⅲ类错牙合得到矫治.     

口外颈牵引装置早期矫治安氏Ⅱ类1分类错的疗效研究

目的 评价口外颈牵引装置对生长发育期的安氏Ⅱ类1分类错(牙合)患者的疗效。方法 采用侧位X线头影测量,对15例患者进行观察分析。结果 上颌骨向前生长受到抑制,下颌骨生长得到充分表达,上下颌骨矢状不调得以改善。上颌第一恒磨牙伸长并向远中移动,上颌切牙唇倾角度减小,第一恒磨牙关系恢复至中性(牙合),覆(牙合)、覆盖有不同程度的减小。同时发现,腭平面角、(牙合)平面角、下颌平面角均无显著性变化。结论 口外颈牵引装置对生长发育期安氏Ⅱ类1分类错(牙合)有明显的矫形效果。     

用新型组合式矫治装置早期矫治安氏Ⅱ1错

目的用新型组合式矫治装置治疗替牙期及恒牙初期安氏Ⅱ1错牙合.方法采用由口外弓、下颌唇挡及上颌斜面导板组成的矫治装置,治疗替牙期及恒牙初期安氏Ⅱ1错牙合66例(男30例, 女36例),治疗前后进行X线头影测量分析.结果66例患者的覆牙合、覆盖及颌关系调整时间为3～13个月,平均7.6个月.治疗后覆牙合平均减小2.5 mm,覆盖减小4.3 mm,SNB角增加1.8°,ANB角减小1.9°,U1-NA角减小8.8°,L1-NB角增加6.4°,IMPA角增加5.7°,Z角增加4.5°,Wits值减小1.6,ANS-Me增加4.0 mm.结论该组合式矫治装置对替牙期及恒牙初期安氏Ⅱ1错牙合具有良好的矫治效果.     

上颌前方牵引矫治器在骨性Ⅲ类错矫治中的作用

目的　探讨上颌前方牵引矫治器在骨性Ⅲ类错牙合矫治中的作用机理。方法　应用上颌前方牵引矫治12例安氏Ⅲ类骨性错牙合的患者 ,比较矫治前后的临床表现及X线头影测量的结果。结果　患者矫治前后的侧貌得到改善 ,并建立了正常前牙覆牙合、覆盖关系和后牙中性关系。治疗前后的SNA角、ANB角、1-SN角、MP -SN角有显著性的差异。结论　上颌前方牵引矫治器有促进上颌骨向前发育、抑制下颌骨向前发育的效果 ,从而调整上下颌骨的相对位置关系 ,使骨性Ⅲ类错牙合得到矫治     

用新型组合式矫治装置早期矫治安氏Ⅱ1错(牙合)

目的:用新型组合式矫治装置治疗替牙期及恒牙初期安氏Ⅱ1错牙合.方法:采用由口外弓、下颌唇挡及上颌斜面导板组成的矫治装置,治疗替牙期及恒牙初期安氏Ⅱ1错牙合66例(男30例, 女36例),治疗前后进行X线头影测量分析.结果:66例患者的覆牙合、覆盖及颌关系调整时间为3～13个月,平均7.6个月.治疗后覆牙合平均减小2.5 mm,覆盖减小4.3 mm,SNB角增加1.8°,ANB角减小1.9°,U1-NA角减小8.8°,L1-NB角增加6.4°,IMPA角增加5.7°,Z角增加4.5°,Wits值减小1.6,ANS-Me增加4.0 mm.结论:该组合式矫治装置对替牙期及恒牙初期安氏Ⅱ1错牙合具有良好的矫治效果.     

高位口外牵引在青少年骨性Ⅱ类错(牙合)治疗中的作用

目的：探讨高位口外牵引在青少年骨性Ⅱ类错[牙合]早期矫治中的作用，并评价其临床疗效。方法：选取11例生长发育期骨性安氏Ⅱ类错[牙合]病例，采用高位口外牵引治疗，与7例未经治疗的生长发育期骨性Ⅱ类错[牙合]进行对照。摄取X线头影侧位定位片，用Pancherz分析法评判治疗过程发生的骨性和牙性变化，以SPSS11．0软件进行独立样本t检验。结果：高位口外牵引可以限制上颌发育，SNA、A—Olp2项指标在治疗组与对照组间具有统计学差异（P〈0．01）。上颌磨牙远中移动具有显著差异（P〈0．01）。结论：高位口外牵引能够限制上颌发育，有利于下颌发育，达到矫治目的；同时，垂直方向和矢状方向的牙及牙槽反应，有利于患者牙颌面形态的进一步改善．     

高位口外牵引在青少年骨性II类错治疗中的作用

目的:探讨高位口外牵引在青少年骨性II类错牙合早期矫治中的作用,并评价其临床疗效。方法:选取11例生长发育期骨性安氏II类错牙合病例,采用高位口外牵引治疗,与7例未经治疗的生长发育期骨性II类错牙合进行对照。摄取X线头影侧位定位片,用Pancherz分析法评判治疗过程发生的骨性和牙性变化,以SPSS11.0软件进行独立样本t检验。结果:高位口外牵引可以限制上颌发育,SNA、A-Olp2项指标在治疗组与对照组间具有统计学差异(P<0.01)。上颌磨牙远中移动具有显著差异(P<0.01)。结论:高位口外牵引能够限制上颌发育,有利于下颌发育,达到矫治目的;同时,垂直方向和矢状方向的牙及牙槽反应,有利于患者牙颌面形态的进一步改善。     

Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis

OBJECTIVE: To evaluate the anteroposterior short-term skeletal and dental effects on Class II malocclusion in growing patients following treatment with functional appliances (activators or twin block), extraoral traction, or combination appliances (appliances with both functional and extraoral traction components), based on published data. MATERIALS AND METHODS: A literature search was carried out identifying a total of nine prospective clinical trials. The data provided in the publications underwent meta-analysis using the random effects model with regard to SNA, SNB, ANB, and overjet. RESULTS: All appliance groups showed an improvement in sagittal intermaxillary relationships (decrease in ANB) when compared to untreated subjects. Activators and twin block appliances accomplish this mainly by acting on the mandible (increases in SNB) while twin block appliances also seem to act on the maxilla (decrease in SNA). Extraoral traction appliances achieve this by acting on the maxilla (decreases in SNA). Combination appliances mainly act on the mandible (increase in SNB). Activators, twin block, and combination appliances also reveal a decrease in overjet, which is not the case in the singular use of extraoral traction. CONCLUSIONS: Intermaxillary changes being present in all appliance groups, anteroposterior treatment response following the use of functional appliances and/or extraoral traction in growing class II malocclusion patients is most evident in one of the two jaws (mandible for activators and combination appliances and maxilla for extraoral traction) except for the twin block group, which shows changes on both jaws.     

Orthopedic cervical headgear in class II treatment: case report

Early treatment for Class II malocclusion was undertaken with the objective of correcting skeletal disproportion by altering the growth pattern. A case of Class II, Division 1 malocclusion in the mixed dentition was corrected to Class I molar relationship using orthopedic cervical headgear, with nonextraction edgewise therapy. Cephalometric analysis indicated a reduction in the maxillomandibular discrepancy (ANB) correcting the Class II malocclusion to Class I malocclusion. The treatment showed that this was achieved by downward displacement and inhibition of the forward growth of the maxilla and growth of the mandible. There was no downward rotation of the mandible nor maxillary first molar extrusion. There was improvement in the jaw relationship.     

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.     

Class II malocclusion with maxillary protrusion from the deciduous through the mixed dentition: a longitudinal study

The aim of this study was to analyze the skeletal characteristics of Class II malocclusion with maxillary protrusion in the deciduous dentition and to describe the growth features of this type of skeletal imbalance during the transition from the deciduous through the mixed dentition. A group of 17 subjects having skeletal Class II malocclusions in the deciduous dentition due to maxillary protrusion was compared with a control group of 30 untreated subjects with ideal occlusion at the same stage of development. Both groups were observed for the first time in the deciduous dentition (T(1)) and followed during the transition from the deciduous to the mixed dentition (T(2)). During this time no orthodontic treatment was provided. Lateral cephalograms were taken for all subjects at T(1) and T(2). A cephalometric analysis was performed based on a reference system that consisted of two perpendicular lines traced through stable basicranical structures. The results indicate that a Class II skeletal pattern due to a maxillary protrusion is established early in the deciduous dentition and remains unmodified in the transition to the mixed dentition. The maxilla appeared to be displaced forward in Class II subjects, whereas the mandibles of the Class I and Class II subjects did not show any significant differences at this stage of growth. In the passage from the deciduous through the mixed dentition, Class I and Class II subjects showed growth increments that were not significantly different from each other. Sucking habits appeared to be correlated with the skeletal maxillary protrusion.     

反复扩缩式快速扩弓矫治器配合前方牵引矫治恒牙早期安氏Ⅲ类错的临床疗效观察

目的 观察上颌固定式快速扩弓矫治器配合面具前方牵引矫治恒牙早期以上颌骨发育不足为主的安氏Ⅲ类骨性错的临床疗效.方法 选择17例恒牙早期以上颌骨发育不足为主的安氏Ⅲ类骨性错病例,采用附殆垫的上颌固定式快速扩弓矫治器配合面具前方牵引进行阻断矫治,并在矫治8或9周内对牙弓行反复扩缩,对前方牵引治疗前后x线头颅侧位片进行测量分...     

Pancherz分析法评价头帽型肌激动器矫治骨性Ⅱ类错的疗效

目的通过Pancherz分析法评价头帽型肌激动器（ HGAC）在矫治生长发育期骨性Ⅱ类1分类错!患者中对牙和颌骨的作用机制。方法选择15例ANB角大于等于5°、覆盖大于6 mm、磨牙远中关系的错!患者为研究对象，戴用HGAC矫治8~12个月，每天戴用时间不少于14 h，治疗前后拍摄X线头颅定位侧位片，采用Pancherz分析法分析治疗前后上下颌骨和牙齿位置的变化，统计方法采用配对t检验。结果治疗后SNA角减小（ P<0.05），SNB角变化不明显（ P>0.05），Go/Me、co/OLP、ML/NSL增大，ANB角减小，pg/OLP增大，下切牙角增加，上切牙角减小（ P<0.05）；覆盖情况改善，其中骨因素44.64%，牙因素55.36%；下磨牙前移，磨牙关系得以改善，其中骨因素65.65%，牙因素34.35%。结论HGAC矫治骨性Ⅱ类1分类错!，可有效地内收远移上牙列，刺激髁突和关节窝的改建，促进下颌骨的生长。在前牙覆盖改善中，牙因素大于骨因素；在磨牙关系改善中，骨因素大于牙因素。     

Longitudinal study of anteroposterior and vertical maxillary changes in skeletal class II patients treated with Kloehn cervical headgear

This is a study to evaluate the posttreatment and long-term anteroposterior and vertical maxillary changes in skeletal Class II Division 1 patients (ANB > or = 5 degrees) who had received Kloehn cervical headgear treatment. The sample consisted of 120 lateral cephalograms obtained at pretreatment (T1), posttreatment (T2), and postretention (T3) phases of 40 patients (18 males and 22 females). The patients were of an average age of 10% years in phase T1, 13% years in phase T2, and 23% years in phase T3. They were treated with cervical traction and an expanded inner bow (4-8 mm) and a long outer bow bent upwards off the horizontal 10-20 degrees in relation to the inner bow. After correction of the molar relationship on both sides, a conventional edgewise fixed appliance was used to complement the correction of the malocclusion. The onset of treatment was either at the late mixed dentition or at the beginning of the permanent dentition. The force applied for the 40 patients averaged 450 g and the recommended use of the appliance was 12-14 hours per day with monthly adjustments. F-Snedecor test was applied to the entire sample and multiple comparisons between phases were tested by the Bonferroni method. Results revealed that treatment had reduced maxillary protrusion, inclined the palatal plane with an increase in the SN-PP angle with reduction at long-term. In conclusion, Kloehn cervical headgear with elevated external bow and expanded inner bow was efficient in correcting the skeletal Class II in late mixed-early permanent dentition. Skeletal Class II correction with Kloehn cervical headgear was found to be very stable long term.