成人女性正畸治疗后鼻唇沟处软组织变化的三维定量研究

目的:研究成人女性鼻唇沟处软组织正畸治疗前后的变化。方法:纳入40例2014~2017年完成治疗的骨性I类或轻度Ⅱ类错的成人女性患者,非拔牙及拔牙正畸治疗各20例,分别于治疗前(T0)、治疗结束(T1)时拍摄3dMD,获得面部软组织的三维数据,并在同一坐标系中进行测量分析。结果:非拔牙与拔牙成人女性正畸后鼻唇沟处软组织均有负向改变的趋势,拔牙组较非拔牙组更为明显(P<0.05)。结论:成人女性正畸后面部鼻唇沟软组织有一定的变化趋势。     

正畸治疗影响成人鼻唇角变化的多元回归分析

目的探索正畸治疗对成人鼻唇角变化的影响。方法挑选125例Ⅰ类和轻度Ⅱ类成人患者,83例拔除第一双尖牙,42例不拔牙治疗,测量治疗前后鼻唇角以及有可能影响鼻唇角的软硬组织测量项目。根据鼻唇角改变值、治疗前上切牙突距大小分组,做多元回归分析,找出影响鼻唇角变化的相关因素。结果鼻唇角的变化与上唇突度改变正相关,治疗前上切牙突距在正常值以外时,其鼻唇角的变化与上切牙唇倾度的改变呈正相关。而正常者,其鼻唇角的改变与上切牙唇倾度无相关性。结论鼻唇角的改变与上唇突度有关,治疗前上切牙位置偏离正常越小,鼻唇角的变化越不明显。     

���������������ƺ������״���ٴ�����

目的    评价上中切牙正畸治疗后根吸收状况,探讨影响根吸收的相关因素。方法    从大连大学附属口腔医院正畸科2名资深医生2007年5月至2009年12月所完成的正畸病例中,随机选择233例（男85例,女148例）。分为成人组90例,平均年龄（21.73 ± 3.68）岁;青少年组143例,平均年龄（13.37 ± 1.81）岁。通过分析治疗前后的头颅侧位片观察上中切牙牙根形态与长度变化,评价上中切牙根吸收状况。结果    233例患者中的13例上中切牙发生了不同程度的根吸收,根吸收发生率为5.58%。成人女性拔牙矫治组的上中切牙根吸收程度高于青少年女性拔牙矫治组,差异有统计学意义（P < 0.05）。青少年组中,女性拔牙矫治患者的根吸收程度较男性拔牙矫治患者明显,差异有统计学意义（P < 0.05）。而是否拔牙,其上中切牙根吸收程度差异无统计学意义（P > 0.05）。结论    女性拔牙矫治患者治疗后的上中切牙根吸收发生率较高。正畸根吸收原因复杂,治疗前应详细分析各种根吸收易发因素,以减小正畸根吸收的发生和程度,维持正畸牙齿的健康。     

正畸牙移动早期牙根吸收的临床研究

目的 应用锥体束计算机断层(Cone beam computed tomography,CBCT)技术分析正畸牙移动早期牙根吸收的发生情况及其影响因素.方法 选择108例正畸患者,432颗上切牙,治疗前及治疗5～9个月,平均(6.9±1.24)个月后分别拍摄上颌4个切牙CBCT.记录患者性别、初诊年龄、拔牙与否、安氏分...     

骨性安氏II类1分类成年患者拔牙矫治前后牙周表型的评估分析

目的　分析不同牙周表型的骨性安氏II类1分类成年患者拔牙矫治后上切牙区唇侧骨开裂、骨开窗及牙根吸收情况。方法　研究纳入24例骨性安氏II类1分类成年患者，通过术前CBCT和数字化印模数据的重叠，对前牙牙龈厚度进行无创的定量测量。根据术前上中切牙牙龈厚度将研究对象分为薄龈生物型组（牙龈厚度<1.5mm）和厚龈生物型组（牙龈厚度≥1.5mm）。使用CBCT测量正畸治疗前后上切牙唇侧牙槽骨骨开裂、骨开窗及牙根吸收的程度。结果　骨性安氏II类1分类成年患者术前骨开裂和骨开窗的发生率为31.2%和18.8%，经拔牙正畸治疗后增加至75%和20.8%。薄龈生物型组术后上前牙唇侧牙槽嵴顶至釉牙骨质界距离为3.19 ± 0.43mm，显著高于厚龈生物型组（2.16 ± 0.11mm），但该距离与牙龈厚度无显著相关性（r= -0.1108，P= 0.6146）。牙根吸收程度和牙龈厚度呈正相关（r=0.4223，P=0.0447），且厚龈生物型组牙根吸收量为2.24 ± 1.24mm，显著高于薄龈生物型组（1.08 ± 0.73mm）。结论　骨性安氏II类1分类成年患者经拔牙正畸治疗后上切牙区唇侧牙槽骨骨开窗、骨开裂及牙根吸收均加重，其中薄龈生物型组垂直牙槽骨吸收风险较大，厚龈生物型组骨开窗及牙根吸收风险较大。     

正畸治疗对成年女性颊部丰满度影响的初步研究

目的 了解正畸治疗对于成年女性颊部丰满度的影响.方法 对40例成年女性正畸患者治疗前后的正面像和侧面像进行“掩盖法”处理,通过小组主观评价颊部丰满度(1～10分).结果 1.专业医师与普通人群对颊部丰满度的评价无统计学差异.2.正畸治疗后患者颊部丰满度较治疗前下降0.53(P＜0.05).3.拔牙和非拔牙病例治疗后颊部丰满度均下降,二者治疗后颊部丰满度之间无统计学差异.结论 正畸治疗后成年女性患者颊部丰满度下降,拔牙与非拔牙病例治疗后颊部丰满度相似.     

安氏Ⅱ类1分类成年与青少年拔牙治疗的软组织改变

目的：探讨安氏Ⅱ类１分类成年与青少年拔牙治疗后其软组织改变的差异。方法：选择经拔除４个第一前磨牙进行正畸治疗结束的安氏Ⅱ类１分类错牙合患者３２例（其中成人与青少年各１６例），应用Ｘ线头影测量技术对其治疗前后软组织发生的变化进行测量研究，并对两年龄组的测量结果加以分析比较。结果：（１）经拔牙治疗青少年患者侧面凸度明显变小，而成年人没有明显改变。（２）青少年患者治疗后由于上唇突软组织增厚，软组织颏前点前移，使正畸治疗后的侧貌轮廓较成人更为满意，而成人由于正畸治疗其上唇及下颌顺时针旋转的改变易致“正畸面容”。结论：临床上预测拔牙治疗后上唇位置，不但要考虑上唇与上切牙后退比例，还应结合上唇软组织厚度的生长发育改变的结果，两组间存在实质性差异     

非常规正畸拔牙的矫治技巧-一组复杂错畸形的个体化治疗设计

正畸治疗中为解除牙列拥挤、减少牙弓突度及调整上下牙弓之间的关系 ,常需要拔牙矫治。选择拔除的牙齿除了考虑到患者的错类型及拥挤部位外 ,还要考虑到牙齿所处的位置及牙齿的健康状况 ,临床上最常见拔牙模式是拔除 4个双尖牙 ,但因牙齿本身的问题不得已而拔之的正畸拔牙也是常遇到的 ,即所谓非常规正畸拔牙 ,包括拔除切牙、尖牙、第一磨牙及第二磨牙。非常规正畸拔牙往往使错的矫治变得更加困难、更加复杂 ,因此常引起正畸医生的困惑。本文总结各种非常规正畸拔牙的个体化治疗设计及矫治技巧 ,并展示一组取得良好治疗效果的非常规正畸拔牙矫治的典型病例。     

临界病例拔牙与非拔牙治疗后侧貌突度变化的研究

目的比较正畸拔牙与不拔牙治疗对临界病例侧貌突度的影响。方法由5位正畸专家判断出的33个临界病例,根据其实际接受的治疗方式分为3组:①不拔牙治疗组12例患者;②拔4个第一双尖牙治疗组13例患者;③拔4个第二双尖牙治疗组8例患者。用结构重叠法,以眼耳平面(阳平面)为水平参照平面,对33例患者治疗前后头颅侧位片上反映侧貌突度的解剖标志点进行测量和比较。结果拔牙组和不拔牙组患者治疗后,仅上下切牙的突度有显著性差异(P < 0.01);而两种不同的拔牙方式对患者侧貌突度的影响无显著性差异(P > 0.05)。结论对于临界病例,拔牙治疗与不拔牙治疗对侧貌突度的影响主要表现为对上下切牙突度的改变,其对上下基骨及侧貌软组织突度的影响并不明显。     

应用CBCT研究不同矫治器正畸拔牙矫治对前牙区牙根及牙槽骨的影响

目的 应用CBCT研究无托槽隐形矫治及传统固定矫治器正畸拔牙对前牙区牙根及牙槽骨的变化情况.方法 选择成人拔牙矫正的患者60例,随机分为无托槽隐形矫治器组及传统固定矫治器组(N=30).正畸治疗前后拍摄CBCT,测量两组正畸患者上下颌中切牙、侧切牙、尖牙的牙根长度及牙槽骨的厚度变化情况.结果 固定矫治器组较无托槽隐形矫...     

双颌前突中国成人拔牙正畸治疗后唇组织变化预测方法初探

目的：探索并建立双颌前突中国成人拔除4个第一前磨牙正畸治疗后的唇组织改变的预测方法。方法：筛选满足纳入标准的32位双颌前突中国成人患者,在计算机辅助下对其治疗前后头颅侧位片行头影测量分析并行配对t检验,软组织变化的相关分析及逐步多重回归分析。结果：治疗前后水平向唇组织改变有统计学意义而垂直向改变无统计学差异。上唇水平向的位置变化（H—LS）与上切牙颈部的位置变化（H—Pro）正相关,下唇水平向的位置变化（H—Li）与上切牙突点（H—UIP）的位置变化正相关。结论：双颌前突中国成人拔除4个第一前磨牙后正畸治疗的患者,可以通过切牙回收量较好地预测其唇组织水平向的改变。     

成人安氏Ⅱ类1分类错牙合患者正畸前后唇部软组织测量和评估

目的 测量和评估成人安氏Ⅱ类1分类错牙合患者正畸前后的唇部软组织形态. 方法 选择30例已经完成正畸治疗的安氏Ⅱ类1分类错牙合成年患者,术后模型及头影测量的数据均在正常范围内. 对其正畸前后正面像和头颅侧位片唇红的矢状向厚度和垂直向厚度进行测量. 结果 正畸后上唇垂直向厚度有变小的趋势,下唇垂直向厚度有变大的趋势,差异有统计学意义(P<0. 05). 上唇矢状向唇红部组织厚度术后有增大的趋势,下唇矢状向唇红部组织厚度矫正后有减少的趋势,且有统计学意义(P<0. 05). 上颌上中切牙(U1C)矢状向内收量与上唇红(TUL)的内收呈显著正相关,下唇红(TLL)矢状向位置的变化与下颌切牙突点(L1C)位置变化存在正相关,下唇红(TLL)矢状向位置的变化与上颌切牙突点(U1C)位置变化存在正相关. 结论 安氏Ⅱ类1分类错牙合成人患者拔牙矫治后,可以通过切牙回收量较好地预测其唇部软组织正畸前后的矢状向厚度和垂直向厚度变化.     

The use of temporary anchorage devices for orthodontic treatment of high-angle Class III malocclusion in a patient with impacted upper canine teeth

This case report describes the orthodontic treatment of a 13-year-old female patient with high-angle Class III malocclusion, including anterior open bite and impacted upper canine teeth with a convex soft tissue profile. In this case, preadjusted edgewise appliances were placed after the extraction of the upper deciduous canine teeth, impacted upper canine teeth and lower first premolars. The upper and lower dental arches were aligned using a temporary anchorage device (TAD) for retraction and intrusion of the lower incisors avoiding the extrusion of the lower molars. A good facial profile and occlusion were achieved after active treatment.     

微种植支抗矫治成人骨性Ⅱ类突面型患者的矢状向疗效观察

目的 使用微种植支抗矫治成人骨性Ⅱ类突面型,观察矫治前后矢状向牙齿突度和唇突度变化.方法 选取36例治疗结束的成人骨性Ⅱ类突面型患者,所有患者均是拔除4颗第一前磨牙使用自攻型微种植体作为支抗内收前牙.对治疗前、后头颅侧位片进行测量分析.结果 36例患者的切牙、软组织等测量指标发生显著性变化,上切牙内收(5.98±3.8...     

自攻微钛钉支抗矫治成人骨性上颌前突的临床研究

目的：探讨自攻微钛钉作为正畸强支抗矫治成人骨性上颌前突的临床疗效。方法：成人骨性上颌前突患者56例,均拔除上颌2颗第一前磨牙,采用白攻微钛钉加强支抗整体内收上前牙。矫治前后均拍摄x线头颅侧位片进行头影测量分析。结果：所有微钛钉均保持稳定;矫治后患者侧貌明显改善,上颌前牙明显内收,U1-SN、U1-NA、U1E-RL、UL-EP、FCA明显减小,矫治前后差异均有统计学意义（P〈0．01）;SNA虽有所减小,但矫治前后差异均无统计学意义（P〉O．05）;上颌磨牙未发生明显前移,治疗前后差异均无统计学意义俨〉0．05）。结论：自攻微钛钉是一种稳固、高效的支抗系统,植入后可即刻加载,能最大限度内收上颌前牙,有效改善成人轻中度骨性上颌前突畸形。     

Soft-tissue profile changes resulting from retraction of maxillary incisors

The response of the soft-tissue profile to retraction of the maxillary incisors is still a matter of controversy. The purpose of this study was to improve the clinician's ability to predict the soft-tissue profile changes caused by retraction of the maxillary incisors by quantifying the profile changes, and identifying and quantifying the contribution of the most significant factors responsible for these changes. The cephalometric records of 80 Class II, Division 1 treated female subjects and 53 untreated female subjects were digitized and analyzed by means of a stepwise multiple regression analysis. The statistical assessment of the data suggested the following conclusions: In general, growth was associated with only minimal changes in the soft-tissue profile in a period not exceeding 36 months. The three clinically significant soft-tissue changes occurring in response to orthodontic treatment that included a mean upper incisor retraction of 6.7 mm were the retraction of the upper lip, the increase in the lower lip length, and the increase in the nasolabial angle. Other soft-tissue changes, which were of little clinical significance, included the retraction of the lower lip, the reduction of the interlabial gap, the increase in the thickness of both the upper and lower lips, the increase in the soft-tissue lower facial height and the lower soft-tissue component, which is the distance between lower stomion and soft-tissue menton. The length of the upper lip did not increase with either growth or orthodontic treatment. In general, changes in the lower lip in response to orthodontic tooth movement were more predictable than those of the upper lip. The low degree of predictability associated with the upper lip response to orthodontic tooth movement may be caused by the complex anatomy and/or dynamics of the upper lip, which could not be evaluated by the presently available cephalometric techniques.     

Skeletal anchorage for orthodontic correction of severe maxillary protrusion after previous orthodontic treatment

The correction of a severe maxillary protrusion in an adult by distal movement of the maxillary molars has been one of the most difficult biomechanical problems in orthodontics. This article reports on the treatment of an adult case of severe maxillary protrusion and a large overjet treated with a skeletal anchorage system. A female patient, age 22 years and 3 months, complained of the difficulty of lip closure due to severe maxillary protrusion with a gummy smile. Overjet and overbite were +7.6 mm and -0.9 mm, respectively. She had a history of orthodontic treatment in which her maxillary first premolars were extracted. In order to conduct distal movement of the maxillary molars, anchor plates were placed in the zygomatic process. After achieving a Class I molar relationship, retraction and intrusion of the maxillary incisors were performed. After a 2-year treatment, an acceptable occlusion was achieved with a Class I molar relationship. Her convex facial profile with upper lip protrusion was considerably improved, and the lips showed less tension in lip closure. After a 2-year retention period, an acceptable occlusion was maintained without recurrence of maxillary protrusion, indicating a stability of the occlusion. The result of this treatment indicated that skeletal anchorage is of great importance as a remedy for achieving intrusion and retraction of the maxillary incisors in cases of severe maxillary protrusion with a patient who had previous orthodontic treatment.     

切牙内收与唇部位置变化相关研究

双唇位置对面部美观有直接影响。因此,在正畸治疗中,常通过内收切牙来调整唇部突度重建面部侧貌美观。然而唇部软组织的变化与牙齿内收并非1∶1的关系。为了建立美好的唇部形态,内收量的精确预测是正畸学中受到广泛关注的问题。文章就切牙位置对唇部突度影响的研究进行综述,为临床治疗和研究提供参考依据。     

Soft tissue adaptability to hard tissues in facial profiles

The purpose of this study was to investigate soft tissue adaptability to hard tissue. A canonical correlation analysis was performed in an attempt to assess the relationships between hard tissue structure and soft tissue profile in the static state. For the dynamic study, multiple-regression analysis was performed to identify the changes of soft tissue profiles associated with the retraction of upper and lower incisors. The samples comprised lateral cephalograms from 297 Japanese women for the static canonical correlation analysis and 32 sets of lateral cephalograms of pre- and posttreatment adult orthodontic patients for the dynamic multiple-regression analysis. In the static state, the vertical dimension of lower facial height and the position of the lower incisors were associated with the thickness of the upper-lip vermilion and soft tissue B, and the horizontal relationships between upper- and lower-jaw positions were associated with the thickness of upper lips and of pogonion (soft tissue chin). In the dynamic state, the results indicated that the changes of stomion and lower lip could be predicted and strongly reflected the changes of the hard tissue. On the contrary, the change of the upper lip showed a weaker association with the hard tissue changes. Predictions of chin form described by the soft tissue B and soft tissue pogonion were less accurate than estimates of upper- and lower-lip form. Chin form was influenced by the hard tissue structures such as ANB angle and lower-facial height rather than by changes in lower- and upper-incisor retraction. (Am J Orthod Dentofacial Orthop 1998;113:674-84.)     

双颌前突正畸治疗前后软组织的三维变化

目的:探讨双颌前突患者矫治前后软组织的三维变化。方法:选取双颌前突成人患者24例,分别在治疗前后拍摄头颅侧位片和三维扫描,测量27个软组织项目。所有结果采用配对t检验。结果:上切牙内收6.12 mm,下切牙内收4.58 mm,上唇显著后移,而下唇显著向上向后移动。唇和切牙内收比率在上颌约为52%,下颌约为82%。结论:三维扫描可以有效的反应软组织变化。双颌前突患者的上下唇显著向后移动。