自攻型微螺钉种植体支抗的临床应用研究

目的 研究自攻型微螺钉种植体作为磨牙强支抗的临床应用效果.方法 在30例采用自攻型微螺钉种植体作为磨牙支抗的临床病例中,选择6例已经结束治疗的患者进行分析.6例患者均为骨性Ⅱ类上颌前突患者,拔除上颌双侧第一前磨牙后采用上颌强支抗进行矫治.选择自攻型微螺钉种植体作为上颌支抗,以内收上颌前牙、关闭拔牙间隙.种植体植入部位为上颌第二前磨牙与第一磨牙牙根间的颊侧牙槽间隔,加力值为每侧1.47～1.96 N.对患者拔牙间隙关闭前后的头颅定位侧位片进行分析,测量前牙内收情况和磨牙支抗的变化.结果 6例患者共植入12枚微螺钉种植体,矫治后其上颌前突症状均得到明显改善,上颌切牙切缘平均内收6.06 mm,支抗磨牙平均前移0.44 mm,均获得了磨牙强支抗效果.治疗中,种植体保持稳定,种植体周围的软组织健康.结论 自攻型微螺钉种植体支抗是一种简便、有效的支抗形式,可以满足正畸临床治疗的需要.     

Clinical study of distalization of maxillary molars with miniscrew implants anchorage in Class Ⅱ malocclusion

目的 研究临床上微螺钉种植体作为强支抗在推磨牙向远中的治疗效果.方法 选取10例AngleⅡ类重度拥挤的患者作为研究对象,采用双侧颊侧植入微螺钉种植体作为强支抗远移上颌磨牙,施力为2.45~2.94N.在治疗前后拍摄头颅侧位片,测量上颌第一磨牙在矢状向的位置变化.取研究模型,通过三维扫描仪及测量软件测量上颌磨牙的三维方向的变化,进行统计学分析.结果 所有病例都达到了预期的矫治效果,磨牙中性关系、面型得到了较好的改善.上颌第一磨牙平均向远中移动3.58±0.87mm;上颌磨牙的压低、颊倾、远中倾斜治疗前后均无显著性差异.结论 微螺钉种植体作为强支抗,能成功远移上颌磨牙,没有出现支抗丧失,是非常有效的非依从性远移磨牙的方法.     

自攻型微钛钉种植体增强磨牙支抗的临床应用研究

目的　介绍自攻型微钛钉种植体用于正畸支抗的临床经验 ,评价该型种植体作为强支抗的有效性。方法　在 6 7例采用自攻型微钛钉种植体作为支抗的临床病例中 ,选择 5例II类骨型、上牙弓前突或双牙弓前突患者 ,矫治设计上颌均为减数双侧第一前磨牙 ,支抗设计为磨牙强支抗。内收前牙阶段的治疗应用自攻型微钛钉支抗种植体 ,种植体植入上颌第一恒磨牙与第二前磨牙颊侧根尖部之间的牙槽间隔 ,以每侧 15 0～ 2 0 0g力滑动法内收前牙。比较内收前后头颅X线侧位片 ,测量前牙内收情况和磨牙支抗的变化。结果　 5例牙弓突度均得到明显改善 ,切牙切缘平均内收 6 4mm ,支抗磨牙平均前移 0 3mm ,均获得磨牙强支抗的效果。治疗过程中种植体均保持了稳定 ,种植体周围软组织健康。结论　自攻微型钛钉种植体能作为稳定的骨性正畸支抗 ,代替口外力的使用 ,起到磨牙强支抗的效能。该型种植体具有操作简单灵活 ,可即刻加力 ,不依赖患者合作的优点     

微螺钉种植体支抗推磨牙向后的临床研究

目的研究临床上微螺钉种植体作为强支抗在推磨牙向远中的治疗效果。方法选取10例AngleⅡ类重度拥挤的患者作为研究对象,采用双侧颊侧植入微螺钉种植体作为强支抗远移上颌磨牙,施力为2.45～2.94N。在治疗前后拍摄头颅侧位片,测量上颌第一磨牙在矢状向的位置变化。取研究模型,通过三维扫描仪及测量软件测量上颌磨牙的三维方向的变化,进行统计学分析。结果所有病例都达到了预期的矫治效果,磨牙中性关系、面型得到了较好的改善。上颌第一磨牙平均向远中移动3.58±0.87mm;上颌磨牙的压低、颊倾、远中倾斜治疗前后均无显著性差异。结论微螺钉种植体作为强支抗,能成功远移上颌磨牙,没有出现支抗丧失,是非常有效的非依从性远移磨牙的方法。     

微种植体用于上颌前突正畸治疗的效果评价

目的：应用微种植体支抗内收上颌前牙,观察种植体对颌骨,牙齿及软组织的影响,评价微种植体支抗在正畸治疗中的临床疗效。方法：成年上颌前突患者16例,在上颌第二前磨牙和第一磨牙牙根间植入微种植体,内收上颌前牙。通过治疗前后X线头影测量对比分析,运用配对t检验比较治疗前后的差别。结果：治疗前、后上前牙平均内收（5．18±2．74）min,压低（1．28±0．63）mm,均有统计学意义。上颌第一磨牙也有远中移动和压低趋势。上下唇分别后退了2．41mm和2．73mm,颌突角减小了2°,差异均有统计学意义白〈0．001）。结论：在成年严重上颌前突患者正畸治疗中,微种植体能够提供绝对支抗,最大限度改变牙齿突度和软组织侧貌。     

微小种植体支抗远移上颌磨牙的临床应用

目的:观察微小种植体作为强支抗远移上颌磨牙的作用及效果.方法:选取安氏Ⅱ类错(牙合)患者16 例,在上颌颊侧牙槽骨内共植入微小种植体22 颗,利用微小种植体做为支抗推磨牙向远中.拍摄磨牙移动前后的X线头影测量片,记录上颌磨牙及切牙移动情况,并进行统计分析.结果:利用微小种植体远移磨牙4～8 月后,所有病例磨牙达到中性关系.磨牙平均移动4.71 mm(P<0.01),上颌中切牙平均舌向移动2.16 mm(P<0.05);磨牙伸长、颊移、远中倾斜及上切牙伸长无统计学意义.结论:微小种植体可作为绝对强支抗,有效地整体远移上颌磨牙,特别适用于安氏Ⅱ类成人错(牙合)的矫治.     

微钛钉种植体支抗后移全牙弓16例临床分析

目的 研究微钛钉种植体作为支抗后移全牙弓矫治成人上颌Ⅱ度牙列拥挤的矫治效果。 方法 应用种植于磨牙颧牙槽嵴的微钛钉种植体整体向后移动全牙弓矫治16例上颌Ⅱ度牙列拥挤患者,以X线头影测量方法评价疗效。 结果 所有病例均获成功矫治,上颌第一磨牙平均远中移动2.93 mm、远中倾斜7.12°,第二前磨牙平均远中移动3.46 mm、远中倾斜11.09°,具有统计学意义(P＜0.05);上中切牙唇向倾斜度轻微增加2.12°、切缘平均前移0.66 mm,无统计学意义(P>0.05)。 结论 微钛钉种植体支抗是一种有效后移全牙弓矫治Ⅱ度牙列拥挤的方法。     

微螺钉型种植体支抗与传统强支抗在上颌前突正畸治疗中的对比研究

目的研究微螺钉型种植体在上颌前突正畸治疗中的支抗应用,同时与口外弓配合Nance弓等传统支抗相比较,总结微螺钉型种植体支抗临床应用中的优势不足以及注意事项。方法选择上颌严重前突的拔牙矫正患者24人,矫治设计需强支抗,随机分成研究组和对照组两组,每组12人,试验组用微螺钉型种植体支抗结合滑动直丝弓技术,对照组用口外弓加Nance弓或者横腭杆结合滑动直丝弓技术,对治疗前后利用X线头颅片进行测量分析。结果试验组上颌第一磨牙在前后向未发生明显移动(P>0.05),而对照组上颌第一磨牙平均前移3.7 mm,经统计学检验差异有极显著性(P<0.01)。结论微螺钉型种植体有效治疗上颌前突畸形,可代替口外弓配合Nance弓等传统强支抗,具有舒适、操作简便灵活,可即刻受力,不依赖于患者合作等特点。     

自攻型微螺钉支抗在上颌前突正畸矫治中的应用

目的探讨自攻型微螺钉作为正畸强支抗矫治上颌前突的治疗效果。方法选择上颌前突患者50例,上牙弓均拔除2颗第一前磨牙,采用自攻型微螺钉加强支抗,微螺钉均植入到上颌双侧第一磨牙与第二前磨牙颊侧根尖部的牙槽间隔处,植入后以每侧加0.98 N的力滑动内收上前牙,关闭间隙。于治疗前后行X线头影测量分析。结果 1)治疗过程中所有微螺钉均稳固;2)所有病例矫治后拔牙间隙均关闭,牙弓突度得到明显改善,上颌切牙明显直立和内收,平均内收7.57 mm,上中切牙长轴与前颅底平面(SN)相交的下内角平均减少13.40°,上中切牙长轴与鼻根点至上牙槽座点(NA)平面之间的上交角平均减少12.82°,上、下中切牙长轴的后交角平均增大20.56°,前牙覆盖平均减少7.94 mm,上唇突点至审美平面的线距平均减少5.52 mm,治疗前后的差异均有统计学意义,上颌第一磨牙矢状向、垂直向的位移分别为0.01、0.09 mm,治疗前后差异无统计学意义;3)所有病例矫治后均获得理想的侧貌改变,前牙覆覆盖正常,后牙尖窝锁结关系良好。结论自攻型微螺钉是一种稳固、舒适、高效的支抗,可即刻受力,能使支抗磨牙处于稳定状态,最大限度地内收上颌前牙,有效矫治上颌前突畸形。     

PASS生理支抗技术矫治双牙弓前突错的临床研究

目的 探讨PASS生理支抗技术治疗双牙弓前突错的临床效果.方法 选择双牙弓前突病例20例,男6例,女14例,平均年龄19.7岁,拔除4个第一前磨牙,应用PASS生理支抗矫治技术进行矫治,对治疗前后头颅侧位片进行测量,并对结果进行统计学分析.结果 治疗后与牙齿、软组织有关的测量指标发生显著性变化,上下切牙切缘分别向远中移动5.32mm和4.76mm,上下磨牙近中移动2.02mm和2.67mm,鼻唇角增大,上下唇至审美平面距离明显减少(P <0.05),而骨性测量指标 SNA,SNB,MP/SN 治疗前后无显著性变化(P >0.05).结论 PASS矫治器在没有额外支抗的条件下可以有效矫治双牙弓前突.     

个性化舌侧托槽的制作与临床应用初探

目的介绍个性化舌侧托槽的制作及其临床应用。方法预成舌侧托槽与个性化托槽底板铸造为一体。使用这种国产个性化舌侧托槽进行正畸治疗,其中安氏Ⅰ类68例,安氏Ⅱ类27例,安氏Ⅲ类9例。错[牙合]问题有：牙弓前突、开[牙合]、深覆[牙合]、反[牙合]、深覆盖、牙齿拥挤、牙齿阻生等。结果近百例舌侧正畸患者矫治效果良好,该方法对舌侧托槽的定位准确,除了可采取间接粘接以外,在二次粘接时可采取直接粘接。结论个性化舌侧托槽粘接精度优于传统的预成舌侧托槽粘接,牙齿排列更加整齐,能够得到满意的治疗效果。     

Maxillary molar distalization with a bone-anchored pendulum appliance

To obtain an effective and compliance-free molar distalization without an anchorage loss, we designed the bone-anchored pendulum appliance (BAPA). The aim of this study was to evaluate the stability of the anchoring screw, distalization of the maxillary molars, and the movement of teeth anterior to maxillary first molars. The study group comprised 10 patients (mean age 13.5 +/- 1.8 years) with Class II molar relationship. A conventional pendulum appliance was modified to obtain anchorage from an intraosseous screw instead of the premolars. The screw was placed in the anterior paramedian region of the median palatal suture. Skeletal and dental changes were measured on cephalograms, and dental casts were obtained before and after distalization. A super Class I molar relationship was achieved in a mean period of 7.0 +/- 1.8 months. The maxillary first molars distalized an average of 6.4 +/- 1.3 mm in the region of the dental crown by tipping distally an average of 10.9 degrees +/- 2.8 degrees . Also, the maxillary second premolar and first premolar moved distally an average of 5.4 +/- 1.3 mm and 3.8 +/- 1.1 mm, respectively. The premolars tipped significantly distally. No anterior incisor movement was detected. The BAPA was found to be an effective, minimally invasive, and compliance-free intraoral distalization appliance for achieving both molar and premolar distalization without any anchorage loss.     

New generation open-bite treatment with zygomatic anchorage

This technical note aims to present the fabrication and application of a new generation of posterior intrusion appliances using zygomatic anchorage. The use of zygomatic anchorage enables en masse impaction of the posterior segment without any side effects such as labial flaring. A 14-year-old, female Class II patient with an anterior open bite was treated with a new generation posterior intrusion appliance. At the end of treatment, a Class I canine and molar relationship and a correction of the anterior open bite were achieved. The molars were impacted 3.6 mm, and this impaction was maintained throughout the treatment. The mandibular plane showed a counterclockwise autorotation of 4 degrees. This case report demonstrates that zygomatic anchorage can be used effectively for molar intrusion and anchorage maintenance. However, further clinical studies with larger samples are required to confirm its effectiveness.     

Unilateral molar distalization with a modified slider

Although there are numerous publications on bilateral non-compliance molar distalization appliances, there is limited information on problems such as asymmetrical unilateral Class II malocclusions. The aim of the present investigation was to examine the distalization of molars unilaterally in patients with a unilateral Class II molar relationship utilizing a Keles Slider, designed without a bite plane. Ten girls (mean age 13.94 +/- 2.13 years) and seven boys (mean age 13.12 +/- 1.51 years) comprised the study material. Following insertion of the appliance, the patients were seen monthly and the screw was reactivated every 2 months. After a super-Class I molar relationship was achieved, the appliance was removed and the molars were stabilized with a Nance appliance for 2 months before the second-phase of orthodontic treatment. The Nance appliance was maintained in the palate until the end of canine distalization. Lateral cephalometric radiographs were obtained before and immediately after insertion of the molar distalizer. The results showed that the maxillary first molars were distalized bodily on average by 2.85 mm. The maxillary first premolars moved forward bodily 2 mm and were extruded 2.03 mm. In all, 1.32 mm of protrusion, 1.12 mm of extrusion, and 1.79 degrees of proclination of the upper incisors were observed. The mandibular incisors and mandibular molars erupted 0.83 and 0.95 mm, respectively. The unilateral Keles Slider distalized molars successfully to a Class I molar relationship.     

Dentoalveolar and skeletal changes associated with the pendulum appliance.

The purpose of the study was to examine the dentoalveolar and skeletal effects of the pendulum appliance in Class II patients at varying stages of dental development and with varying facial patterns (high, neutral, and low mandibular plane angles). Specifically, the amount and nature of the "distalization" of the maxillary first molars and the reciprocal effects on the anchoring maxillary first premolars and incisors were studied, as were skeletal changes in the sagittal and vertical dimensions of the face. Pretreatment and posttreatment cephalometric radiographs obtained from 13 practitioners were used to document the treatment of 101 patients (45 boys and 56 girls). The average maxillary first molar distalization was 5.7 mm, with a distal tipping of 10.6 degrees. The anchoring anterior teeth moved mesially, as indicated by the 1.8-mm anterior movement of the upper first premolars, with a mesial tipping of 1.5 degrees. The maxillary first molars intruded 0.7 mm, and the first premolars extruded 1.0 mm. Lower anterior facial height increased 2.2 mm; there was no significant difference in lower anterior facial height increase between patients of high, neutral, or low mandibular plane angles. In patients with erupted maxillary second molars, there was a slightly greater increase in lower anterior face height and in the mandibular plane angle and a slightly greater decrease in overbite in comparison to patients with unerupted second molars. Similar findings were observed in patients with second premolar anchorage versus those with second deciduous molar anchorage. The results of this study suggest that the pendulum appliance is effective in moving maxillary molars posteriorly during orthodontic treatment. For maximum maxillary first molar distalization with minimal increase in lower anterior facial height, this appliance is used most effectively in patients with deciduous maxillary second molars for anchorage and unerupted permanent maxillary second molars, although significant bite opening was not a concern in any patient in this study.     

Anchorage provided during intra-arch distal molar movement: a comparison between the Nance appliance and a fixed frontal bite plane

The aim of this retrospective study was to evaluate and compare the anchorage provided with the Nance appliance (NA) and the fixed frontal bite plane (FBP) during intra-arch distal molar movement. After a sample size calculation, 20 patients were recruited and randomly selected for each group from patients who fulfilled the following criteria: use of an intra-arch Ni-Ti coil appliance with either NA or FBP to provide anchorage during a six-month molar distalization period, no orthodontic treatment before molar distalization, and first and second maxillary molars in occlusion. The outcome measures assessed were anchorage loss, ie, anterior movement of maxillary central incisors, distal movement of maxillary molars, and bite opening effect. The mean age in the NA group was 14.7 years (SD 1.09) and in the FBP group 15.0 years (SD 0.99). The data revealed that the maxillary central incisors moved anteriorly 1.4 mm in the NA group and 1.9 mm in the FBP group. The difference in anchorage loss was not significant. The mean amount of molar distalization within the maxilla was 1.7 mm in the NA group and 1.8 mm in the FBP group. In both groups, the overbite was significantly reduced and the overbite was decreased significantly more in the FBP group. Because neither the NA nor FBP provided stable anchorage, a second treatment phase is recommended to reverse the anchorage loss after distal molar movement. If molar distalization is planned in deep bite cases, the FBP is the anchorage system of choice.     

平面导板配合种植钉非减数矫治安氏Ⅱ类深覆牙合临床观察

目的    应用固定式平面导板配合种植钉牵引,采用非减数方法矫治安氏Ⅱ类深覆牙合,探讨其临床要点。方法    2009—2012年在广州市荔湾区口腔医院就诊的安氏Ⅱ类错牙合伴有轻度上颌前突或下颌轻度后缩患者41例,其中安氏Ⅱ1错牙合患者21例,Ⅱ2错牙合患者20例。采用上颌选择性拔除第三恒磨牙,下颌不拔牙或拔除第三磨牙,矫正器采用Smart-clip系列自锁托槽直丝弓矫治器,选用A1自攻型不锈钢微种植钉,在颧牙槽嵴区第一磨牙和第二磨牙交界区植入;制作固定式平面导板打开咬合,排齐整平后利用种植钉整体内收前牙,竖直磨牙或推磨牙向后,调整覆牙合覆盖及尖、磨牙关系至正常。结果    41例患者除2例种植体松动脱落,其余患者第一磨牙在前后向和垂直向均未发生显著性移动,患者颜面侧貌得到了明显改善,取得了较为满意的治疗效果。与矫治前相比,矫治后安氏Ⅱ1患者SNA角、U6-Y距、覆牙合及覆盖明显减小,差异均有统计学意义（P＜0.05）;安氏Ⅱ2患者U1-Y距、U1-X距及覆牙合明显减少,覆盖明显增加,差异均有统计学意义（P＜0.05）。结论    平面导板配合种植钉能够有效治疗安氏Ⅱ1和Ⅱ2错牙合患者,并达到竖直磨牙或推磨牙向后效果;对安氏Ⅱ类错牙合伴有轻度上颌前突或下颌轻度后缩患者,可选择非减数矫治。     

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??Objective    To evaluate the non-reduction treatment results and clinical treatment method for Angel' s Class ?? deep overbite malocclusion cases by the application of microscrews anchorage and fixed bite flat. Methods    The study comprised 41 patients from Orthodontic Department of Liwan District Hospital of Guangzhou??from the year 2009 to 2012. All the patients presented with maxillary protrusion or little mandible intrusion treated with Smart-clip straight wire appliance by non-extraction of premolars. Self-drilling microscrews were impanted in the bilateral huccal alveolar bone between the maxillary first molars and second molar before bonding straight wire appliance.Upper canines were ligated backward to the microscrews in the initial treatment. When the main arch was stable enough??the frontal teeth were retracted together with the microscrews anchorage and retracted teeth. The average treatment time was 19 months??and follow-up lasted 1 year after the treatment. The cephalometric films before and after the treatment were measured and compared. Results    Angel' s Class?? malocclusion in 41 patients were corrected effectively??except for 2 failure cases. Patients' facial profile had been improved greatly. After the treatment??SNA angle??U6-Y??U1-Y??overbite and overject decreased significantly in Class ?? division 1 malocclusion??and in the Class ?? division 2 malocclusion cases?? U1-Y U1-X and overbite decreased significantly??overject increased significantly??both differences had statistical significance ??P < 0.05??. Conclusion    Angel's Class ?? malocclusion can he treated effectively by microscrew anchorage and fixed bite flat??with no loss of molar anchorage. To the  maxillary protrusion or little mandible cases??non-reduction treatments is an effective method.     

钟摆联合NiTi推簧矫治器远移磨牙的疗效观察

目的 评价钟摆联合NiTi推簧矫治器远移磨牙的疗效。方法 测量15例使用该装置远移磨牙病例的术前术后模型，观测磨牙远移的距离及磨牙间的宽度，覆He覆盖的变化。结果 钟摆联合NiTi推簧矫治器使磨牙每月平均远移2mm，磨牙间宽度平均增加0.7mm，前牙覆盖平均增加0.4mm，覆He基本无变化。结论 钟摆联合NiTi推簧矫治器是一种快速有效的推磨牙远移的矫治器。     

Hyperefficient orthodontic treatment using tandem mechanics

This article presents an advanced and efficient noncompliance method of therapy referred to as tandem treatment. Tandem treatment was devised to harness the predictable orthodontic and orthopedic responses elicited by two proven fixed Class II correction devices, the pendulum and Herbst appliances. Tandem treatment involves two separate actions to resolve certain types of Class II malocclusions. First, the upper arch is expanded and the upper molars moved distally into a Class I relation. The pendulum appliance uses palatal and tooth-borne anchorage to move the upper molars distally. The pendulum is followed by a simplified version of the fixed Herbst appliance, which serves as anchorage to retract the remainder of the maxillary teeth to previously Class I positioned molars. This tandem of “pendex” appliance and fixed anchorage Herbst appliance has the ability to greatly improve treatment efficiency when used in appropriately selected patients. A case report is used to illustrate the treatment protocol.