影响牙列中线偏移审美认知的相关因素分析

目的从审美理想值、察觉值及容忍度3个维度上探讨可能影响人群牙列中线偏移审美认知的相关因素。方法设计牙列中线偏移审美认知电子问卷,对符合纳入标准的正畸求诊患者进行电子问卷调查,配合相应口腔临床检查。应用Logistic回归分析研究牙列中线偏移审美认知的影响因素。结果牙列中线偏移审美理想值在0mm左右呈集中趋势,且不受受试者个人因素的影响。Logistic回归分析显示,影响牙列中线偏移察觉值的因素包括文化程度、矫治情况及错程度客观评价;影响牙列中线偏移容忍度的因素包括文化程度和错程度客观评价。结论牙列中线与面中线一致是大众审美追求的目标。调查群体的文化程度、矫治情况及错程度会影响其牙列中线偏移的审美认知。     

正畸患者对女性上颌中切牙和侧切牙牙龈高度不对称的审美评价

目的：调查正畸患者对女性上颌中切牙和侧切牙牙龈高度变化的关注程度和审美评价。方法建立女性上颌中切牙和侧切牙牙龈向切端偏移的模型（上颌中切牙和侧切牙牙龈向切端偏移0.5 mm、1.0 mm、1.5 mm和2 mm）,利用调查问卷对正畸患者进行调查。结果上颌中切牙和侧切牙左右牙龈对称和上颌中切牙牙龈向切端偏移0.5 mm时,是患者认为最美观的笑容;上颌中切牙和侧切牙牙龈向切端偏移1.0 mm时,患者开始察觉上颌中切牙和侧切牙牙龈不对称（P<0.05）;上颌中切牙和侧切牙牙龈向切端偏移1.5 mm到2.0 mm时,患者认为已经影响了美观和笑容（P<0.05）。结论上颌中切牙和侧切牙牙龈不对称的牙龈高度变化1.0 mm到1.5 mm以上时,患者开始察觉和开始认为影响了美观和笑容。     

错(牙合)畸形矫治后中线偏移分析

矫正牙列中线是正畸治疗的重要部分。但是由于错[牙合]畸形的复杂性及患者审美观的不同,临床上牙列中线不调虽未矫正,但患者及其家属能够接受而同意或要求结束治疗。作者对1999～2004年期间本科36例错［牙合］畸形患者治疗结束后,牙列中线偏移情况进行回顾性分析。     

错畸形矫治后中线偏移分析

矫正牙列中线是正畸治疗的重要部分[1]。但是由于错牙合畸形的复杂性及患者审美观的不同,临床上牙列中线不调虽未矫正,但患者及其家属能够接受而同意或要求结束治疗。作者对1999～2004年期间本科36例错牙合畸形患者治疗结束后,牙列中线偏移情况进行回顾性分析。材料和方法收集1     

正畸患者对露龈微笑的审美认知

目的：调查成人正畸患者对露龈微笑的审美认知，并探讨医师的专业知识对正畸患者审美认知的影响。方法建立露龈微笑模型，采用电子调查问卷对正畸患者进行问卷调查。结果调查样本共计99例，露龈微笑的审美理想值-1.0 mm，可接受程度为2.0 mm。经医师对患者进行审美干预后可接受程度为2.5 mm。结论露龈微笑的理想值和可接受度可以为临床治疗提供一定的量化标准，正畸患者接受正畸专业知识干预后，对微笑显露牙龈的可接受程度增大。     

牙列中线偏移的矫治

牙列中线偏移或不对称在正畸临床病例中比较常见，严重者明显影响颜面美观。本文介绍了几种矫治牙列中线偏移或不对称的方法，并对其矫治时机、矫治方法选择以及矫治时是否需拔牙问题进行了一系列探讨。     

牙列中线偏斜的审美研究进展

面部对称是容貌美观的重要影响因素。在微笑美学的研究中,牙列中线与面中线的一致性与微笑审美评价结果密切相关,直接影响患者微笑的美观程度。由于牙列中线偏斜在普通人群中发生率较高,因此,牙列中线与面中线不一致常作为患者就诊的主诉,同时也是正畸医生在制定治疗计划时需要特殊考虑的一个临床诊断指标和矫治目标。本文将对牙列中线偏斜的流行病学情况、病因学分类、诊断与治疗方法及其对微笑审美的影响作一综述,以期指导临床操作。     

青少年患者正畸治疗后不同牙位邻面探诊深度的分析

目的本文对青少年患者正畸结束时,不同牙位的牙周探诊深度进行比较,以确定正畸过程中牙龈炎的好发牙位.方法选择12名青少年患者正畸结束时,对牙列中不同牙位进行邻面位点牙周探诊深度的检查,并比较不同牙位的探诊深度有无显著差别.结果第一磨牙邻面探诊深度(3.11±1.07mm)明显高于其他牙位的牙齿(P值为0.000-0.028),其他牙位的牙齿之间邻面探诊深度无明显差别.结论第一磨牙为正畸过程中最易发生牙龈炎的牙位.     

正畸与修复联合治疗成人前牙列散在间隙的临床分析

目的:评价成人患者应用正畸及修复联合治疗前牙列散在间隙的临床疗效。方法:对31例曾经进行直接修复法修复前牙列散在间隙不满意患者,废弃原有修复体,实施固定正畸及修复联合治疗方案,先期正畸方法排齐整平牙列,集中牙列间隙,调整咬合关系,根据正畸后的牙列情况进行修复治疗。结果:通过正畸与修复联合治疗,所有病例前牙形态正常,上下前牙中线与面中线一致,不仅达到了良好的咬合功能,而且达到了美观的效果。结论:成人采用正畸与修复联合治疗,矫治时注意成人患者的心理,生理特点,制定治疗方案,能够较好地达到恢复患者咬合功能,同时获得前牙美容效果的治疗目标。     

隐形功能矫治器治疗骨性下颌后缩青少年患者一例

患者,女,12岁.主诉牙飘要求矫治.全身状况良好,既往体健,否认正畸治疗史及家族史,无不良习惯. 一、临床检查: 1.面部检查:正面观:左右基本对称,开唇露齿,闭唇困难;侧面观为凸面形,下颌后缩(图1). 2.口内检查:恒牙列,双侧磨牙和尖牙为远中尖对尖关系;上牙列无拥挤,下牙列轻度拥挤,上牙列中线居中;前牙覆盖10 mm,Ⅲ度深覆(牙合)(图1).     

正畸患者对上颌牙列中线轴向倾斜的审美评价

目的:探讨正畸患者对不同程度上颌牙列中线轴向倾斜的审美评价。方法:采用上颌牙列中线不同程度轴向倾斜的图片模型,制作电子问卷软件,对203位符合条件的正畸患者(男79人,女124人)分理想值、觉察值和容忍值3个层次进行问卷调查。结果:受试对象对女性图片上颌牙列中线轴向向左、右倾斜的平均觉察值分别是4.7°、4.9°,容忍值是9.7°、9.5°;男性图片则为4.1°、5.1°和9.0°、9.7°。其中除了男性图片左、右侧的觉察值之间有统计学差异之外(P<0.05),其余评价值左、右侧之间无统计学差异(P>0.05)。觉察值的中位数和四分位数间距均为4.0°,2.0°;容忍值则均为10.0°,6.0°。女性和男性图片平均理想值分别为0.1°和0.4°,且与总体均数μ=0间无统计学差异(P>0.05)。女性受试者对男性图片牙列中线右侧轴向倾斜的觉察值要明显低于男性受试者。结论:该审美评价的3个层次是合理的,其研究结果对口腔科医生具有临床指导意义。     

Young People's Esthetic Perception of Dental Midline Deviation

Objective:To test the hypothesis that young people''s esthetic perception of dentition midline deviation or the threshold below which they find the deviation “acceptable” depends on the gender and face type of the person with the deviation and the gender of the evaluator.Materials and Methods:Facial images of six young subjects with three different face types were captured, and their dentition midlines were altered digitally. The images were evaluated by young people with no dental training. Statistical analysis was carried out to determine the threshold for acceptable dentition midline deviation and factors influencing perception.Results:The mean value for the threshold below which a deviation was judged “acceptable” was 2.403 mm (95% confidence interval, 2.315–2.491). The preferences of evaluators did not significantly depend on the direction of the deviation. Both male and female evaluators were significantly less tolerant of deviation in female subjects than in male subjects. However, female evaluators were significantly more tolerant of midline deviations in male subjects than were male evaluators. In addition, the same degree of deviation was most noticeable in male subjects with a tapered face type and least noticeable in female subjects with a square face type.Conclusions:The gender and face type of an individual with dentition midline deviation and the gender of the evaluator do affect young people''s esthetic perception of a dentition midline deviation and the threshold below which they find the deviation “acceptable.”     

骨性下颌前突伴偏斜畸形的牙弓和牙齿代偿分析

目的：作者对骨性下颌前突伴偏斜患者的牙弓和牙齿代偿现象进行研究。方法：测量11例骨性下颌前突伴偏斜患者治疗前模型，将上颌腭中缝作为中线标准，测量牙弓两侧同名牙接触点到腭中缝的距离，观测牙弓的对称性。同时He平面作为参考平面，测量上下颌后牙颊舌向倾斜程度。结果：骨性下颌前突伴偏斜患者的上牙弓左右不对称,偏斜侧（下颌颏部所指向的一侧）牙弓宽度明显大于对侧。偏斜侧上后牙颊向倾斜， ．下后牙舌向倾斜。结论：下颌前突伴偏斜形会导致上颌牙弓和上下颌后牙出现代偿，在术前矫治的重点是去代偿治疗。     

Comparing the perception of dentists and lay people to altered dental esthetics

PURPOSE: This study was designed to determine the perceptions of lay people and dental professionals with respect to minor variations in anterior tooth size and alignment and their relation to the surrounding soft tissues. MATERIALS AND METHODS: Smiling photographs were intentionally altered with one of eight common anterior esthetic discrepancies in varying degrees of deviation, including variations in crown length, crown width, incisor crown angulation, midline, open gingival embrasure, gingival margin, incisal plane, and gingiva-to-lip distance. Forty images were randomized in a questionnaire and rated according to attractiveness by three groups: orthodontists, general dentists, and lay people; 300 questionnaires were distributed. RESULTS: The response rate was 88.2% for orthodontists, 51.8% for general dentists, and 60.6% for lay people. The results demonstrated threshold levels of noticeable difference between the varying levels of discrepancy. A maxillary midline deviation of 4 mm was necessary before orthodontists rated it significantly less esthetic than the others. However, general dentists and lay people were unable to detect even a 4-mm midline deviation. All three groups were able to distinguish a 2-mm discrepancy in incisor crown angulation. An incisal plane cant of 1 mm as well as a 3-mm narrowing in maxillary lateral incisor crown width were required by orthodontists and general dentists to be rated significantly less esthetic. Lay people were unable to detect an incisal plane asymmetry until it was 3 mm, or a lateral incisor narrowing until it reached 4 mm. Threshold levels for open gingival embrasure and gingiva-to-lip distance were both at 2 mm for the orthodontic group. Open gingival embrasure became detectable by the general dentists and lay people at 3 mm, whereas gingiva-to-lip distance was classified by these groups as noticeably unattractive at 4 mm. CLINICAL SIGNIFICANCE: The results of this study show that orthodontists, general dentists, and lay people detect specific dental esthetic discrepancies at varying levels of deviation, which may aid the dental professional in making specific treatment recommendations.     

Prevalence and severity of malocclusion in children with cleft lip and/or palate in Hong Kong.

The prevalence and severity of malocclusion among children with cleft lip and palate in Hong Kong has never been assessed or documented. A group of 20 children in the primary or early mixed dentition stages, with clefts of the lip and/or palate were assessed using the Occlusal Index. Results of this preliminary study showed that 92.3 percent of the male and 71.5 percent of the female subjects had severe malocclusion, which implied that comprehensive orthodontic treatment at a later stage would be needed. More than half (69.2% of the male, and 57.1% of the female subjects) had syndrome F, defined as mesial molar relationship, overjet, overbite, posterior crossbite, midline diastema, and midline deviation (Summers, 1966). Therefore malocclusion problems were shown to manifest early in patients with cleft lip and/or palate, and further that it is possible to assess malocclusion prevalence and severity in early stages of dental development.     

Comparing the Perception of Dentists and Lay People to Altered Dental Esthetics

Abstract: Purpose: This study was designed to determine the perceptions of lay people and dental professionals with respect to minor variations in anterior tooth size and alignment and their relation to the surrounding soft tissues.
Materials and Methods: Smiling photographs were intentionally altered with one of eight common anterior esthetic discrepancies in varying degrees of deviation, including variations in crown length, crown width, incisor crown angulation, midline, open gingival embrasure, gingival margin, incisal plane, and gingiva-to-lip distance. Forty images were randomized in a questionnaire and rated according to attractiveness by three groups: orthodontists, general dentists, and lay people; 300 questionnaires were distributed.
Results: The response rate was 88.2% for orthodontists, 51.8% for general dentists, and 60.6% for lay people. The results demonstrated threshold levels of noticeable difference between the varying levels of discrepancy. A maxillary midline deviation of 4 mm was necessary before orthodontists rated it significantly less esthetic than the others. However, general dentists and lay people were unable to detect even a 4-mm midline deviation. All three groups were able to distinguish a 2-mm discrepancy in incisor crown angulation. An incisal plane cant of 1 mm as well as a 3-mm narrowing in maxillary lateral incisor crown width were required by orthodontists and general dentists to be rated significantly less esthetic. Lay people were unable to detect an incisal plane asymmetry until it was 3 mm, or a lateral incisor narrowing until it reached 4 mm. Threshold levels for open gingival embrasure and gingiva-to-lip distance were both at 2 mm for the orthodontic group. Open gingival embrasure became detectable by the general dentists and lay people at 3 mm, whereas gingiva-to-lip distance was classified by these groups as noticeably unattractive at 4 mm.     

颊旁间隙对微笑美影响的研究

目的：探讨汉族人颊旁间隙对微笑美的影响。方法：选出青年美貌男性1名，女性1名，用 Adobe Flash CS4软件制作连续大小颊旁间隙（0％～25％）模型。选取正畸医师96名，平均年龄（35．1±7．2）岁，非专业人员96名，平均年龄（37．3±5．1）岁，分别对男、女模特颊旁间隙进行最低容忍值（A）、理想值（B）以及最高容忍值（C）的测量，数据经统计学处理。结果：对男模特的审美：正畸医师组的 A、B、C 值（％）分别为5．00±0．17、9．75±2．77、15．00±2．84，非专业人员组的 A、B、C值分别为4．79±1．00、9．20±3．08、15．05±2．91；对女模特的审美：正畸医师 A、B、C 值分别为3．92±0．17、11．87±2．77、15．82±2．84，非专业人员的 A、B、C 值分别为4．00±1．00、12．05±3．08、15．11±2．91；各项数据组间比较，P ＞0．05。男、女性颊旁间隙的理想值（％）分别为9．48±2．73 和 11．96±1．99，P ＜0．05。结论：正畸医师与非专业人员对汉族青年颊旁间隙的审美观无差异，性别不同最美颊旁间隙大小不同。     

MEAW技术在成人正畸后期中线改正中的应用

目的总结多曲方丝弓(MEAW)技术在成人错牙合畸形矫治后期进行中线改正的应用效果。方法临床矫治12例,年龄18~26岁,平均21.4岁。经直丝弓技术非拔牙矫治后遗留的轻度上下前牙中线不齐、单侧咬合关系欠佳等缺陷,采用MEAW技术并配合不同方式的牵引。结果经过MEAW技术3~6个月的精细调整,全部病例均达到预期矫治效果,改正了轻度上下前牙中线不齐,建立了良好的咬合关系,达到了稳定的矫治效果。结论对成人非拔牙矫治后期出现的轻度上下前牙中线不齐及单侧咬合关系欠佳,可以通过MEAW技术配合不同方向和力值的颌间弹力牵引,达到理想矫治效果。     

Acceptable Deviation between Facial and Dental Midlines in Dentate Population

The success of the dental restorations largely depends on its esthetics, although various literature reviews recommend that anterior teeth midline be placed coinciding the facial midline, the amount of acceptable deviation between facial and dental midline has not been fully investigated. To observe the acceptable deviation between the dental and facial midline. Facial photographs of 200 students aged about 18–30 years of both sexes, without any missing teeth, with complete alignment of anterior teeth, were selected and scanned on to computer screen. Using specialized programme, the crown width of the central incisor in the mouth and on photograph was ensured constant. The distance between the facial midline, (obtained by bisecting intercanthal line) and the mesial surfaces of the central incisors were read on the computer. 44.4 % Boys and 55 % of Girls showed deviation between dental and facial midline in the range of 0–1 mm. while, 54 % of boys and 33 % of girls showed deviation of the dental and facial midline in the range 1–2 mm. 37 % of boys and 8 % of girls showed deviation of dental midline with facial midline with the range of 2–3 mm. 80 % of the study population showed maxillary and mandibular dental midlines never coincide. Majority of the study population showed deviation between facial midline and anterior teeth midline within the range of 0–1 mm.