应用固定螺旋缩弓器矫治严重多个后牙正锁

目的研究利用固定螺旋缩弓器缩小上颌牙弓,矫治上牙弓较宽为主的严重多个后牙正锁的可行性。方法选择6例恒牙颌患者,因为上颌牙弓过宽,有2～3个后牙正锁,均使用固定的直丝弓矫治技术,配合上颌固定螺旋缩弓器治疗,通过测量治疗前后的模型上的牙弓宽度,比较治疗前后牙弓宽度变化。结果平均疗程2～3个月,后牙正锁解除。牙弓宽度平均缩小4.5 mm。结论固定螺旋缩弓器矫治正锁高效,避免了一些常规方法引起的不良副作用。     

正畸螺旋缩弓器矫治正锁

目的　探讨正畸螺旋器缩弓治疗以上牙弓较宽为主的正锁的新途径。方法　对入选的 17例正锁患者进行模型分析 ,间隙开辟 ,再用螺旋器缩弓治疗。比较治疗前后牙弓宽度变化。结果　全部患者的正锁均得到矫正 ,牙弓宽度平均缩小 :单侧锁为 2 .5mm ,双侧锁为 4.5mm。正畸螺旋缩弓器戴用时间为 6～ 15周 ,平均为 8周。结论　正畸螺旋缩弓器治疗正锁能提供颌内强支抗 ,力源稳定 ,治疗时间短 ,同时能避免锁牙伸长     

正畸螺旋缩弓器矫治正锁He

目的探讨正畸螺旋器缩弓治疗以上牙弓较宽为主的正锁He的新途径。方法对人选的17例正锁骀患者进行模型分析，间隙开辟，再用螺旋器缩弓治疗。比较治疗前后牙弓宽度变化。结果全部患者的正锁He均得到矫正，牙弓宽度平均缩小：单侧锁He为2.5mm，双侧锁He为4.5mm。正畸螺旋缩弓器戴用时间为6-15周，平均为8周。结论正畸螺旋缩弓器治疗正锁He能提供颌内强支抗，力源稳定，治疗时间短，同时能避免锁He牙伸长。     

固定支架式扩弓器扩大上下颌牙弓初探

目的 探讨替牙(牙合)早期采用固定支架式扩弓器扩大上下颌牙弓矫治牙列拥挤的方法.方法 在1例9岁男童的上下颌同时黏结固定支架式螺旋扩弓器,上颌扩弓1个月,下颌扩弓2.5个月后,用"2×4"技术排齐拥挤的上下颌前牙,并用Hawley保持器保持.结果 上颌尖牙间宽度扩大5.4 mm,磨牙间宽度扩大9.0 mm;下颌尖牙间宽度扩大3.4 mm,磨牙间宽度扩大6.6 mm;上下牙列排列整齐,咬合关系良好.结论 对于基骨丰满、牙弓狭窄的轻度或边缘性中度牙列拥挤拟不拔牙患者,可在替牙(牙合)早期或中期试行上下颌同时扩弓治疗.     

DAMON技术及MBT技术对安氏Ⅱ^1拔牙病例牙弓宽度影响的研究

目的：采用Damon-Ⅲ自锁托槽矫治技术和MBT矫治技术拔除四个第一双尖牙矫治治疗安氏Ⅱ^1错患者,研究治疗前后的牙弓宽度变化。方法：选择20例Damon-Ⅲ自锁托槽矫治技术及20例MBT矫治技术治疗安氏Ⅱ类1分类患者,均采用减数四颗第一双尖牙治疗方案,未额外使用增强支抗装置,治疗前后取寄存模型并进行测量。结果：患者经Damon矫治技术及MBT技术治疗后,均获得良好的咬合关系,Damon组治疗后上尖牙间宽度增大2.24 mm,下尖牙宽度增大1.02 mm,没有统计学意义;上双尖牙宽度减小1.57 mm,下双尖牙宽度减小1.86mm;上磨牙宽度减小1.83 mm,下磨牙宽度减小2.69 mm;MBT组治疗后上尖牙间宽度增大1.72 mm,下尖牙宽度增大1.21 mm;上双尖牙宽度减小1.03 mm,下双尖牙宽度减小1.65 mm;上磨牙宽度减小1.51 mm,下磨牙宽度减小2.37 mm;两组样本对比,上颌尖牙及双尖牙宽度变化有统计学意义。结论：Damon-Ⅲ自锁托槽矫治技术与MBT技术均可快速高效治疗安氏Ⅱ类1分类错[牙合],与MBT技术相比较,Damon-Ⅲ自锁托槽矫治技术在拔牙病例中并没有表现出明显的扩大牙宽度     

单侧完全性唇腭裂患者牙弓宽度正畸扩弓治疗后的稳定性研究

目的探讨单侧完全性唇腭裂后牙反[牙合]患者正畸扩弓矫治后牙弓宽度的稳定性。方法已经完成保持的经过四角舌弓及固定矫治器正畸治疗的手术后单侧完全性唇腭裂患者20名（男性14名，女性6名），三维测量仪对治疗前、治疗后及保持后的研究模型进行尖牙间、第一、二双尖牙、第一磨牙间宽度以及基骨和牙槽弓宽度的测量。统计方法为配对资料的方差分析，两两比较用Fishe rLSD法。结果经过四角舌弓及固定矫治器治疗后单侧完全性唇腭裂患者上颌各段宽度均增加，差异有统计学意义；下颌除第一双尖牙外各段宽度变化不具统计学意义。正畸治疗后上颌牙弓宽度的增加在尖牙和双尖牙区大于磨牙区。保持结束后牙弓各段宽度较治疗后均有减小，其中上颌尖牙间宽度减小1．34±0．82mm（P〈0．05）、第一双尖牙间宽度减小1．52±0．78mm（P〈0．05）达到显著水平。但是保持结束后上颌各段的牙弓宽度仍大于治疗前，差异有统计学意义。结论经过四角舌弓及固定矫治器系统治疗后，单侧完全性唇腭裂患者上颌牙弓各段的宽度均显著增加；保持结束后上颌牙弓各段宽度虽有复发，但是大部分矫治结果能够保持。     

上颌快速扩弓联合固定矫治器治疗的稳定性研究

目的 观察患者接受上颌快速扩弓联合直丝弓矫治器治疗后覆牙合、覆盖及上牙弓宽度的变化。方法 选择2003年2月—2008年1月于青岛市口腔医院进行治疗的患者37例（男19例,女18例）,将患者分为4个不同的时期进行测量（N1:治疗前;N2:进行上颌快速扩弓后;N3:固定治疗后;N4:保持1年后）。分别测量每位患者的上颌尖牙间宽度、前磨牙间宽度、磨牙间宽度,并对前牙覆盖和覆牙合进行测量。患者的平均年龄（11.3±1.4）岁（10.2～15.3岁）。结果 治疗全部结束后、尖牙间宽度、前磨牙间宽度、磨牙间宽度、覆盖、覆牙合分别增加（2.6±2.3）mm、（3.7±2.1）mm、（5.2±2.5）mm、（0.3±0.6）mm、（-0.1±1.6）mm,患者复发率在尖牙宽度为47%,前磨牙间宽度为21％,磨牙间宽度为10%,覆盖复发率为9%,覆牙合为13%。结论 患者经过上颌快速扩弓后,在固定矫治阶段复发明显,保持阶段也有一定程度的复发。 上颌快速扩弓能够减小覆牙合,增加覆盖。     

正畸治疗安氏Ⅲ类错伴下颌偏斜的临床研究

目的探讨治疗安氏Ⅲ类错伴有单侧的后牙反、锁和单侧前牙反的牙源性下颌偏斜的有效方法。方法选择安氏Ⅲ类错伴单侧的后牙反、锁和单侧前牙反等牙源性下颌偏斜患者21例,年龄8~25岁,平均15.5岁。单侧后牙反、锁引起的下颌偏斜通过上颌扩弓、上下牙交互牵引纠正宽度不调,促使下颌自行复位;前牙反通过Ⅲ类牵引予以解除。结果 21例患者均取得良好的矫治效果,治疗后颜面对称性和咬合关系恢复正常,颏点偏斜平均减少（2.9±0.6）mm,因长期错导致的下颌骨偏斜亦得到了明显改善。结论牙源性下颌偏斜,经过合理正畸治疗,随着单侧后牙反、锁及单侧前牙反的解除可得到明显的改善。     

改良Nance弓矫治后牙锁(牙合)伴前牙深覆(牙合)的临床效果

目的探讨改良Nance弓矫治上颌第二磨牙正锁伴前牙深覆病例的临床效果。方法应用改良Nance弓矫治40例上颌第二磨牙正锁伴前牙深覆患者,对矫治前后X线头影进行测量分析和测量临床牙冠高度,并设空白对照组24例作对照。结果治疗组经过3~4个月的矫治,上颌第二磨牙正锁解除,前面高平均增加(2.63±0.57)mm,后面高平均增加(1.66±0.26)mm,覆平均减少(2.59±1.28)mm,上下前磨牙临床牙冠高度均有显著增加,下颌多于上颌。下磨牙临床牙冠高度亦明显增加,上磨牙不明显。结论改良Nance弓是一种简单有效的矫治上颌第二磨牙正锁的口内装置,并能快速打开咬合,尤其适用于深覆低角型患者。     

安氏Ⅱ类2分类错扩弓后牙弓宽度的稳定性研究

目的探讨安氏Ⅱ类2分类错扩弓矫治后的牙弓宽度的稳定性。方法分别测量17例安氏Ⅱ类2分类错患者扩弓治疗前后及保持2年磨牙间及尖牙间牙弓宽度。结果安氏Ⅱ类2分类错患者扩弓治疗前后上下尖牙及磨牙间宽度均明显增大(P<0.05),保持2年后上尖牙及磨牙宽度基本稳定,而下尖牙间宽度明显缩窄。结论安氏Ⅱ类2分类错扩弓矫治后,最好用舌侧保持器做永久保持。     

Long-Term Effects of Rapid Maxillary Expansion Followed by Fixed Appliances

Objective:To evaluate the long-term changes in maxillary arch widths, overjet, and overbite in patients who were treated with rapid maxillary expansion (RME) followed by edgewise appliances.Materials and Methods:The material for the study consisted of study casts taken from 41 patients (19 males, 22 females) on four different occasions (before treatment, T1; after RME, T2; after treatment, T3; and during follow-up period, T4). The upper intercanine, interpremolar, and intermolar widths and overjet and overbite were measured on each set of study casts. Mean age of the subjects was 13.2 ± 1.3 years (range, 11.2–16.9 years) at T1, 13.3 ± 1.3 years (range, 11.3–17 years) at T2, 15.5 ± 1.4 years (range, 13.1–18.8 years) at T3, and 20.4 ± 1.6 years (range, 17.9–24.8 years) at T4.Results:The net increase in intercanine width, interpremolar width, intermolar width, overjet, and overbite was 1.4 ± 2.4 mm, 4.6 ± 2.6 mm, 4.3 ± 2.5 mm, 0.1 ± 0.6 mm, and 0.2 ± 0.6 mm, respectively, and the relapse rates were 37% for intercanine width, 19% for interpremolar width, and 17% for intermolar width at the end of the follow-up period.Conclusions:A significant amount of relapse occurred in maxillary arch widths at the postretention assessment, the greatest being in intercanine width. RME significantly decreased overbite and increased overjet, and a statistically significant decrease was observed in both overbite and overjet at the postretention assessment.     

Short- and long-term evaluation of mandibular dental arch dimensional changes in patients treated with a lip bumper during mixed dentition followed by fixed appliances

Objective:To evaluate short- and long-term mandibular dental arch changes in patients treated with a lip bumper during the mixed dentition followed by fixed appliances, compared with a matched control sample.Materials and Methods:Dental casts and lateral cephalograms obtained from 31 consecutively treated patients before (T₀) and after (T₁) lip bumper, after fixed appliances (T₂), and a minimum of 3 years after fixed appliances (T₃) were analyzed. The control group was matched as closely as possible. Arch width, arch perimeter, arch length, and incisor proclination were evaluated. Repeated measures ANOVA was used to analyze changes in measurements over all four time points between treatment and control groups.Results:Arch widths and crowding were always significantly different except at T₂−T₁. At T₁−T₀, only crowding decreased 3.2 mm while intercanine, interpremolar, and intermolar widths increased by 3.8, 3.3, and 3.9 mm, respectively. Changes at T₃−T₂ showed a significant decrease of 2.1 mm for crowding and an increase of 3.5, 2.9, 2.7, and 0.8 mm for intercanine, interpremolar, and intermolar widths and arch perimeter, respectively. Finally, at T₃−T₀, the reduction in crowding of 5.03 mm was significant and clinically important in the treated group. The differences between intercanine, interpremolar, and intermolar widths were also significant (2.1, 3.8, and 3.6 mm, respectively). All those differences favored the treated group.Conclusions:Mandibular dental arch dimensions were significantly changed after lip bumper treatment. At follow-up, all arch widths were slightly decreased, generating an increase of 0.4 mm in crowding, considered clinically irrelevant. Overall changes remained stable after an average 6.3-year follow-up.     

Relapse tendency in maxillary arch width in unilateral cleft lip and palate patients with different maxillary arch forms.

OBJECTIVE: The aim of this study was to investigate the relapse tendency in the maxillary dental arch widths in unilateral cleft lip and palate patients with different types of maxillary arch form. SUBJECTS: Thirty-two unilateral cleft lip and palate patients treated by one-stage surgical palatal closure were included. The subjects were divided into three groups according to the types of the maxillary arch forms: group A, symmetrical arch form; group B, collapse of minor segment; group C, collapse of both segments. METHODS: Using dental casts obtained at three different times, relapse in the intercanine, interpremolar, and intermolar widths in each group was assessed and differences between groups were investigated. Results: Patients in group A showed stable results in all measurements. Patients in group B showed posttreatment relapse in the intercanine width only, whereas patients in group C demonstrated significant posttreatment relapses in the interpremolar and intermolar widths. Comparison between groups showed more significant relapse in the interpremolar and intermolar widths of group C than in those of group B. CONCLUSION: The types of the maxillary arch forms in unilateral cleft lip and palate patients might play a stronger role in the stability of the maxillary dental arch widths after orthodontic treatment in patients with collapse of both segments and a severe degree of maxillary narrowness.     

Aging in the craniofacial complex

OBJECTIVE: To describe the dental arch changes occurring after adolescence through the sixth decade of life. MATERIALS AND METHODS: Longitudinal dental casts from 40 patients (20 male and 20 female) were digitized and analyzed. Measurements were recorded after the presumed cessation of circumpubertal growth (T1), at approximately 47 years of age (T2), and at least one decade later (T3) were compared. RESULTS: The majority of the measurements were found to have a significant time effect, demonstrating at least some level of change throughout the aging process (T1-T3). Exceptions to this observation were the posterior maxillary arch width measurements, mandibular intermolar and interpremolar (as measured at the second premolars) widths, the maxillary incisor irregularity index, overjet, overbite, and curve of Spee. The T1-T3 changes reflected for the most part the T1- T2 changes, while the T2-T3 changes affected overall modifications only for the mandibular intercanine width and maxillary depth, as measured at the second premolars. All changes reflected a decrease in arch width, depth, and perimeter, with a significant increase in the mandibular incisor irregularity index. CONCLUSIONS: The dental arches continue to change and adapt throughout life and into the sixth decade, though the degree of change decreases with time.     

亚历山大矫治技术治疗安氏Ⅰ类非拔牙患者的临床研究

目的探讨亚历山大矫治器治疗安氏Ⅰ类非拔牙拥挤病例的牙弓变化特征及矫治器应用特点。方法选取33例使用亚历山大托槽系统进行非拔牙矫治的安氏Ⅰ类轻、中度拥挤病例。对治疗前后的研究模型进行三维测量。应用SPSS16．0统计软件分析治疗前后牙弓宽度、牙弓长度变化、排齐阶段所用时间以及下牙列弓丝使用情况。结果牙列治疗后与治疗前阶段相比,牙弓长度、下颌尖牙宽度、前磨牙间宽度和第一磨牙间宽度均显著增加,上颌尖牙间宽度无显著变化。上下牙列排齐时间分别为（2．41±1．13）月和（2．42±1．23）月,下牙列排齐阶段13例患者使用1根弓丝,19例使用2根弓丝,1例使用3根弓丝。结论对于牙列轻、中度拥挤的患者,应用亚历山大矫治技术可以较快实现牙列排齐,并使上下颌牙弓宽度、牙弓长度增大,提高矫治效率。     

不同拔牙正畸模式牙弓形态变化的研究

目的 探讨不同拔牙正畸模式下,成人牙弓形态变化的规律.方法 选40例拔牙正畸病例,分为G1组20例:拔除四颗第一前磨牙,其中男13例,女7例,平均22岁;G2组20例:拔除四颗第二前磨牙,其中男8例,女12例,平均24岁.用模型测量观察矫治前后牙弓长度及尖牙区、前磨牙区和磨牙区宽度;用X线头影测量观察矫治前后切牙内收及...     

Maxillary arch changes with transpalatal arch treatment followed by full fixed appliances

Objective:To evaluate short- and long-term maxillary dental arch dimensional changes in patients treated with a transpalatal arch (TPA) during mixed dentition followed by full fixed appliances in the permanent dentition compared with an untreated sample.Materials and Methods:Dental casts and lateral cephalograms obtained from 36 consecutively treated patients before TPA treatment (T₀), after TPA treatment (T₁), after fixed appliance treatment (T₂), and a minimum of 3 years after fixed appliance treatment (T₃) were analyzed. The control group was matched as closely as possible. Arch widths, perimeter, and length, as well as crowding and incisor proclination, were evaluated.Results:In the treated group, intercanine, interpremolar, and intermolar widths and arch perimeter increased significantly at T₁. At T₂, only the intercanine width increase was still significant. At T₃ all arch dimensions decreased, remaining larger than they were at T₀. The arch length increased after T₁, significantly decreased at T₂, and slightly decreased at T₃. The crowding decreased significantly at T₁, was eliminated at T₂, and increased at T₃. At T_3, 50% of the patients showed relapse with crowding ranging from 0.5 to 2 mm. In the control group at T1, only slight changes were noted but crowding increased. At T2, crowding and upper incisor inclination increased but arch length decreased. At T3, intercuspid width, arch perimeter, and arch length continued to decrease, thereby increasing crowding.Conclusion:Maxillary dental arch dimensions changed significantly after TPA followed by treatment with fixed appliances. Relapse occurred to some extent, especially in intercanine width and arch perimeter, but most of the dental arch changes remained stable.     

Application of Pont's Index to a Jordanian population

The aim of this study was to assess the applicability of Pont's Index to a Jordanian population and to compare the results with those obtained from studies of different ethnic subjects. Dental casts of 144 Jordanians (71 males and 73 females; mean age, 15.5 years) with 'normal' occlusions were selected from the records of a random stratified sample of 383 Jordanian schoolchildren in the 10th grade. The mesiodistal widths of the maxillary permanent incisors, as well as intercanine, interpremolar, and intermolar arch widths, were measured directly on the selected dental casts using a digital calliper. An independent sample t-test was used to determine significant differences in tooth and/or arch width values for males and females. Correlation coefficients determined between the measured arch width values and those calculated according to Pont's Index were low in all cases, with r values ranging from 0.25 to 0.39. It was concluded that Pont's Index should not be used to pre-determine ideal arch width values in Jordanian individuals.     

Twenty-year follow-up of functional treatment with a bionator appliance: A retrospective dental cast analysis

Objective:To investigate changes in dental arch configuration, relationship, and malocclusion directly after Class II malocclusion treatment with a Balters bionator modified by Ascher as well as 20 years after treatment.Materials and Methods:Orthodontic dental cast analysis of 18 patients with skeletal Class II treated with a bionator without any additional fixed therapy was performed with a digital caliper at three stages: before (T0), after (T1) and 20 years after (T2) treatment. Arch perimeter and depth, intermolar and intercanine distance, overjet, overbite, sagittal molar and canine relationship, mandibular incisor irregularity (Little''s index), and malocclusion (PAR index) were assessed.Results:During treatment (T0–T1), upper arch perimeter significantly increased with a significant decrease in the upper and lower arch perimeter long-term (T1–T2), whereas corresponding arch depths changed only slightly in both periods. Transverse intermolar width increased significantly during treatment, remaining almost constant from T1 to T2. Lower intercanine distance remained fairly unchanged during treatment, but decreased significantly during follow-up. Lower incisor irregularity improved slightly during treatment but increased significantly long-term. After treatment, sagittal molar relationships on both sides were improved, overjet and overbite reduced; these significant changes remained stable long-term. The peer assessment rating (PAR) index was significantly lower after treatment and increased insignificantly during follow-up.Conclusions:20 years after bionator treatment without additional fixed appliances, the improved sagittal relationship and the reduced overjet and PAR index remained fairly stable. Long-term changes are most likely due to physiological aging processes and are not associated with bionator treatment.