病例报告：成人正畸与修复治疗结合病例

成人患者口腔情况较儿童复杂，常常有牙体缺损、颜色异常以及牙齿缺失与错袷畸形并存的情况。近些年来，随着人们的生活水平不断提高，对功能与美观的追求也越来越高。对于存在错验畸形的患者单纯修复治疗不能解决间隙不足，咬合紊乱等问题，可酉通过正畸治疗首先纠正牙齿位置异常，使之形成良好的咬合关系，再进行修复，恢复完整牙列，而成人正畸往往由于生长发育已停止，上下颌骨关系不理想，或不希望矫治时间过长等原因难以达到理想的矫治效果，而正畸医师与修复医师配合可以使一些复杂的成人错袷畸形通过较为简单快捷的方法得到理想的结果。     

三种错[牙合]类型患者治疗前心理状态的调查分析

目的探讨3种错[牙合]类型患者正畸治疗前的心理特征,为临床医生治疗患者提供参考。方法随机选取AngleⅠ、Ⅱ、Ⅲ类错患者各100例,男、女各50例,成人、青少年各50例,在治疗前对其进行心理状态调查,记录相应的分值,采用SPSS 10.0进行统计分析。结果Ⅲ类错[牙合]患者想改善牙齿的愿望最强烈;对正畸治疗的恐惧程度Ⅲ类错[牙合]患者最低,其次是Ⅰ类错[牙合]患者,Ⅱ类错患者最高;3种错类型患者对正畸矫治是否有益于牙齿健康、能否改善面型的认知差异均无统计学意义（P〉0.05）,均倾向于认同正畸不仅有益于牙齿健康,也能改善面型。结论 3种错[牙合]类型患者治疗前心理状态存在差异,临床医生治疗前应针对不同错[牙合]类型患者的心理特点进行有效沟通。     

骨性错畸形健康效用值的测定

目的测定正畸患者对不同骨性错畸形的健康效用值。方法使用评价标尺法和时间权衡技术测定青少年及成人正畸患者对不同骨性错畸形的健康效用值。结果对于骨性Ⅱ类（凸面型）低角,青少年患者效用值稍高于成人患者。在青少年患者和成人患者中,骨性Ⅲ类（凹面型）低角的效用值最低,骨性Ⅱ类（凸面型）均角的效用值最高,二者具有统计学差异。评价标尺法与时间权衡技术测定的健康效用值之间均无统计学差异。结论对特定类型的骨性畸形,青少年和成人测定的效用值有差异。     

成人牙周病的正畸治疗

目的探讨正畸治疗对成人牙周病的治疗作用。方法通过对28例患有牙周病的错畸形患者进行常规牙周治疗及正畸治疗,通过比较治疗前后患者的牙周、牙槽骨情况的变化来评价正畸治疗对患有牙周病的错畸形患者的治疗作用。结果28例患者的错畸形得到矫正达到个别正常,矫正结束时牙周情况较矫治前明显改善。结论正畸治疗为错畸形患者创造了健康的牙周环境和功能良好的牙列,对牙周病的治疗有显著作用。     

正畸治疗对成人安氏Ⅱ~1错面部容貌影响的研究

目的通过研究成人AngleⅡ类1分类错畸形患者治疗前后面部彩色照片的视觉模拟评分变化,探讨非手术正畸治疗对这类患者面部容貌造成的影响。方法①选定评分参照照片:从我院就诊的正畸患者中随机挑选男女各40例,由评分小组对每位患者的一组照片给出视觉模拟评分,选择视觉模拟评分均数与中位数最接近且标准差较小的男女各1例患者的照片作为参照照片。②对成年AngleⅡ1错畸形患者治疗前后照片进行视觉模拟评分:随机挑选20例已治疗结束的成年AngleⅡ类1分类错畸形患者,将每位患者矫治前或治疗后的相片及同性别的参照照片作为1个单位同时显示,顺序随机排列,由评分小组进行视觉模拟评分。对治疗前后的评分进行比较和统计分析。结果①选出了男女各1例患者的照片作为评分参照照片;②成年AngleⅡ类1分类错畸形患者治疗前评分值低于普通人群,治疗后评分值与普通人群无差别;治疗后高于治疗前。结论 AngleⅡ类1分类错畸形明显影响患者的面部容貌,非手术的正畸治疗也可以明显的改善成年患者的面部容貌。     

成人牙周病正畸治疗疗效分析

目的:探讨正畸治疗对成人慢性牙周病的治疗作用。方法:选择伴有前牙唇倾、牙间隙增宽、覆牙合覆盖增大的18例患有牙周病的错牙合畸形患者进行常规牙周治疗及正畸治疗,通过比较治疗前后患者的牙周、牙槽骨情况的变化来评价正畸治疗对患有牙周病的错牙合畸形患者的治疗作用。结果:18例患者平均疗程21个月,正畸治疗后牙齿稳定度增加、移位牙复位、牙周袋变浅或消失、牙龈无明显炎症,患者的错牙合畸形均达到个别正常牙合,结束时牙周情况较矫治前明显的改善。结论:正畸治疗改善了错牙合畸形患者的牙周环境和牙列功能,对牙周病的治疗有显著的作用,为成人牙周病的正畸治疗提供一定的参考依据。牙周病是多因素所致的慢性进展性疾病。牙周病患者因牙周支持组织的破坏吸收,常引起牙齿的松动、移位、伸长等,从而引起继发性的牙牙合畸形及咬合创伤。成人牙周病通常会伴有前牙唇侧漂移、牙间隙增宽,覆牙合覆盖增大等错牙合畸形,不仅影响咀嚼功能,还严重影响美观。正畸治疗成为牙周病治疗的重要手段之一,应用固定矫治器对牙周病致错牙合畸形的患者进行矫治,恢复相对理想的牙弓形态和咀嚼功能以及稳定的口腔环境,一直是学者们所关注的问题。临床笔者对18例因牙周病所致前牙散隙的错牙合畸形患者进行牙周及正畸联合治疗,取得满意疗效。     

成人骨性Ⅰ类错(牙合)双颌前突的正颌-正畸联合治疗

目的采用正畸-正颌手术联合治疗成人骨性Ⅰ类错[牙合]前突患者，以期取得面貌及咬合关系的改善。方法选择10例成人骨性Ⅰ类错[牙合]双颌前突患者，通过术前正畸-正颌手术-术后正畸的联合治疗。对治疗前后的头颅侧位片进行测量分析。结果建立良好的上下颌咬合关系，面型改善；SNA、SNB显著减小。结论成人Ⅰ类骨性错[牙合]畸形患者采用正颌-正畸联合治疗，能快速地、有效地获得满意的咬[牙合]功能及侧貌效果。     

正畸-正颌联合治疗成人骨性Ⅲ类错(牙合)研究进展

成人严重骨性Ⅲ类错(牙合)是临床上骨性错(牙合)畸形最为常见的一种,不仅存在牙性问题,同时还伴有颌骨形态、位置的异常,严重影响患者面部美观、口颌功能及心理健康.正畸-正颌联合治疗是行之有效的手段.本文从正畸-正颌联合治疗适应证选择、手术时机、对软硬组织侧貌及稳定性的影响等方面做一综述.     

锥形束CT的特点及其在正畸专业中的应用

在正畸治疗中,X线检查对明确患者的错袷类型、制定错[牙合]畸形患者的矫治计划等具有重要的价值。长期以来,医生使用的曲面断层片和头颅侧位片,均为二维影像,且存在着重叠、图像放大等缺点。传统的扇形CT,因其占地面积大、设备价格高、操作复杂、射线量大、费用昂贵等因素,无法成为正畸患者常规的检查方法。近年来,随着锥形束CT（CBCT）的引入,对正畸患者的诊断和治疗,以及在医患沟通方面均带来了很大的帮助。本文就CBCT的起源和技术特点及其在正畸专业中的应用作一综述。     

骨性Ⅲ类错畸形对语音功能的影响

为了探讨骨性Ⅲ类错畸形对语音功能是否有影响，我们以２０名骨性Ⅲ类错畸形的成年患者为研究对象，由语音专家对其语音进行判听，同时应用计算机语音工作站（ｃｏｍｐｕｔｅｒｉｚｅｄｓｐｅｅｃｈｌａｂ）进行了语音声学分析。结果表明：①多数此类错患者存在语音功能异常，在ｚｈ、ｃｈ、ｓｈ、ｚ诸辅音上最常出现发音错误，错误类型为发音失真（ｄｉｓｔｏｒｔｉｏｎ）和发音替代（ｓｕｂｓｔｉｔｕｔｉｏｎ）。②语音声学分析显示，与正常辅音相比，有发音错误的辅音频率下限下移，频率分布范围变宽，低频成份增加。本项研究结果表明，骨性Ⅲ类错畸形能导致语音功能异常，在口腔正畸外科正畸联合矫治骨性畸形的同时，应考虑患者语音功能的改善。     

The role of occlusion and extraction in orthodontics. Historical overview

Occlusion is important in each unit of dentistry. The authors describe not only the meaning of normal occlusion and dysgnathy but also the historical background focusing on the most important orthodontists, their achievements and literary works. This article gives an overview of the development of orthodontics from the very beginning (ancient times) to nowadays. The most important figures of these periods are: P. Fauchard, F. C. Kneisel, E. H. Angle, C. Case (dark ages); C. F. Ballard, P. R. Begg, C. H. Tweed (golden ages); L. F. Andrews and R. H. Roth (contemporary period). Along these three eras development and changing of the extraction-principles are shown. Nowadays the orthodontists still use Angle's classification and orthodontic treatment with extraction is also accepted. However it is not a separate treatment method, but only used as complement treatment. The authors stress on the importance of normal occlusion, which should be result of every orthodontic, but also prothetic and gnathological treatment.     

Analysis of orthodontic anomalies in mentally retarded developmentally disabled (MRDD) persons

For this epidemiologic study, 458 individuals with mental retardation and developmental disability (MRDD), from 6 to 87 years old, from the Lower Hudson Valley region of New York, were evaluated for the occurrence of orthodontic anomalies. High occurrence of both anomalies of intermaxillary relation, as determined by Angle's classification, and the anomalies of occlusion were found in these individuals when compared with the general population. An increased incidence of both acquired (i.e., open bite) as well as hereditary (Le., prognathia) orthodontic anomalies correlated with the severity of mental retardation. In addition, an increased incidence of Angle class II malocclusion was found in persons with cerebral palsy and autism, and an increase of Angle class 111 malocclusion in persons with autism and Down syndrome. Moreover, it was found that 74% of MRDD persons had definitive malocclusion, while only 37% of the US general population of comparable age has definitive malocclusion. High incidence of malocclusion in this population remained present into old age, mainly due to a lack of treatment and the need to employ non-conventional orthodontic treatment in this population.     

安氏Ⅰ类拔牙正畸治疗牙槽嵴高度变化的CBCT研究

目的 通过分析锥形束CT(cone beam CT, CBCT)比较成人和青少年安氏Ⅰ类正畸患者经减数正畸治疗前后的牙槽嵴高度,探究减数治疗对成人及青少年安氏Ⅰ类患者牙槽骨高度的影响及差异。方法 研究纳入成人和青少年安氏Ⅰ类拔牙正畸患者共40例(成人20例,青少年20例),均减数4颗第一前磨牙进行矫治,通过术前及术后CBCT分别对青少年及成人患者的20颗牙颊、舌侧牙槽嵴高度进行测量及分析。结果 在测量的3 200个根面中,成人在正畸治疗后前牙区牙槽骨高度降低明显;成人矫治前有210个根面骨开裂,拔牙矫治术后为477个,青少年矫治前骨开裂有14个,拔牙矫治术后为40个。结论 正畸拔牙矫治将导致成年患者牙弓前部牙槽骨高度降低,而青少年组拔牙矫治前后各区段牙槽骨高度未见明显变化。     

Occlusal status in Asian male adults: prevalence and ethnic variation

The purpose of this study was to determine the occlusal status in young Asian male adults of three ethnic groups. Study models of a sample of male army recruits (N = 339, age 17-22 years) with no history of orthodontic treatment were assessed. The ethnic proportions of the sample were Chinese 76.1% (n = 258), Malay 17.7% (n = 60), and Indian 6.2% (n = 21). British Standard Institute (BSI) and Angle's classification were used to determine incisor and molar relationships, respectively. Chi-square test or Fisher's Exact test was performed to compare the occlusal traits between ethnic groups. The distribution of incisor relationships of the total sample consisted of Class I = 48.1%, Class II/1 = 26.3%, Class II/2 = 3.2%, and Class III = 22.4%. Right Angle's molar relationships were 49.9%, 24.5%, and 24.2% whereas left Angle's molar relationships were 53.1%, 25.1%, and 21.2% for Class I, II, and III, respectively. Comparison between ethnic groups found that Indian subjects were more likely to have Class II/1 malocclusions and clinically missing permanent teeth (P < .05). The study found that the overall prevalence of malocclusion (BSI) was Class I, Class II/1, Class III, and Class II/2 in descending order of proportions. Angle's Class I molar was most prevalent followed by Class II and Class III relations. A significant difference in occlusal status between the ethnic groups was found regarding incisor relationship and missing permanent teeth (P < .05).     

中国25 392名儿童与青少年错(牙合)畸形患病率的调查

目的调查我国儿童与青少年错(牙合)畸形的患病率。方法 以个别正常(牙合)和Angle错(牙合)分类法为标准,设计统一的调查表格,由口腔正畸专业人员对全国25 392名各牙龄期的儿童与青少年进行错(牙合)形的患病率调查。结果得出了我国儿童与青少年的错(牙合)患病率为67.82％,同时统计出各牙龄期的患病率和错(牙合)畸形类别的构成比。结论 我国儿童与青少年的错(牙合)患病率近40年来有明显增高,由20世纪60年代初的40％升至2000年的67.82％。     

中国25 392名儿童与青少年错（牙合）畸形患病率的调查

目的 调查我国儿童与青少年错He畸形的患病率。方法 以个别正常He和Angle错He分类法为标准，设计统一的调查表格，由口腔正畸专业人员对全国25392名各牙龄期的儿童与青少年进行错He畸形的患病率调查。结果 得出了我国儿童与青少年的错He患病率为67.82%，同时统计出各牙龄期的患病率和错He畸形类别的构成比。结论 我国儿童与青少年的错He患病率近40年来有明显增高，由20世纪60年代初的40%升至2000年的67.82%。     

Orthodontic treatment-service studied retrospectively in a group of Danish children aged 15-16 years

Abstract In a group of adolescent children in 9th grade attending a municipal dental health service, a certain amount of orthodontic treatment has been performed. 27% of the children had completed, or were undergoing, orthodontic appliance therapy. 9% of the children had completed extraction therapy only. 4% were recorded as discontinued appliance treatments and 3% as discontinued after extraction of permanent teeth as the only treatment. 21% had no anomalies and no treatment and 36% had a malocclusion but no treatment carried out. The effect of the orthodontic service was studied on the group as a whole according to the frequency and pattern of change in four selected malocclusion symptoms and to the degree of personal satisfaction about dental appearance and any orthodontic appliances. The individuals most satisfied with the results from their orthodontic treatment were found in the three middle socioeconomic groups.     

农村唇腭裂患者心理健康状况调查研究

目的:了解农村成年唇腭裂患者的心理健康状况,为改善患者的心理健康状况提供理论依据。方法:采用SCL-90症状自评量表对78名农村成年唇腭裂患者及50名农村正常成年人的心理健康状况进行评价。结果:农村成年唇腭裂患者SCL-90总分、阳性项目数及抑郁、焦虑和人际关系诸因子分高于对照组,差异有统计学意义。其中唇裂(CL)、腭裂(CP)、唇腭裂(CLP)三亚组患者之间的心理健康状况差异无统计学意义。唇裂组不同性别之间在SCL-90总分、阳性项目数及抑郁、焦虑诸因子分存在差异,差异有统计学意义。治疗满意度与患者的心理健康状况显著相关。结论:农村成年唇腭裂患者的心理健康状况较差,对唇腭裂患者临床治疗的同时,要重视社会、心理等因素。     

Evaluation of a quality of life measure for children with malocclusion

OBJECTIVE: To explore the validity and reliability of the child perception questionnaire as an oral-health-related quality of life (OHRQoL) measure in adolescents with malocclusion. DESIGN: A cross-sectional study comparing two groups of individuals. SETTING: One group of children with malocclusion was recruited from the orthodontic departments at the Charles Clifford Dental Hospital (CCDH), Sheffield and Chesterfield Royal Hospital (CRH), Chesterfield. A second group with no malocclusion was recruited from the Paediatric Department at CCDH and one General Dental Practice in Sheffield. SUBJECTS AND METHODS: The malocclusion group consisted of 116 patients aged 11-14 years about to commence orthodontic treatment. The non-malocclusion group consisted of 31 11-14-year-old patients with index of orthodontic treatment need (IOTN) 1 and 2, and DMFT 相似文献   

�����������ߵ��ٴ��������

目的研究成人错畸形患者的心理状态,探讨解决方案。方法选择2007年1月至2008年12月在大庆油田总医院集团五官医院口腔科和大庆油田总医院口腔正畸科就诊的成年错畸形患者30例,应用汉密顿焦虑(HAMA)、汉密顿抑郁(HRSD)量表对成人口腔正畸患者矫治前后进行心理状况评定。结果矫治前患者HAMA、HRSD的测量结果明显高于正畸矫治加心理支持治疗后的结果,其差异有统计学意义(P<0.05)。结论成人正畸患者在治疗前普遍存在焦虑、抑郁等临床心理问题,正畸矫治加有针对性的心理支持可改善患者的心理问题。