利用微种植支抗系统矫治成人前牙开(牙合)的进展

开(牙合)是一种病因复杂又相对较难矫治的错(牙合)畸形,治疗方法多样.随着微型种植体支杭系统在正畸领域的应用发展,利用种植体支抗压低磨牙成为矫治成人前牙开?的新而有力的手段.     

利用微种植支抗系统矫治成人前牙开(牙合)的进展

开(牙合)是一种病因复杂又相对较难矫治的错(牙合)畸形,治疗方法多样.随着微型种植体支杭系统在正畸领域的应用发展,利用种植体支抗压低磨牙成为矫治成人前牙开?的新而有力的手段.     

前牙开(牙合)早期治疗的研究进展

前牙开(牙合)作为常见错牙合畸形影响患者口颌功能和颜面美观。其病因复杂,治疗难度大,复发风险高。早期开牙合治疗利用患者生长潜力,改善颌面部垂直向生长异常,减轻后期治疗负担,备受推崇。各类矫治器通过阻断口腔不良习惯、调节异常肌功能、抑制颌骨垂直向发育等作用解除开牙合。本文旨在探究前牙开牙合早期治疗时机以及各类矫治器的临床应用、疗效及稳定性。     

前牙开(牙合)畸形的原因.诊断及正畸治疗研究进展

前牙开(牙合)作为错牙合畸形的一种类型,也是正畸医生常遇到的一个较棘手的问题.此类畸形严重影响患者的切割、发音、呼吸、美观等功能,治疗较难,治愈后又具很高的复发趋势,在正畸领域一致备受关注.本文对开(牙合)的原因和机制,明确开(牙合)畸形的性质及治疗原则予以综述.     

Tweed-Merrifield固定矫正技术治疗开(牙合)

目的 探索使用Tweed-Merrifield技术治疗开He畸形,简化治疗过程,方法 使用国产Broussard单翼托槽,应用Tweed-Merrifiled技术顺序粘结,顺序支抗准备,定向力原理,治疗开始就使用方丝弓,逐步纠正开He病例后牙近中斜,治疗开He。结果 观察病例在治疗早期,开He程度得到迅速减轻。结论 Tweed-Merrifield技术简化弓丝弯制,减少弓丝的使用,有效地弓正后牙的牙轴,解除后牙段不调,治疗楔形效应所致的开He。     

开(牙合)及个别正常(牙合)人群后牙倾斜度的测量研究

目的比较开(牙合)和个别正常(牙合)人群上下颌后牙近中倾斜度。方法选择34例开(牙合)患者和40例个别正常(牙合),拍摄曲面断层片;在曲面断层片上测量开(牙合)患者及个别正常(牙合)人群上下颌第一磨牙,第一、二前磨牙牙长轴的倾斜度并进行统计学分析。结果开(牙合)患者上下颌后牙近中倾斜度明显大于个别正常(牙合)人群,有统计学意义(P<0.0001)。无论开(牙合)还是正常(牙合)人群上下颌后牙的近中倾斜度由大到小依次为:第一恒磨牙、第二前磨牙、第一前磨牙。结论上下颌后牙近中倾斜是开(牙合)形成的机制之一,开(牙合)矫治的重点应放在竖直近中倾斜的上颌后牙及下颌第一磨牙。     

摇椅弓配合种植钉非减数矫治前牙开(牙合)

目的 研究摇椅弓配合种植钉技术矫治前牙开(牙合)的效果,探讨该技术矫治开(牙合)的机制和临床要点.方法 选择18例青少年前牙开(牙合)患者,应用摇椅弓配合后牙区种植钉及前牙段垂直牵引进行矫治,分析矫治前、后的X线头颅侧位片变化.结果 矫治后上下磨牙直立并略压低,上、下颌切牙伸长且上切牙内收,(牙合)平面平整,前牙覆(牙合)覆盖正常,上下唇略内收.结论 摇椅弓配合种植钉技术能有效矫治青少年牙性前牙开(牙合),该技术矫治机理与MEAW技术相似,对轻度拥挤病例可以推磨牙向后并内收前牙.     

开(牙合)畸形的外科整复治疗

本文报告52例开(牙合)畸形的外科整复治疗,其中前牙开(牙合)7例,前牙伴部分磨牙开(牙合)17例,前牙开(牙合)伴部分磨牙开(牙合)及反(牙合)16例,前牙开(牙合)伴磨牙反(牙合)8例,一侧开骀另一侧反(牙合)4例。骨性开(牙合)均伴有颌面畸形,表现为颌骨前突后缩,或不对称畸形。外科整复方法颇多,采用牙槽骨段截骨术11例,下颌体部截骨术9例,下颌升枝部截骨术27例,上颌LeFort Ⅰ型截骨术5例。通过复查与随访:牙性开(牙合)作牙槽骨段截骨术的病例较满意,上颌作LeFon Ⅰ型截骨术的2例,也未发现有失败的病例。     

微种植体支抗矫治高角开牙合病例的临床研究

目的:探讨微种植体支抗矫治高角开牙合病例的可行性。方法:9例高角开牙合拔牙矫治病例,在双侧上、下颌后部牙槽骨上植入微种植体使用轻力对磨牙进行持续压低,对矫治前后的X线头颅定位侧位片进行测量分析。结果:治疗后所有患者建立了正常的覆牙合覆盖关系,上下磨牙被有效压低,下颌骨发生了逆时钟旋转,矫治前后SNB、ANB、MP-FH、MP-SN、ANS-Me/N-Me、U6-PP、L6-MP、OB的变化比较均具有统计学差异。结论:微种植体支抗压低磨牙可有效矫治高角开牙合病例,是一种疗效确切且经济便捷的治疗方法。     

Treatment of open bite with microscrew implant anchorage.

Open bite treatment with microscrew implant anchorage is discussed in relation to vertical control of the posterior dentoalvelar dimension. Maxillary microscrew implants provided anchorage for intruding the posterior teeth and retracting the anterior teeth; mandibular microscrew implants were used to apply intrusion force distal to the mandibular first molars to prevent mesial tipping of the posterior teeth during space closure. Closing the mandibular plane after intruding the maxillary posterior teeth and bodily mesial movement of the mandibular posterior teeth contributed to facial profile improvement. The efficacy and potency of microscrew implants in open bite treatment are discussed.     

应用种植支抗进行颌面部矫形的研究进展

稳定的支抗在正畸矫形治疗中十分重要.正畸通常利用牙齿将矫形力传递至颌骨以发生颌骨变化.这种利用牙列的矫形方法不仅不能提供满意的支抗,而且还会产生各种不理想的牙齿移动和根吸收.因此,将矫形力直接施加于颌骨上的方法更为理想.近年来,种植支抗以良好的生物相容性被口腔正畸领域用于矫形治疗.本文就种植支抗在正畸矫形方面的应用作一综述.     

正畸治疗中磨牙的拔除和保留（五十四）——骨钉矫治恒磨牙正锁

目的：评价应用骨钉矫治恒磨牙正锁的临床效果。方法：选择合并有磨牙正锁的各类错病例14例,男4例,女10例,年龄12-36岁,平均17岁。其中植入骨钉矫治锁者9例,6例进行了后牙减数。单纯植入上颌腭侧骨钉5例,辅助颊侧颧牙槽嵴区骨钉2例,辅助下颌颊棚区骨钉2例;链状皮圈对正锁牙进行颌间交互牵引,为防止链状皮圈被咬断,可做少量的面树脂垫高处理。结果：9例应用骨钉矫治的正锁病例矫治疗程最短15个月,最长24个月,平均18个月。正锁解除时间最短者2个月,最长8个月,平均5个月,全部正锁解除后均达到良好的稳定状态。结论：种植支抗钉用于解除磨牙正锁,直接针对锁发生的机理进行矫治,同步矫治锁牙的高度异常及宽度异常,避免了以往各种方法的诸多缺点,并且使正锁的矫治成为同期矫治各种错内容的一部分,极大地缩短了疗程。     

Correction of severe open bite using miniscrew anchorage

This report describes the treatment of a case of severe open bite with posterior crossbite. While treating open bite, the outcome may not always be successful with orthodontic therapy alone. In such cases, surgical therapy is often chosen to gain a stable occlusion. Skeletal anchorage systems such as miniscrews are now frequently used for correcting severe malocclusion. In this report, we treated an open bite by intruding the molars with miniscrews placed bilaterally in the interdental space between both the upper and lower posterior teeth. The active treatment period was 36 months and the patient’s teeth continued to be stable after a retention period of 36 months.     

微螺钉种植体支抗压低磨牙矫治前牙开（牙合）

近些年来各种骨性支抗系统被开发并应用于临床,来完成牙齿各种类型的运动.微型种植体用于垂直支抗控制方面比传统方法有着更多的优势.本文病例通过应用自攻型微钛钉种植体支抗压低上下颌后部牙齿槽,治疗严重的骨性前牙开（牙合）畸形,证明自攻型微钛钉种植体提供垂直支抗控制的能力.本文也提示通过简单有效的骨性支抗手段,可以提供一种治疗较复杂骨性开（牙合）畸形的全新方法.     

微螺钉种植体支抗压低磨牙矫治前牙开(牙合)

近些年来各种骨性支抗系统被开发并应用于临床,来完成牙齿各种类型的运动.微型种植体用于垂直支抗控制方面比传统方法有着更多的优势.本文病例通过应用自攻型微钛钉种植体支抗压低上下颌后部牙齿槽,治疗严重的骨性前牙开(牙合)畸形,证明自攻型微钛钉种植体提供垂直支抗控制的能力.本文也提示通过简单有效的骨性支抗手段,可以提供一种治疗较复杂骨性开(牙合)畸形的全新方法.     

The use of skeletal anchorage in open bite treatment: a cephalometric evaluation

The aims of the present study were to assess the effectiveness of skeletal anchorage for intrusion of maxillary posterior teeth, to correct open bite malocclusion, and to evaluate the usage of titanium miniplates for orthodontic anchorage. Anterior open bite is one of the most difficult malocclusions to treat orthodontically. Currently, surgical impaction of the maxillary posterior segment is considered to be the most effective treatment option in adult patients. Various studies have reported the use of implants as anchorage units at different sites of midfacial bones for orthodontic tooth movement. The zygomatic buttress area could be a valuable anchorage site to achieve intrusion of maxillary posterior teeth. Ten patients, 17 to 23 years old and characterized with an anterior open bite and excessive maxillary posterior growth, were included in this preliminary study. Titanium miniplates were fixed bilaterally to the zygomatic buttress area, and a force was applied bilaterally with nine mm Ni-Ti coil springs between the vertical extension of the miniplate and the first molar buccal tube. The results showed that, with the help of skeletal anchorage, maxillary posterior teeth were intruded effectively. As compared with an osteotomy, this minimally invasive surgical procedure eased treatment and reduced treatment time and did not require headgear wear or anterior box elastics for anterior open bite correction. In conclusion, the zygomatic area was found to be a useful anchorage site for intrusion of the molars in a short period of time.     

Anterior open bite treatment with magnets

The aim of this study was to examine the effects of repelling magnets on the treatment of anterior open bite and compare them with the effects of acrylic posterior bite-blocks. Twenty patients, aged 9-16 years with skeletal anterior open bite, were randomly divided into two groups. In one group the patients wore posterior repelling magnet splints and in the other they wore acrylic posterior bite-blocks of the same thickness as the magnet splints. The patients were instructed to use their appliance as much as possible (the minimum accepted being 18 hours daily) during a 6-month period. Dental casts, intra-oral photos, and lateral cephalograms were taken before and after treatment, and the patients were also examined regularly to identify the development of any craniomandibular disorders. In the first group, the dental and skeletal vertical relation responded quickly to the magnet treatment. The open bite was generally closed in just under 4 months, especially in patients in early mixed dentition. Spacing in the labial segments decreased in some cases, while slight crowding was induced in others. Transverse problems, i.e. unilateral cross-bite, sometimes followed by scissor-bite on the opposite side, was observed in those patients who were in the early mixed dentition and had used the magnets intensively. The patients who wore acrylic posterior bite-blocks also showed improvement in the dental and skeletal vertical relationships, especially during the first months. This was followed by a 'plateau' period. No transverse problems were found in these patients.