MEAW技术用于矫治末期精细调整14例报告

目的：总结MEAW技术在错He畸形矫治末期进行精细调整中的应用效果。方法：临床矫治14例，年龄14-26岁，平均17．8岁，18岁以上6例。经标准方丝弓技术矫治后遗留局部小开He，上下颌牙齿尖窝交错关系未建立等缺陷，采用MEAW技术加颌间弹力牵引进行咬合关系的精细调整。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，建立了正常的覆He覆盖关系，建立良好的咬合关系，达到了He的稳定状态。结论：对矫治末期出现的缺陷，通过MEAW技术加各种不同方向和力值的颌间弹力牵引，进行牙列的精细调整，可建立完善的牙齿尖窝对应关系，提高矫治效果。     

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。     

MEAW技术在正畸末期精细调整的应用

目的 :探讨多曲唇弓技术在正畸矫治末期精细调整的作用。方法 :选择拔牙矫治病例 8例 ,非拔牙病例 4例 ,均在矫治末期存在轻度的咬合紊乱。使用方丝弓及国产直丝弓矫治器 ,经过排齐、整平、关闭拔牙间隙 ,最后使用多曲方丝弓矫治前、后牙的局部开牙合、磨牙轻度近中、远中关系 ,尖牙尖对尖关系 ,上下中线不齐等局部错牙合。结果 :12例病人平均两个半月时间达到较理想效果。结论 :可将多曲方丝弓技术应用于正畸末期的精细调整 ,操作准确、效果稳定     

MEAW：新一代的理想弓——在矫治末期利用MEAW进行精细调整及建立理想咬合的技巧

MEAW:新一代的理想弓——在矫治末期利用MEAW进行精细调整及建立理想咬合的技巧@姚森$厦门解放军第174医院!南京军区口腔正畸中心361003     

MEAW技术治疗开(牙合)的体会

多曲方丝弓矫治技术（MultiloopEdgewiseArchwire简称MEAW技术）因其特殊的结构和特殊的功用，已愈来愈多地受到国内外正畸学者的重视。而开（牙合）畸形是一种危害严重的错（牙合）畸形，其病因、机制复杂，临床诊断治疗困难、复发率高。作者在临床工作中运用该技术在矫治后期对临床较疑难的开（牙合）畸形病例进行矫治，取得了满意效果。     

口腔正畸治疗要点Ⅰ.正畸治疗的诊断分析与矫治设计

口腔正畸治疗的诊断分析、矫治设计以及治疗的基本理论和技能是十分重要的。各种不同的矫治技术，不论是方丝弓矫治技术、直丝弓矫治技术，还是多曲方丝弓矫治技术，虽然各有特点，但都建立在相同的矫治基础上，如矫治中的支抗设计和矫治牙移动的控制等方面。而要取得矫治成功，必须能掌握和应用这些基本内容。即将陆续发表的口腔正畸系列讲座主要介绍这些方面的内容。讲座的作者都是具有丰富的教学、临床经验的医师，希望能给读者带来裨益。[编者按]     

多曲方丝弓技术在矫治末期咬合调整中的临床应用

目的 观察多曲方丝弓(MEAW)技术在错验畸形矫治末期调整咬合的临床应用效果。方法 13例患者，使用MEAW技术前存在磨牙支抗丧失，前牙覆He覆盖过深或磨牙前倾，前牙小开He或上下牙尖窝关系不紧密，中线偏斜等问题。采用MEAW技术配合颌间牵引进行调整。结果 经过3～6个月的咬合调整，全部病例均覆He覆盖关系正常，尖窝关系良好。结论 MEAW技术配合颌间牵引用于矫治末期的咬合调整效果满意。     

一种能在口腔中应用的正畸实习训练器

学习正畸矫治技术的初学者通常要面对两方面困难：理论学习和实践操作。两者之间必然是相辅相承的。从理论学习到临床工作有一个必然的过渡阶段，形象地说就是从机械的模仿到一个“自如”的工作阶段。随着社会发展，正畸患者就诊的要求不断提高，教学医院中允许学生直接进入临床诊室实习的机会在相对减少，而现实又要求我们的学生能够迅速进入工作的“自如”状态。实习操作     

正畸弓丝在口腔环境中力学性能的实验研究

作者通过模拟牙矫治实验，测定常用的正畸弓丝在口腔环境中２８天的力学性能变化，结果显示；在口腔环境中，各种弓丝都有力值的下降和残余变形量的增加。力值衰减主要由多动引起，残余变形主要发生在７天内，不锈钢丝力衰减快，镍钛丝性能稳定。带垂曲的弓丝和镍钛丝性能相似，能提供较持续的矫治力。     

多曲方丝弓在直丝弓矫治后期的临床应用

目的 总结多曲方丝弓技术(multiloop edgewise arch wire,MEAW)在错牙合畸形矫治末期进行精细调整中的应用效果。方法 15例患者,经直丝弓技术矫治后期遗留磨牙支抗丧失,前牙覆牙合覆盖过深或磨牙前倾,局部小开牙合或上下牙尖窝关系不紧密,中线偏斜等问题,采用MEAW技术配合颌间牵引进行调整。结果 经过3～6个月的咬合调整,全部病例均覆牙合覆盖关系正常,尖窝关系良好。结论 MEAW技术配合颌间牵引用于直丝弓矫治末期的咬合调整效果满意。     

双颌前突畸形正畸治疗后颅面硬组织变化的研究

目的研究正畸治疗对双领前突患者硬组织矢状及垂直向的影响。方法对24例广东籍双领前突患者在拔除4个第一双尖牙后,采用标准方丝弓矫治技术进行矫治,并对矫治前后硬组织侧貌的变化进行分析。结果 ①上下领骨间关系无明显变化,上下前牙突度和倾斜度明显减小。②前后面高明显增加,但前后面高间的比值及反映下领平面倾斜度的MP-FH无明显变化。③上下磨牙高度随前后面高的增加而明显增加。④上前牙高度明显增加,下前牙高度明显减小。结论双领前突畸形正畸治疗中垂直向及矢状向支抗可得到较好控制。     

CC—1型正畸粘合剂的研制与临床应用

介绍了一种双糊剂型正畸专用粘合剂,物理性能测试显示:表面硬度为4.57MPa,径向拉伸强度为43.2MPa,压缩强度为168.3MPa,与牛牙釉质及金属的剪切强度各为21.2和14.8MPa,固化时间为1.5min。毒性试验显示其为无毒级。常温下放置半年或冷藏1年,其外观、固化时间及物理性能无明显改变。临床粘结5286只托槽,观察2年2月,托槽脱落率低(2.49％),操作方便。显示该粘合剂为较理想的正畸粘合剂。     

Influence of Supplemental Written Information on Adolescent Anxiety,Motivation and Compliance in Early Orthodontic Treatment

Objectives:To test the null hypotheses that supplementation of verbal information with written information when obtaining consent to orthodontic treatment has no effect on (1) anxiety, motivation and apprehension related to treatment and (2) compliance in the early stages of fixed appliance therapy.Materials and Methods:Seventy-six adolescents who were due to start fixed appliance therapy were randomly allocated to receive verbal information only or verbal and written information before orthodontic treatment. Participants'' anxiety, motivation, and apprehension were assessed using a questionnaire that was completed prior to meeting the orthodontic clinician (T1), following consent to treatment (T2), and after 12 weeks of treatment (T3). Appointment attendance, appliance breakages, and periodontal scores were used as measures of patient compliance.Results:Sixty participants completed the study. At T2 there was no change in anxiety scores for either group (P  =  .412); however, increased motivation was detected in the group that had been given both written and verbal information (P  =  .049). At T3 both groups demonstrated similar reductions in anxiety (P  =  .311) and apprehension (P  =  .790) and similar levels of motivation (P  =  .756). A reduction in periodontal scores (P  =  .065), better appointment attendance (P  =  .732), and fewer breakages (P  =  .525) were reported in the group that was given additional information, although these changes were not statistically significant.Conclusions:Supplementation of verbal information with written information resulted in improved motivation for orthodontic treatment but had no statistically significant effect on anxiety, apprehension, or patient compliance.     

A Survey of Perceived Problems in Orthodontic Education in 23 European Countries

Abstract

This paper reports on a survey of perceived problems in the provision of orthodontic education at the stages of undergraduate, postgraduate, and continuing professional education (CPE) in 23 European countries in 1997. A questionnaire, together with an explanatory letter, was mailed to all members of the EUROQUAL II BIOMED project. Answers were validated during a meeting of project participants and by further correspondence, when necessary. The topics covered in the questionnaire were adequacy of funding, numbers of orthodontic teachers, availability of equipment, regulations, training centres, numbers of orthodontists, availability of books, journals, and information technology. Completed questionnaires were returned by orthodontists from all 23 countries. Respondents from seven countries did not answer all questions. Respondents reported a perceived almost universal lack of adequate funding for postgraduate orthodontic training (from 18 out of 20 countries) and, to a lesser extent, at undergraduate (13 out of 20 countries) and CPE levels (17 out of 21 countries). Respondents from 12 of the 20 countries reported adequate numbers of qualified teachers at undergraduate level, but only seven out of 18 at postgraduate level and eight out of 19 for CPE. Lack of suitable equipment was reported as a more frequent problem by central and eastern European countries (six out of 20 countries at undergraduate level, eight out of 20 countries at postgraduate level, and 12 out of 19 at CPE level). Too few or too many regulations were only perceived to be a problem by the respondent from one country out of 19 at undergraduate level, by seven out of 19 at postgraduate level, and by eight out of 16 at CPE level). Lack of training centres was more frequently reported as a problem by respondents from central and eastern European countries, but was generally not perceived as a problem by respondents from west European countries. Respondents from seven countries reported a lack of training centres for CPE. Respondents from six countries reported that they perceived there to be too many orthodontists at postgraduate level, from seven countries that there were an appropriate number, and from seven that there were too few. A lack of books, journals, and information technology was reported to be a problem by respondents from four out of 19 countries at undergraduate level, eight out of 20 at postgraduate level, and 10 out of 20 at CPE level. At both undergraduate and postgraduate level, the majority of respondents from central and eastern European countries reported problems with books, journals, and information technology. The results of the survey confirmed many anecdotal impressions and provided an extremely useful background against which to formulate quality guidelines for orthodontic education in Europe.     

正畸患者就诊原因的调查研究

目的　 调查泸州地区正畸患者就诊的原因。方法　 将在泸州医学院附属口腔医院正畸科进行正畸治疗的452名患者纳为就诊人群组,泸州市第二中学的600名在校学生纳为非就诊人群组,对其进行问卷调查,并将两组问卷结果进行?掊２检验。结果　 就诊人群组收回有效问卷452份,非就诊人群组收回有效问卷529份。统计分析结果表明：①正畸治疗的主要目的是排齐牙列;②37.39％的正畸患者是应父母的要求来接受正畸治疗;③就诊人群组中期望排齐牙齿的患者占调查总人数的76.1%,其显著高于非就诊人群组（43.29％）;④就诊人群组多数人能够接受正畸所需时间及费用,其接受率高于非就诊人群组;⑤大部分正畸患者认为人的相貌很重要。结论　 美观是正畸患者前来就诊的主要原因。     

正畸牵引术在下颌第三磨牙低位近中阻生拔除中的应用

目的 :研究正畸牵引拔除下颌近中阻生第三磨牙对改善邻牙牙槽骨缺损的作用。方法 :选取2016-07—2018-01期间,我院收治的单侧或双侧有第二磨牙远中牙槽骨缺损的下颌第三磨牙近中阻生患者60例,按照随机数字表法将所有患者分为对照组(30例)和正畸牵引组(30例)。对照组患者常规拔除下颌第三磨牙,正畸牵引组患者经正畸牵引1~6个月后拔除下颌第三磨牙。检测患者正畸牵引治疗前(T0)、拔牙前(T1)、拔牙后3个月(T2)、拔牙后6个月(T3)这几个时间点,下颌第二磨牙近中及远中牙槽嵴顶至釉牙骨质界高度、下颌第二磨牙近中及远中牙槽骨密度、张口受限情况。结果:正畸牵引组患者在T1、T2、T3节点时,下颌第二磨牙近中牙槽嵴顶至釉牙骨质界高度分别为5.16、3.98、2.12 mm,均低于对照组的7.16、4.57、3.16 mm,差异有统计学意义(t/P=12.250/0.001、8.963/0.001、56.680/0.001)。正畸牵引组患者在T1、T2、T3节点时,下颌第二磨牙远中牙槽嵴顶至釉牙骨质界高度分别为5.24、3.15、2.34 mm,低于对照组的8.12、5.49、3.16 mm,差异有统计学意义(t/P=17.670/0.001、43.280/0.001、15.110/0.001)。正畸牵引组患者在T1、T2、T3节点时,张口受限评分分别为2.10、1.25、0.68分,均低于对照组的2.56、2.00、1.69分,差异有统计学意义(t/P=9.690/0.001、30.530/0.001、41.120/0.001)。结论:正畸牵引拔除下颌近中阻生第三磨牙可有效改善邻牙牙槽骨缺损现象,增大牙槽骨密度。     

Orthodontic appliances made of organic polymer used in the metal allergic patient can withstand orthognathic surgery

We developed an orthodontic appliance completely made of organic polymer. The appliance was used for many years and proved very effective. It was used for the treatment of patients with metal allergy, and as a result, it is believed to be the best choice for treating metal allergies. In this report, we are presenting a surgical case with Class III malocclusion for a patient with metal allergy, and the concept of the appliance is briefly discussed.