3种功能矫治器矫治骨性Ⅱ类错的临床疗效对比研究

目的探讨Twin- block、Activator和Herbst功能矫治器治疗骨性Ⅱ类错的临床疗效是否存在差异。方法 选择使用Twin- block、Activator和Herbst功能矫治器矫治成功的60例骨性Ⅱ类错患者为研究对象。根据使用矫治 器的不同，将其分为Twin- block组、Activator组和Herbst组，每组均为20例患者。在正畸治疗前和功能矫治完成后 （第一恒磨牙建立中性关系）对每位患者拍摄X线头颅侧位片，对其治疗前后X线头影测量值进行比较。结果3 组患者功能矫治器治疗后，矢状向关系上ANB角、SNB角、Go- Gn、Co- Gn、L1-MP的变化具有统计学意义，垂直 向关系上N-Me、ANS-Me、S- Go、SN-MP及Co- Go的变化具有统计学意义。与Twin- block组、Activator组相比， Herbst组患者下前牙的唇倾（L1-MP）更明显，但抑制上前牙前倾（U1- SN）的效果不明显。3组患者上颌向前生长 （Ptm- A）及垂直向变化（OB、N-Me、ANS-Me、S- Go、Co- Go）无明显差异。结论Twin- block、Activator和Herbst 矫治器对骨性Ⅱ类错的早期矫治机制是相似的，但Herbst矫治器对下颌的矫形和下前牙的唇倾作用更明显。     

高位口外牵引在青少年骨性II类错治疗中的作用

目的:探讨高位口外牵引在青少年骨性II类错牙合早期矫治中的作用,并评价其临床疗效。方法:选取11例生长发育期骨性安氏II类错牙合病例,采用高位口外牵引治疗,与7例未经治疗的生长发育期骨性II类错牙合进行对照。摄取X线头影侧位定位片,用Pancherz分析法评判治疗过程发生的骨性和牙性变化,以SPSS11.0软件进行独立样本t检验。结果:高位口外牵引可以限制上颌发育,SNA、A-Olp2项指标在治疗组与对照组间具有统计学差异(P<0.01)。上颌磨牙远中移动具有显著差异(P<0.01)。结论:高位口外牵引能够限制上颌发育,有利于下颌发育,达到矫治目的;同时,垂直方向和矢状方向的牙及牙槽反应,有利于患者牙颌面形态的进一步改善。     

Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion

Objective:To analyze the long-term skeletal and dentoalveolar effects and to evaluate treatment timing of Class II treatment with functional appliances followed by fixed appliances.Materials and Methods:A group of 40 patients (22 females and 18 males) with Class II malocclusion consecutively treated either with a Bionator or an Activator followed by fixed appliances was compared with a control group of 20 subjects (9 females and 11 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (mean age 10 years), end of treatment with functional appliances (mean age 12 years), and long-term observation (mean age 18.6 years). The treated sample also was divided into two groups according to skeletal maturity. The early-treatment group was composed of 20 subjects (12 females and 8 males) treated before puberty, while the late-treatment group included 20 subjects (10 females and 10 males) treated at puberty. Statistical comparisons were performed with analysis of variance followed by Tukey''s post hoc tests.Results:Significant long-term mandibular changes (Co-Gn) in the treated group (3.6 mm over the controls) were associated with improvements in the skeletal sagittal intermaxillary relationship, overjet, and molar relationship (∼3.0–3.5 mm). Treatment during the pubertal peak was able to produce significantly greater increases in total mandibular length (4.3 mm) and mandibular ramus height (3.1 mm) associated with a significant advancement of the bony chin (3.9 mm) when compared with treatment before puberty.Conclusion:Treatment of Class II malocclusion with functional appliances appears to be more effective at puberty.     

Treatment effects of Fr?nkel, activator and extraoral traction appliances

The effects of the Fr?nkel appliance on the treatment of Class II, Division 1 malocclusion were compared with the activator, high-pull headgear, cervical traction and a control group. A sample of 16 Fr?nkel cases treated in the mixed dentition was tested in four craniofacial areas, with findings as follows: a. Maxillae, no significant horizontal effect b. Mandibular length, significantly increased c. Lower face height, widely variable effects. d. Less upper molar eruption and more lower molar eruption. Although the findings of this study should be interpreted as tentative, they do show the Fr?nkel appliance to have some different mean effects on the craniofacial complex. Variability is a most important aspect of the findings of this study. Future studies must deal not only with mean changes, but with the Fr?nkel appliance's variable effects on differential individuals. Optimal application of this appliance requires judgment in case selection and careful analysis of progress, using adequate follow-up records and a firm knowledge of normal growth and development of the craniofacial complex.     

A comparison of the MARA and the AdvanSync functional appliances in the treatment of Class II malocclusion

Abstract Objectives: To determine the skeletal and dentoalveolar effects produced by the MARA and the AdvanSync functional appliances in the treatment of growing patients with Class II malocclusion. Materials and Methods: A retrospective study was conducted using lateral cephalograms of patients consecutively treated with MARA (n = 40) and AdvanSync (n = 30) during their skeletal growth spurt as evaluated by the improved cervical vertebral maturation method. A comparison was made with 24 untreated Class II control subjects obtained from the University of Michigan growth study and matched with the experimental groups for skeletal age, sex, and craniofacial morphology. Cephalograms were taken at three time points: (T1) pretreatment, (T2) postfunctional appliance treatment, and (T3) fixed orthodontic treatment completion. Treatment changes were evaluated between the time points using 35 variables. Data were analyzed using one-way analysis of variance and Scheffe's post hoc test. Results: At the postfunctional appliances' phase (T2-T1), both appliances showed significant increases in total mandibular length, ramus height, and anterior/posterior facial height. The AdvanSync resulted in significant restriction of maxillary growth, 1° more than MARA. This effect continued during the fixed orthodontic treatment stage (T3-T2). The net changes (T3-T1) revealed significant mandibular growth enhancement with MARA (+2.7mm) and significant headgear effect with AdvanSync. Both appliances caused 5° flaring in mandibular incisors as well as significant decreases in overjet and overbite. The treatment time for AdvanSync was 1 year less than MARA. Conclusion: The MARA and the AdvanSync resulted in normalization of the Class II malocclusion. The AdvanSync showed more headgear effect but less mandibular length enhancement than MARA did. Both appliances showed similar dentoalveolar changes.     

Twin-block功能矫正器矫治下颌后缩型安氏Ⅱ类Ⅰ分类错的研究

目的通过对用Twin-block功能矫正器矫治安氏Ⅱ类1分类下颌后缩型错(牙合)进行头影测量分析,揭示该功能矫正器引起的硬组织变化特点,强调早期阻断矫治的必要性。方法随机选择15例下颌后缩型Ⅱ类错(牙合)患者,年龄8-12岁,平均10.8岁,男8例,女7例,全部病例用Twin-block功能矫正器矫正骨骼的矢状关系,时间6-9个月,矢状关系稳定后即拍摄侧位头影测量进行分析。结果在替牙期侧切牙萌出后即用Twin-biock功能矫正器进行阻断矫治,可以纠正骨骼矢状关系不调,促进下颌骨的发育。上颌骨相对于颅底的矢状关系无显著性变化。SNB、AO-BO及下颌骨长度明显增加,ANB角明显减小,Ⅱ类关系得到明显改善。结论Twin-block矫正器在一定程度上促进了下颌骨的发育,改善了Ⅱ类骨骼关系和(牙合)关系。     

Twin-block功能矫正器矫治下颌后缩型安氏Ⅱ类Ⅰ分类错(牙合)的研究

目的通过对用Twin-block功能矫正器矫治安氏Ⅱ类1分类下颌后缩型错(牙合)进行头影测量分析,揭示该功能矫正器引起的硬组织变化特点,强调早期阻断矫治的必要性.方法随机选择15例下颌后缩型Ⅱ类错(牙合)患者,年龄8-12岁,平均10.8岁,男8例,女7例,全部病例用Twin-block功能矫正器矫正骨骼的矢状关系,时间6-9个月,矢状关系稳定后即拍摄侧位头影测量进行分析.结果在替牙期侧切牙萌出后即用Twin-biock功能矫正器进行阻断矫治,可以纠正骨骼矢状关系不调,促进下颌骨的发育.上颌骨相对于颅底的矢状关系无显著性变化.SNB、AO-BO及下颌骨长度明显增加,ANB角明显减小,Ⅱ类关系得到明显改善.结论Twin-block矫正器在一定程度上促进了下颌骨的发育,改善了Ⅱ类骨骼关系和(牙合)关系.     

Pancherz法评价两种功能矫治器治疗安氏Ⅱ类1分类的骨牙效应

目的通过Pancherz法比较Activator+Headgear、Frankel-Ⅱ治疗生长发育期Ⅱ类错牙合的作用机制。方法Activator+Headgear(A组):20例,男12例,女8例;Frankel-Ⅱ(F组):24例,男12例,女12例,年龄均为男10～13岁,女9～12岁,ANB角>6°,覆盖≥4mm,后牙远中关系。收集治疗前后X线头影测量片,测量项目10项。结果①A组上颌骨生长受到抑制,上牙弓后移。F组上颌骨无明显抑制效果,上前牙内收。②两组下颌骨均显著生长,F组变化更为明显。③两组覆盖明显减小,A组骨因素40%。牙因素占60%。F组骨因素59%,牙因素41%。④两组磨牙关系均得到改变。A组骨因素48%,牙因素52%,F组骨因素83%,牙因素17%。结论①两种功能矫治器矫治Ⅱ类1分类错牙合均可刺激髁突和关节窝的改建,促进下颌骨生长,改善覆盖和磨牙关系。②经Pancherz分析法分析,在前牙覆盖及磨牙关系的改善中Activator+Headgear的牙因素明显,而Frankel-Ⅱ则相对表现出骨性改善的明显。     

口外弓推磨牙向后治疗安氏Ⅱ类1分类错(牙合)的分析研究

目的 :探讨口外弓推磨牙向后治疗安氏 II类 1分类错牙合的机制。方法 :对 12例安氏 II类 I分类错牙合的少年进行口外弓推磨牙向后治疗 ,第二期用方丝弓矫治器治疗 ;对两期相关的软硬组织进行 X线头影测量。结果 :口外弓推磨牙向后的治疗使颌骨、牙齿、软组织有不同程度的改变 ,主要通过抑制上颌骨 ,使下颌正常生长而使 ANB明显减小 ;口外力也使上中切牙倾斜度明显减小。方丝弓矫治器使治疗更完善。结论 :口外弓推磨牙向后配合方丝弓矫治器是不拔牙治疗安氏 II类 1分类错牙合简便有效的方法之一。     

Class II malocclusion treatment effects with Jones Jig and Distal Jet followed by fixed appliances

Objectives:To compare the skeletal, dentoalveolar, and soft tissue changes in Class II malocclusion patients treated with Jones Jig and Distal Jet distalizers followed by fixed appliances.Materials and Methods:The experimental groups comprised 45 Class II malocclusion subjects divided into two groups. Group 1 consisted of 25 patients treated with the Jones Jig, and group 2 consisted of 20 patients treated with the Distal Jet. Group 3 comprised 19 untreated Class II subjects. Cephalograms were analyzed before and after orthodontic treatment. For intergroup comparisons, one-way analysis of variance and post hoc Tukey tests were performed.Results:During treatment, the experimental groups exhibited significant increases in occlusal plane inclination and maxillary second molar mesial tipping. Additionally, the molar relationship improved and overjet decreased significantly in the experimental groups. The Jones Jig group showed greater mandibular incisor proclination and greater overbite reduction than the control group. No significant intergroup differences in nasolabial angle changes were found.Conclusions:Treatment protocols using the Jones Jig and Distal Jet followed by fixed appliances were effective in correcting Class II malocclusion by means of dentoalveolar changes without significant skeletal and soft tissue changes. The experimental groups showed occlusal plane clockwise rotation and greater mesial tipping of maxillary second molars when compared to the untreated group.     

Comparative evaluation of treatment effects between two fixed functional appliances for correction of Class II malocclusion: A single-center,randomized controlled trial

Objective:The objective of this study was to evaluate and compare the effects of PowerScope and Forsus in the treatment of Class II division 1 malocclusion.Materials and Methods:This was a 2-arm parallel, double-blind, randomized, controlled trial. A total of 28 Class II division 1 malocclusion patients indicated for treatment with fixed functional appliances were randomized and equally divided (n = 14) among PowerScope (American Orthodontics, Sheboygan, Wis; mean age 14.11 ± 1.3 years) and Forsus (3M Unitek Corp, Monrovia, Calif; mean age 15.5 ± 1.1 years) groups. Skeletal and dentoalveolar effects of PowerScope and Forsus were compared. The secondary outcomes were evaluation of patient comfort and operator convenience. Randomization was accomplished with a 1:1 allocation ratio, and concealment was achieved by sealed opaque envelopes. The participants and data collectors were all blinded to study group allocation. Data were analyzed for 26 patients, 13 in each group, as one patient from each group discontinued treatment. Statistical comparisons were carried out using Student''s t-tests and chi square tests (P ≤ .05).Results:A significantly greater mesial mandibular movement and improvement in sagittal skeletal relation were found in the Forsus patients (P ≤ .05). The forward movement of the mandibular molar and incisors were greater in the PowerScope patients (2.3 mm and 2.80 mm) than in the Forsus patients (1.9 mm and 2.38 mm).Conclusions:Both PowerScope and Forsus are effective in correcting Class II malocclusion. The percentage of dentoalveolar effects in correcting Class II malocclusion is more for PowerScope when compared with Forsus. Patient comfort was the same with both appliances. This trial was registered.     

A cephalometric study to compare the effects of cervical traction and Andresen therapy in the treatment of class II division 1 malocclusion. Part 2--Dentoalveolar changes

Absolute distal movement of upper first molars together with distal tipping, but no significant extrusion, occurred with cervical traction. Distal movement of the maxillary first molars was more stable in the group where maxillary 2nd molars had been extracted. With Andresen treatment a restraining effect took place on the upper molars, while mesial movement of the lower first molars contributed to correction of the molar relationship.     

Oropharyngeal airway dimensions after treatment with functional appliances in class II retrognathic children

Class II skeletal malocclusion and respiratory disorders owing to the obstruction of the upper airway at early growth stages have been correlated. The retro/micrognathism can be treated with functional appliances. However, the effects of an early functional orthopedic treatment on the airway dimensions have not been evaluated before the growth peak. Therefore, the objective of this study was to evaluate the changes in the airway dimensions of class II retrognathic children who received treatment with either Klammt or Bionator on a pre-pubertal stage. The sample consisted of 50 lateral cephalograms of class II retrognathic patients in a pre-puberal stage, before and after the use of a Klammt or Bionator II treatment for 1 year. The data were evaluated by Student's t-test or Mann-Whitney test, and significance was set at 5% (P < 0·05). When the measurements before and after treatment were compared, a statistically significant increase in the airway dimensions was found at the space where the adenoid tissue was located. The only airway dimensions that increased after treatment with functional appliances were the ones located at the nasopharynx. The adenoid tissue is still in the peak of growing at the ages of the subjects included in this study. However, the measurements along the nasopharynx increased when compared with the initial ones. Still, similar retrospective and prospective studies are needed at older stages.