微型种植体支抗在安氏Ⅰ类双颌前突矫治中的应用研究

目的:观察微型种植体支抗在安氏Ⅰ类双颌前突矫治中的临床应用.方法:选择安氏Ⅰ类双颌前突拔牙矫正患者36例,分为实验组和对照组,每组18例.实验组使用微型种植体作为支抗关闭间隙,对照组使用常规滑动法关闭间隙.通过术前术后X线头影测量分析进行对比研究.结果:所有病例通过矫治后,前牙突度及轴倾度得到改善,拔牙间隙均关闭.矫治后上下切牙内收明显,实验组UI-SN平均减少9.13°,L1-NB平均减少6.55°,UI-LI平均增加34.42°.上唇突点-H线平均减少0.16 mm,下唇突点-H线平均减少0.26 mm.实验组治疗前后上下颌磨牙无明显前移,与对照组比较有显著性差异(p＜0.05).结论:微型种植体支抗避免了上下颌磨牙的近中移动,能为安氏Ⅰ类双颌前突病例的矫正提供稳定的支抗来源.     

Comparative evaluation of micro-implant and headgear anchorage used with a pre-adjusted appliance system

The aim of this study was to compare and evaluate the anchorage effectiveness of using either micro-implants or extraoral headgear with the McLaughlin-Bennett-Trevisi (MBT) system. Thirty young Chinese adults (14 males and 16 females) aged 18-22 years with anterior bimaxillary protrusion were divided randomly into two equal groups, treated with the MBT system anchored by either micro-implants or headgear. Nine measurements obtained before and after treatment from lateral cephalometric radiographs were assessed for the two groups, using the Mann-Whitney U test with alpha = 0.05 for statistical significance. The maxillary incisors in the micro-implant group were significantly more retracted and intruded, while the lower incisors were more lingually inclined, than in the headgear group. The occlusal and mandibular planes were rotated more counterclockwise in the micro-implant group than in the headgear group (P < 0.05). Compared with headgear anchorage, micro-implant anchorage may counteract clockwise rotation of the occlusal and mandibular planes and result in different final positions for the maxillary and mandibular incisors.     

微螺钉型种植体支抗对成人双颌前突患者的疗效分析

目的 探讨成人双颌前突畸形患者采用微螺钉型种植体支抗治疗的临床疗效。方法 双颌前突畸形患者100例,随机数字表法分为2组,对照组50例,采用传统口外加强支抗方案进行治疗;实验组50例,采用微螺钉型种植体支抗进行治疗。比较2组患者治疗后的唇部软组织,上、下颌牙槽突,牙列及上、下颌骨变化状况。采用SPSS19.0软件包对数据进行t检验。结果 实验组患者的治疗时间为（18.84±2.61）个月,显著短于对照组的（24.72±2.32）个月;治疗后实验组患者的上唇、下唇突度差值,上唇、下唇-E线差值,唇间隙差值均显著高于对照组（P<0.05）;治疗后实验组患者的上切牙、下切牙突度差值,上、下中切牙角差值,上、下牙槽突度差值均显著高于对照组（P<0.05）。结论 成人双颌前突畸形患者采用微螺钉型种植体支抗治疗疗效显著,值得临床推广应用。     

支抗控制在双颌前突畸形矫治中的作用

目的 研究支抗控制在滑动直丝弓技术矫治双颌前突畸形中的作用。方法 利用国产直丝弓托槽，滑动技术矫治双颌前突畸形患者30例，使用口外唇弓和不使用口外唇弓者各15例，均拔除4颗第一双尖牙，均采用一步法关闭拔牙间隙。将矫治前后的头颅侧位定位片进行对比分析，其变化量进行独立t检验。结果 矫治后戴口外唇弓组争不戴口外唇弓组上颌磨牙分别前移3．21mm和4．67mm；下颌磨牙分别前移3．32mm和5．21mm；两组的差异有统计学意义（P〈0．01）。前牙内收量戴口外弓组上颌为5．19mm，下颌为4．43mm；不戴口外弓组上颌为3．43mm。下颌为2．62mm。两组的差异有统计学意义（P〈0．01～0．001）。结论 口外唇弓在使用国产直丝弓托槽，运用滑动机制矫治双颌前突畸形中较有效地保护了后牙支抗，从而减少面部突度。     

Evaluation of the rate of anterior segment retraction in orthodontic patients with bimaxillary protrusion using friction vs frictionless mechanics: a single-center,single-blind randomized clinical trial

ObjectivesTo evaluate the effect of friction vs frictionless mechanics on the rate of anterior segment retraction (ASR) in patients with bimaxillary protrusion.Materials and MethodsThirty females (18.3 ± 3.7 years) with bimaxillary protrusion were randomly allocated into the friction group, using elastomeric power chains, and the frictionless group, using T-loop springs for ASR. Eligibility criteria included absence of skeletal discrepancies and any systemic diseases or medications, among others. Randomization in a 1:1 ratio was generated by Microsoft Excel. Opaque sealed envelopes were sequentially numbered for allocation concealment. Only blinding of the outcome assessor was applicable. Activations were done every 4 weeks until completion of ASR. The primary outcome was the rate of ASR measured on digital models. Anchorage loss, molar rotation, and pain experienced were also assessed.ResultsTwo patients were lost to follow-up. The rate of ASR was 0.68 ± 0.18 mm/mo in the friction group vs 0.88 ± 0.27 mm/mo in the frictionless group, with no significant difference. A significant difference in anchorage loss of 1.63 mm and molar rotation of 7.06° was observed, being higher in the frictionless group. A comparable pain experience associated with both mechanics was reported.ConclusionsNo difference in the rate of ASR or pain experience was observed between friction and frictionless mechanics. However, extra anchorage measures should be considered when using frictionless mechanics as greater anchorage loss and molar rotations are anticipated.     

种植体支抗矫正双颌前突畸形疗效回顾性研究

目的 对比研究微螺钉型种植体支抗与常规口内加强支抗矫正双颌前突的侧位头影测量及软组织美学分析结果变化,回顾性评价种植体支抗的疗效。方法 研究2011年1月至2012年12月第四军医大学口腔医学院正畸科成年双颌前突拔牙矫治患者62例,其中38例应用双颌后牙区微螺钉型种植体支抗内收前牙（种植支抗组）,24例应用常规口内加强支抗（常规支抗组）。通过矫治前后X线头影测量、软组织美学分析和疗程疗效比较,明确不同支抗方式对治疗效果的影响。结果 两种支抗方式的疗程差异无统计学意义（P＞0.05）。治疗前后62例患者在矢状向上均出现牙列、牙槽突及上下唇软组织的位置改变,种植支抗组患者上下颌切牙切端平均内收7.23、5.89 mm,上下牙槽突点平均内收3.61、2.78 mm,上下唇突点平均内收3.21、2.24 mm;常规支抗组患者上下颌切牙切端平均内收4.62、4.17 mm,上下牙槽突点平均内收1.93、1.67 mm,上下唇突点平均内收2.13、1.82 mm,种植支抗组内收效果优于常规支抗组,差异均有统计学意义（均P＜0.01）。两组患者治疗前后上下颌骨基点在矢状向的位置差异均无统计学意义（均P＞0.05）。结论 微螺钉型种植体支抗在内收前牙、矫正双颌前突及改善面部美学效果方面优于传统常规支抗,但对颌骨并无矫形作用。     

微螺钉型种植体支抗对成人双颌前突患者的治疗效果分析

目的：探讨运用微螺钉型种植体支抗矫治双颌前突畸形患者的临床效果。方法选取62例因双颌前突畸形进行正畸治疗的成年患者,根据所选择治疗方法的不同,分为微螺钉型种植体支抗组（A组,27例）以及口外支抗组（B组,35例）,并对两组的治疗效果进行比较分析。结果 A组的治疗时间较B组明显缩短,差异有统计学意义（P＜0.05）;A组患者的上唇突度、下唇突度、上唇?E线、下唇?E线以及唇间隙治疗前后变化差值均大于B组,差异有统计学意义（P＜0.05）;A组患者的上切牙突度、下切牙突度、上中切牙角、下中切牙角、上牙槽突度以及下牙槽突度治疗前后变化差值均大于B组,差异有统计学意义（P＜0.05）。结论微螺钉型种植体支抗可为双颌前突畸形患者的矫治提供满意的支抗作用,其临床效果较口外支抗更好。     

Uvulo-glossopharyngeal dimensions in non-extraction, extraction with minimum anchorage, and extraction with maximum anchorage

The aim of this study was to investigate upper respiratory airway dimensions in non-extraction and extraction subjects treated with minimum or maximum anchorage. Lateral cephalograms of 39 Class I subjects were divided into three groups (each containing 11 females and 2 males) according to treatment procedure: group 1, 13 patients treated with extraction of four premolars and minimum anchorage; group 2, 13 cases treated non-extraction with air-rotor stripping (ARS); and group 3, 13 bimaxillary protrusion subjects treated with extraction of four premolars and maximum anchorage. The mean ages of the patients were 18.1 ± 3.7, 17.8 ± 2.4, and 15.5 ± 0.88 years, respectively. Tongue, soft palate, hyoid position, and upper airway measurements were made on pre- and post-treatment lateral cephalograms and the differences between the mean measurements were tested using Wilcoxon signed-ranks test. Superior and middle airway space increased significantly (P < 0.05) in group 1. In group 2, none of the parameters showed a significant change, while in group 3, middle and inferior airway space decreased (P < 0.01). The findings show that extraction treatment using maximum anchorage has a reducing effect on the middle and inferior airway dimensions.     

微种植体支抗在双颌前突正畸治疗中的临床研究

目的:研究使用和不使用微种植体支抗矫正双颌前突的硬组织变化.方法:选取双颌前突病例12例,随机分为两组,I组不使用微种植体支抗,Ⅱ组使用微种植体支抗.通过对两组治疗前后的头颅侧位X线片进行头影测量分析,评价微种植体支抗在双颌前突治疗中的临床效果.结果:矫正结束,两组病例面型均得到了显著改善,I组上下颌切牙切缘分别内收3...     

40例双颌前突患者头影测量分析

目的探讨双颌前突患者的颅面特征，为临床诊治提供参考。方法用审美平面检出40例双颌前突患者（其中青少年组20例，成年组20例，每组男、女各半），对其头颅侧位定位片进行描图，通过计算机辅助多功能容貌测量系统软件定点、测量。结果青少年组与成年组相比，青少年组随年龄增长面下部有显著生长，且以前颅底后部及下颌后部生长明显，上颌基骨生长不显著；女性组与男性组相比，女性前颅底相对短，下颌角较大，上唇软组织突度较明显；与北京、华西正常[牙合]相比，双颌前突患者均显示下颌骨位置相对后缩，切牙过度唇倾。结论对需要通过矫形力来抑制颌骨过度发育而达到矫治双颌前突目的的患者，应从青春期前进行；矫治女性双颌前突患者更应内收上前牙，以改善上唇过突导致的不美观；用审美平面检出的双颌前突患者不仅仅表现为上下颌骨和（或）牙的前突，还可表现为下颌相对后缩。     

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??Abstract??Objective To observe the cepholemetric and soft-tissue results of microscrew implant anchorage and TPA??Nance orthodontic anchorage in the treatment of bimaxillary protrusion??and to evaluate the effect of microscrew implant anchorage. Methods The 62 adult patients with bimaxillary protrusion were divided into two groups??38 patients were reinforced with microscrew and 24 patients with TPA??Nance orthodontic anchorage respectively. The cephalometric and soft-tissue results of the patients before and after treatment with two measures were evaluated. Results The treatment time of two groups was not significantly different. All the facial profile in the sagittal direction was improved significantly. In the microscrew implant anchorage group??the edge of upper and lower incisors was retracted 7.23 and 5.89 mm??the points of prosthion and infradental were retracted 3.61 and 2.78 mm??the points of Labrale superior and Labrale inferior were retracted 3.21 and 2.24 mm respectively. In the TPA??Nance orthodontic anchorage group??the edge of upper and lower incisors was retracted 4.62 and 4.17 mm??the points of prosthion and infradental were retracted 1.93 and 1.67 mm??the points of Labrale superior and Labrale inferior were retracted 2.13 and 1.82 mm respectively. The retraction results in the microscrew implant anchorage group were superior to the TPA??Nance orthodontic anchorage group??P??0.01??.There were no significant differences between the two anchorage groups??P??0.05??. Conclusion The retraction results of the dental arch??lips and alveolar in the microscrew implant anchorage group are superior to the TPA??Nance orthodontic anchorage group in the treatment of bimaxillary protrusion.     

微螺钉种植体和口外弓增强支抗的临床对比研究

目的比较微螺钉种植体支抗和口外弓增强磨牙支抗的效果。方法选择上颌前突的患者32例,随机分为种植支抗组和口外弓组,每组16例。种植支抗组采用微螺钉种植体支抗,口外弓组采用口外弓支抗。记录并比较两组正畸疗程的差异。矫治前后均拍摄X线头颅定位侧位片,分析前牙覆盖、SNA角、U1-SN角、U1-NA距、U6-Ptm距5项头影测量参数的变化并比较两组间的差异。结果种植支抗组的正畸疗程平均为（20.06±2.02）个月,口外弓组平均为（22.17±1.76）个月,种植支抗组较口外弓组疗程缩短,疗程差异有统计学意义（t=3.158,P=0.004）。种植支抗组前牙覆盖的改善大于口外弓组（P=0.020）,上颌中切牙倾斜度和突度的改善显著大于口外弓组（P〈0.01）,磨牙近中移动的距离显著小于口外弓组（P=0.000）,两组间上颌基骨的位置变化无统计学差异（P=0.085）。结论微螺钉种植体支抗比口外弓支抗能更好地保护磨牙支抗,缩短正畸疗程。     

3种减数方案矫治双颌前突高角病例的临床研究

目的比较3种减数方案矫治双颌前突高角病例的临床疗效。方法选取14～25岁安氏Ⅰ类高角的双颌前突患者共30例为研究对象,分为3组,每组10例。Ⅰ组拔除4颗第一前磨牙;Ⅱ组拔除上颌2颗第一前磨牙及下颌2颗第一磨牙;Ⅲ组拔除上颌2颗第一前磨牙及下颌2颗第一磨牙,并在上颌2颗第一磨牙的近中分别种植2枚微型种植体。使用直丝弓矫治技术进行矫治。对3组患者治疗前后的头颅侧位X线片进行头影测量分析,并对结果进行统计学分析。结果1）硬组织方面,矫治后Ⅱ、Ⅲ组的前面高、后面高与前面高之比、前下面高、眶耳平面与下颌平面交角、前颅底平面与下颌平面交角、ODI值的变化与Ⅰ组相比,其差异均有统计学意义（P<0.01）。2）软组织、牙齿及牙槽方面,矫治后Ⅱ、Ⅲ组的颏厚度、下唇凸度、颏唇沟深度、LL-E、L1-NB、L1/NB、U1/L1、L7-MP的变化与Ⅰ组相比,其差异均有统计学意义（P<0.01）。3）所有患者均得到完善的正畸治疗,矫治后后牙咬合关系良好,前牙覆覆盖正常,软组织侧貌协调。结论1） 拔除下颌第一磨牙可使下颌平面角变小,前面高及前下面高降低,下颌切牙后缩明显,相应的软组织改变较好;2）上颌附加使用微型种植体支抗更有利于上颌切牙内收和继发的软组织改善;3）矫治高角双颌前突患者时,拔除第一磨牙并使用微型种植体支抗可有效改善患者的面部外型轮廓。     

自攻型微钛钉种植体增强磨牙支抗的临床应用研究

目的　介绍自攻型微钛钉种植体用于正畸支抗的临床经验 ,评价该型种植体作为强支抗的有效性。方法　在 6 7例采用自攻型微钛钉种植体作为支抗的临床病例中 ,选择 5例II类骨型、上牙弓前突或双牙弓前突患者 ,矫治设计上颌均为减数双侧第一前磨牙 ,支抗设计为磨牙强支抗。内收前牙阶段的治疗应用自攻型微钛钉支抗种植体 ,种植体植入上颌第一恒磨牙与第二前磨牙颊侧根尖部之间的牙槽间隔 ,以每侧 15 0～ 2 0 0g力滑动法内收前牙。比较内收前后头颅X线侧位片 ,测量前牙内收情况和磨牙支抗的变化。结果　 5例牙弓突度均得到明显改善 ,切牙切缘平均内收 6 4mm ,支抗磨牙平均前移 0 3mm ,均获得磨牙强支抗的效果。治疗过程中种植体均保持了稳定 ,种植体周围软组织健康。结论　自攻微型钛钉种植体能作为稳定的骨性正畸支抗 ,代替口外力的使用 ,起到磨牙强支抗的效能。该型种植体具有操作简单灵活 ,可即刻加力 ,不依赖患者合作的优点     

微种植支抗矫治成人骨性Ⅱ类突面型患者的矢状向疗效观察

目的 使用微种植支抗矫治成人骨性Ⅱ类突面型,观察矫治前后矢状向牙齿突度和唇突度变化.方法 选取36例治疗结束的成人骨性Ⅱ类突面型患者,所有患者均是拔除4颗第一前磨牙使用自攻型微种植体作为支抗内收前牙.对治疗前、后头颅侧位片进行测量分析.结果 36例患者的切牙、软组织等测量指标发生显著性变化,上切牙内收(5.98±3.8...     

微型种植体支抗对拔牙矫治病例的垂直向控制研究

目的：评估利用微型种植体支抗关闭间隙对拔牙矫治病例的垂直向控制情况.方法：回顾研究26例安氏Ⅱ类错（牙合）畸形或安氏Ⅰ类伴双颌前突,拔除4颗前磨牙矫治的病例.根据采用不同的支抗方式,把所选病例分为A、B两组,每组13例.A组采用微型种植体支抗,B组采用Nance托＋横腭杆（TPA）增强支抗,两组病例均利用滑动法关闭拔牙间隙.分析比较两组病例治疗前后X线头影测量的变化.结果：经T检验显示两组病例SN-MP、OP-SN、ANS-Me、U 1-PP、U6-PP、Yaxis之间的变化具有统计学意义（P＜0.05）.结论：与传统的Nance托联合TPA作为支抗相比,微型种植体支抗关闭拔牙间隙,能对患者的垂直向支抗提供良好的控制.     

微螺钉种植体支抗与口外弓增强支抗临床疗效的对比研究

目的比较微螺钉种植体支抗与口外弓增强磨牙支抗的效果。方法选择上颌前突的患者30名,随机分为两组,分别采用种植体支抗和口外弓支抗,对两组治疗前后的X线头颅侧位片测量并通过Pancherz分析法进行对比分析,同时记录并比较两组的正畸疗程。结果种植支抗组较口外弓组在覆盖、磨牙关系以及上中切牙位置方面改善明显,其差异有显著性（P〈0．05）;种植支抗组较口外弓组上磨牙位置更为稳定（P〈0．05）,正畸疗程更短（P〈0．05）。结论种植支抗比传统口外弓支抗增强上颌支抗的效果更为理想。     

微螺钉型种植体支抗与传统强支抗在上颌前突正畸治疗中的对比研究

目的研究微螺钉型种植体在上颌前突正畸治疗中的支抗应用,同时与口外弓配合Nance弓等传统支抗相比较,总结微螺钉型种植体支抗临床应用中的优势不足以及注意事项。方法选择上颌严重前突的拔牙矫正患者24人,矫治设计需强支抗,随机分成研究组和对照组两组,每组12人,试验组用微螺钉型种植体支抗结合滑动直丝弓技术,对照组用口外弓加Nance弓或者横腭杆结合滑动直丝弓技术,对治疗前后利用X线头颅片进行测量分析。结果试验组上颌第一磨牙在前后向未发生明显移动(P>0.05),而对照组上颌第一磨牙平均前移3.7 mm,经统计学检验差异有极显著性(P<0.01)。结论微螺钉型种植体有效治疗上颌前突畸形,可代替口外弓配合Nance弓等传统强支抗,具有舒适、操作简便灵活,可即刻受力,不依赖于患者合作等特点。     

两种支抗配合MBT直丝弓技术矫治双颌前突的效果比较

目的 比较J钩和种植体支抗配合MBT直丝弓技术矫治双颌前突病例的矫治效果,以及支抗对磨牙的控制作用.方法 30例需最大支抗的双颌前突病例(男性12例,女性18例),采用MBT直丝弓矫治技术,分别配合J钩(15例,A组)和种植体支抗(15例,B组)控制磨牙,对治疗前后的头颅侧位X线片进行头影测量分析,并对结果进行统计学分析.结果 虽然矫治前A组和B组U6C-PP分别为(12.4±0.2)mm和(12.5±0.1)mm,治疗后两组U6C-PP分别为(12.6±0.1)mm和(12.8±0.1)mm,差异有统计学意义(P＜0.01),但两组矫治结果临床差异不显著;两组其余指标差异均无统计学意义(P＞O.05).结论 J钩和种植体支抗配合MBT技术矫治双颌前突病例,均能控制支抗磨牙,且在支抗控制上两者无明显差异.     

Use of intermaxillary forces in early treatment of maxillary deficient Class III patients: Results of a case series

IntroductionThe early treatment of Class III malocclusion with a protraction facemask can produce forward movement of the maxilla but is generally associated with posterior rotation of the mandible and dentoalveolar compensations. This article shows the dental and skeletal effects of intermaxillary elastics applied to temporary anchorage devices in the treatment of maxillary deficient Class III patients.Materials and methodsA total of 6 patients with skeletal Class III malocclusion were treated with intermaxillary elastics only. This traction was applied between modified miniplates placed in the maxilla and a modified lower acrylic resin plate bonded on mandibular tooth surfaces. To evaluate the orthodontic changes, lateral cephalograms were taken at the start of the treatment (T1), at the end of the orthopaedic treatment (T2) and at the follow-up (T3).ResultsAll patients showed orthopaedic correction of the skeletal Class III relationship with reduction of facial concavity. No dentoalveolar compensations or changes in mandibular position were observed.ConclusionThe treatment of maxillary deficiency with orthopaedic forces from skeletal anchorage directed to the hooks of a modified lower acrylic resin plate bonded on the mandibular tooth surfaces, seems to be a promising technique.