儿童下颌偏斜者颌面结构与颈椎姿势相关性研究

目的:研究儿童下颌偏斜病例的颌面结构与颈椎姿势的相关性。方法:对20例儿童下颌偏斜患者拍摄X线头颅定位侧位片,进行头影测量及统计学分析。结果:儿童下颌偏斜患者的颈椎齿突倾斜度、颈椎齿突平面倾斜度、颈椎倾斜度与眶耳平面、腭平面、咬合平面、下颌平面的倾斜度之间均呈正相关;患者第2颈椎到第4颈椎的弯曲度与颈椎齿突倾斜度、颈椎齿突平面倾斜度、颈椎倾斜度及眶耳平面、腭平面、咬合平面、下颌平面的倾斜度之间均呈负相关。结论:儿童下颌偏斜患者的颌面结构与颈椎姿势具有相关性,下颌偏斜应尽早矫治,在矫治颌面畸形的同时还应矫正异常的颈椎姿势。     

下颌偏斜患者颌面结构特征及其与颈椎姿势相关性的研究

目的：探讨下颌偏斜者的颌面形态、颈椎姿势与正常He者的差异;研究颌面形态与颈椎姿势的相关性。方法：对20例恒牙列下颌偏斜患者及41例正常咬合者拍摄自然头位时的头颅定位侧位片。结果：①下颌偏斜者咬俣平面、下颌平面的陡度及颈椎弯曲度大于正常咬合者而颈椎倾斜度小于对照组,患者头呈前倾位;②下颌偏斜者的齿突倾斜度、颈椎平面倾斜度与眶耳平面、腭平面、咬合平面、下颌平面的倾斜度之间均呈正相关,齿突前倾时,各平面倾斜度大;③下颌偏斜者第2颈椎到第4颈椎的弯曲度与齿突倾斜度、颈椎平面倾斜度呈负相关,齿突前倾时,上位颈椎弯曲度小,龄突后倾时,上位颈椎弯曲度增加。结论：颌面形态与上位颈椎的倾斜有明显相关关系;下颌偏斜得的颌面形态、颈椎姿势与正常He者有明显差异。     

伴有或不伴有下颌偏斜的成人骨性Ⅲ类患者的颈椎姿势差异的研究

目的：比较伴有或不伴有下颌偏斜的成人骨性Ⅲ类患者颈椎姿势的差异。方法：选择伴有和不伴有下颌偏斜的成人骨性Ⅲ类患者各20例作为实验组1和实验组2,20例正常牙合者作为对照组,对其自然头位时拍摄的头颅侧位片进行颈椎姿势的测量及统计学分析。结果：实验组1和实验组2的SN-CP、SN-OPT及SN-CVT明显小于对照组,HOR-CVT、HOR-OPT明显大于对照组（P〈0.05）;CVT-OPT大于对照组,但差异不显著。实验组1、2之间的各测量结果差异均不显著。结论：伴有或不伴有下颌偏斜的成人骨性Ⅲ类患者的颈椎姿势均存在异常,颈椎成前倾位。应提高对无下颌偏斜的单纯成人骨性Ⅲ类患者颈椎姿势的关注。     

成人颞下颌关节紊乱病与颈椎姿势的相关性研究

目的：探讨颞下颌关节紊乱病成人患者颈椎姿势与健康者的差异,研究颞下颌关节紊乱病与颈椎姿势的相关性。方法：对20例成人颞下颌关节紊乱病患者及20例成人健康者拍摄自然头位时的头颅定位侧位片,进行投影测量及统计学分析。结果：成人颞下颌关节紊乱病组的颈椎弯曲度大于健康对照组而颈椎倾斜度小于健康对照组,颈椎齿突切线、颈椎切线分别与前颅底平面及水平线交角减小,表明成人颞下颌关节紊乱病患者头呈前倾、前伸位。结论：头颈姿势位与颞下颌关节紊乱病存在明显相关性,颞下颌关节紊乱病患者头呈前倾、前伸位。     

(牙合)平面偏斜及其非手术治疗的研究进展

在矫治颅面部错牙合畸形方面,牙合平面的作用非常突出,是评估矫治成功与否的关键标准之一.(牙合)平面偏斜主要表现为两侧牙合平面不在同一水平位置.其形成原因复杂,研究表明,(牙合)平面偏斜与咬合力、咬合接触面积、咀嚼运动、颞下颌关节形态,甚至头颈姿势位有关.常见(牙合)平面偏斜与下颌偏斜关系主要为同侧偏斜,也有少部分患者为...     

牵张成骨联合正颌正畸治疗成人严重小下颌畸形

目的：探讨牵引成骨技术联合正颌正畸治疗重度小下颌伴偏颌畸形患者下颌骨严重发育不足及咬合关系紊乱的疗效。方法：对2例继发于儿童时期颞下颌关节损伤的小下颌伴偏颌畸形患者采用牵张成骨技术进行治疗。手术行双侧下颌角处截骨,安置牵引器,延长下颌升支及下颌体。第二期在拆除牵引器后进行正畸治疗,继而采用正颌外科方法进一步矫正颌面畸形及咬合关系,术后正畸治疗矫正咬合关系,排齐牙列。结果：2例患者均顺利完成治疗。下颌骨最小牵引距离25 mm,最大牵引距离30 mm,牵引区成骨良好,SNB角由术前平均67°增加到术后80°,小下颌及偏颌畸形得以矫治。联合正颌外科及正畸治疗后,面形及咬合功能均获得满意效果。术后经过2年6个月随访,未见复发。结论：联合应用牵张成骨和正颌外科技术并配合正畸治疗是矫治成人重度小下颌不对称性牙颌面畸形的有效治疗方案。     

儿童和成人打开咬合不同机制的初探──附20例X线头影测量分析

本文通过儿童和成人各１０例伴深覆错病例矫治前后的Ｘ线头影测量分析，对儿童和成人打开咬合的不同机制进行了初步探讨。为排除牙齿倾斜度变化对测量切牙压低量的影响，作者增选了上下切牙转动中心分别至上下颌平面垂直距离的测量，能较准确地代表切牙实际压低量。结果表明儿童打开咬合的机制主要是升高磨牙，其次是压低下切牙，同时伴随了面颌垂直高度的显著增长。成人打开咬合的机制是绝对压低切牙。     

颞下颌关节强直继发颌面畸形的外科矫治

为矫治颞下颌关节强直继发的颌面畸形，应用颞下关节成形术与正颌外科技术，对２２例该类患者（双侧关节强直９例，单侧关节强直１３例）进行了矫治。１３例患者关节成形术与正颌外科手术同期进行，９例患者分期进行，均达到满意的功能与畸形矫治效果。结论：颞下颌关节及继发颌面畸形的矫治，关键在于保证患者的开口功能，并在此基础上矫治继发畸形。同时对颞下颌关节强直伴有阻塞性睡眠呼吸暂停综合征的情况应予以高度重视。     

偏颌患者牙合平面偏斜特征及非手术治疗

牙合平面偏斜是下颌偏斜的主要特征,其形成原因较为复杂且目前尚无定论。研究表明,牙合平面偏斜与咬合力、咬合接触面积、咀嚼运动,甚至头颈姿势位有关。锥形束CT（CBCT）是目前评估牙合平面偏斜程度的最佳诊断方法。常见牙合平面偏斜与下颌偏斜关系主要为同侧偏斜,也有少部分患者为对侧偏斜,可对颞下颌关节及咀嚼运动造成不良影响。临床上非手术纠正牙合平面偏斜一直是治疗难点。文章根据现有文献,对牙合平面偏斜特征及不良影响进行梳理,并针对临床常用的非手术治疗方法进行归纳综述。     

儿童替牙期骨性AngleⅢ类错He咀嚼肌肌电研究

目的：研究儿童替牙期骨性AngleⅢ类错He与正常He的咀嚼肌肌电变化规律。方法：对20例替牙期AngleⅢ类骨性错He儿童及20名正常He儿童进行咀嚼肌肌电图检查，测量嚼肌深浅层和颞肌前后束在姿势位，牙尖交错咬合位，前伸运动边缘位，后退运动边缘位的肌电活动，所得数据进行统计学分析。结果：骨性安氏Ⅲ类错He姿势位嚼肌与颞肌的肌电活动均大于正常He;牙尖交错咬合位嚼肌，颞肌肌电位均较正常He小；下颌前伸时颞肌前束肌电显著性高于正常He；下颌后退时，嚼肌显著性高于正常He。结论：替牙期AngleⅢ类骨性错He肌电有其特征性，提示早期矫治替牙期AngleⅢ类骨性错He不仅能解决美观问题，更有利于改善咀嚼肌收缩功能，减少肌功能对颅面形态的不良影响。     

Relationship between thoracic, lordotic, and pelvic inclination and craniofacial morphology in adults

OBJECTIVE: To analyze the correlation ratios between the spinal posture (thoracic, lordotic, and pelvic inclination) and the craniofacial morphology. MATERIALS AND METHODS: The sample consisted of 53 healthy adults (32 women, 21 men; mean age 24.6 years). Six angular skeletal measurements (facial axis, mandibular plane angle, inner gonial angle, lower facial height, facial depth, and maxilla position) were determined based on the analysis of lateral head cephalographs. Rasterstereography was used for a precise reconstruction of the back sagittal profile. From the profile parameters, the upper thoracic inclination, the thoracic angle, the lordotic angle, and the pelvic inclination were determined. The correlations to the craniofacial morphology were calculated by means of the Pearson and Mann-Whitney U-test. RESULTS: Significant correlations could be obtained with respect to the facial axis and the lordotic angle, the facial axis and the pelvic inclination, the inner gonial angle and the lordotic angle, the inner gonial angle and the pelvic inclination, the mandibular plane angle and the lordotic angle, the mandibular plane angle and the pelvic inclination, as well as the facial depth and the pelvic inclination. CONCLUSIONS: In the case of postural disorders of the back shape, an interdisciplinary treatment approach seems to be of clinical value. Further prospective studies are necessary to prove how changes in craniofacial parameters can affect the postural balance of an individual.     

骨性Ⅰ、Ⅱ、Ⅲ类错殆患者自然头位、颅面形态与颈椎姿势的研究

目的：探讨骨性Ⅰ、Ⅱ、Ⅲ类错殆患者自然头位、颅面形态与颈椎姿势的关系。方法：测量86例8～15岁均角错胎患者自然头位头颅侧位片并对测量项目进行统计分析。结果：颅部水平参考线与真垂线之间的夹角及颅颈角在骨性Ⅱ类错骀最大,骨性Ⅲ类错殆最小。结论：骨性Ⅰ、Ⅱ、Ⅲ类错殆畸形间自然头位及颈椎姿势有显著差别。     

Cervical column morphology related to head posture, cranial base angle, and condylar malformation

The present study describes the cervical column as related to head posture, cranial base, and mandibular condylar hypoplasia. Two groups were included in the study. The 'normal' sample comprised 21 subjects, 15 females aged 23-40 years (mean 29.2 years), and six males aged 25-44 years (mean 32.8 years) with neutral occlusion and normal craniofacial morphology. The condylar hypoplasia group comprised the lateral profile radiographs of 11 patients, eight females, and three males, aged 12-38 years (mean 21.6 years). For each individual, a profile radiograph was taken to perform a visual assessment of the morphology of the cervical column. For the normal group only, the profile radiographs were taken in the standardized head posture to measure the head posture and the cranial base angle. Cervical column: Morphological deviations of the cervical column occurred significantly more often in the subjects with condylar hypoplasia compared with the normal group (P < 0.05 and P < 0.01, respectively). The pattern of morphological deviations was significantly more severe in the subjects with condylar hypoplasia compared with the normal group (P < 0.01). Cervical column related to head posture and cranial base: The cervicohorizontal and cranial base angles were statistically larger in females than in males (P < 0.05 and P < 0.01, respectively). No statistically significant age differences were found. Only in females was the cervical lordosis angle (OPT/CVT, P < 0.01), the inclination of the upper cervical spine (OPT/HOR, P < 0.05), and the cranial base angle (n-s-ba, P < 0.05) significantly positively correlated with fusion of the cervical column. These associations were not due to the effect of age.     

Orientation of craniofacial planes and temporomandibular disorder in young adults with normal occlusion

The aim of this study was to investigate the relationship between orientation of craniofacial planes relative to the true horizontal and temporomandibular disorder (TMD), in normal occlusion. Fourteen university dental students, with full natural dentition and bilateral Angle Class I occlusion, who exhibited signs and symptoms of TMD, were compared with 14 age- and sex-matched healthy controls. Frontal and lateral photographs were taken in natural head position with the subject standing up, clenching a Fox plane and having a facial arch positioned. Photographs were examined by a standardized image analysis. Inter-pupillary axis, Frankfurt, occlusal and Camper planes were evaluated. In frontal view, the Frankfurt plane was right rotated relative to the true horizontal both in TMD subjects (P < 0.01) and controls (P < 0.05), but rotation was larger in TMD subjects (mean difference between groups, 1.1 degrees, 95% confidence interval, 95% CI, 0.2-2.0 degrees ). No significant deviation from the horizontal or difference between groups was observed for the interpupillary axis and occlusal plane. In lateral view, the Frankfurt plane was upward-orientated relative to the true horizontal in TMD group (mean angular deviation 2.8 degrees, 95% CI, 1.0-4.6 degrees ). The occlusal and Camper planes were downward-orientated in both groups (P < 0.0001), but inclination of occlusal plane tended to be smaller in TMD subjects (mean difference between groups, -3.8 degrees, 95% CI, -7.6-0.1 degrees ). Angles between any craniofacial planes did not significantly differ between groups. The findings show that in young adults with normal occlusion, a weak association exists between the orientation of craniofacial planes in natural head position and signs and symptoms of TMD. Furthermore, they suggest that, within this population, TMD might be mainly associated with head posture rather than with craniofacial morphology.     

下颌偏斜患者颜面与颈背部肌肌电研究

目的 探讨下颌偏斜对咀嚼机、颈、肩背部肌肌电的影响。方法 采用K6－Ⅰ系统对15例正常咬合者及12例下颌偏斜患者在最大开闭口运动、咀嚼运动、颈肩背部肌运动时咬肌、二腹肌、胸锁乳突肌与斜方肌的表面肌电进行采集分析，比较两组受试者双侧对应肌肌电平均幅值的对称性。结果 ①下合同功能性运动时颈背部肌有肌电活动；颈背部运动时咀嚼肌也有相应的肌电增强。②开闭口运动与咀嚼运动时患者组双侧咬肌、二腹肌、胸锁乳突肌肌电平均幅值的对称性明显差于正常咬合组；双侧斜方肌对称性在颈肩部运动时两组间差异显著。③正常咬合组三种运动时对应肌肌电幅值无显著性差异；患者组咀嚼运动时双侧二腹肌及颈肩部运动时双侧胸锁乳突肌、二腹肌肌电幅值有明显差异。结论 下颌偏斜影响咀嚼肌、颈肩背部肌肌电的对称性并可能导致头颈、双肩姿势的偏斜。     

恒牙列早期安氏Ⅲ类错患者下颌边缘运动轨迹的研究

目的　定量定性分析恒牙列早期安氏Ⅲ类错患者下颌边缘运动轨迹的特征及其与颅面形态的关系。 方法　选择恒牙列早期安氏Ⅲ类错患者21例作为试验组,20例恒牙列早期个别正常人作对照组,使用K6-I型 下颌运动描记仪描记两组研究对象的下颌边缘运动轨迹,同时拍摄X线头侧位片,分析二者的相关性。结果　试 验组下颌边缘运动范围与对照组无统计学意义。对照组ICP-最大张口线距与前下面高呈正相关,开口度与下颌支 高度及后面高呈正相关;试验组ICP-最大张口线距与前下面高及下前牙牙槽高度呈正相关,开口度与下颌体长度 及下前牙牙槽高度呈正相关。结论　安氏Ⅲ类错患者的下颌边缘运动与颅面形态的关系和个别正常人不同。