前牙修复前正畸治疗的体会

在临床上 ,经常遇到一些伴有错牙合存在的前牙修复患者 ,由于错牙合的存在给修复设计带来了一定的困难 ,勉强地进行修复 ,效果也很不理想。 1993年以来我们对 68例病例配合进行修复前的正畸 ,修复效果满意。现报告如下 :1　临床资料　　 68例患者 ,男 32例 ,女 36例 ;年龄 12～ 32岁 ,其中以长度不调为主的 2 4例 ,高度不调占 5例 ,个别牙错位的占 39例。2　方　法先对错牙合进行矫治 ,然后修复 ,如有多生牙 ,待拔除、正畸后再修复。疗效标准 :①前牙修复后具有正常覆牙合覆盖 ;②修复后邻牙无间隙、错位、扭转及斜轴畸形 ;③修复后前牙左右…     

间接法制作个别取模器龈下取模技术的临床应用评价

目的：介绍一种简便高质量的龈下取模技术，解决龈下肩台边缘至龈沟底之间的牙体，牙龈外形精确复制问题。方法：在备牙的同时制作个别取模器，采用一次调和两步取模法。结果：可清晰、准确、完全地取得基牙肩台及肩台下精细结构的外形，经20例患者76颗基牙固定修复一年半的随访，修复质量明显提高。结论：个别取模器龈下取模技术操作简便易学，可大幅度改善固定修复颈缘质量，值得推广。     

自制个别取模器颈缘取模技术精确度的研究

目的：对比个别取模器龈下取模技术与常用藻酸盐及硅橡胶取模方法的颈缘精度的差异。方法：在患口中用3种方法制取印模,灌模后分别在体视显微镜下测量代型标志点到龈沟底的距离。结果：个别取模器法的标志点到龈沟底的距离大于常用藻酸盐法,与硅橡胶法相比,其颊侧点到龈沟底的距离较大,但在近、远中标志点无差异。结论：使用个别取模器的取模效果优于常用藻酸盐方法,与硅橡胶取模技术相类似。     

几种加强支抗方法的临床体会

在当今广泛使用Edgewise固定矫治器治疗错 牙合中 ,尤其是设计拔牙提供所需间隙进行治疗的病例 ,正畸治疗成功与否的关键之一 ,就是如何更好地增强后牙支抗 ,尤其是上颌的后牙支抗。也就是说怎样防止后磨牙的近中移动 (支抗丧失 )而不至于拔牙间隙丧失 ,是每一个正畸医生自始至终都不得不重视的问题。本文就近Edgewise固定矫治器的几种加强支抗方法的应用体会介绍如下。一、口外弓 :是采用头或颈部作为支抗的抗基 ,利用口外弓将牵引力传递于牙弓之上的矫治器[1] 。它可被用作限制上颌发育、推磨牙向后 ,同时它也是加强支抗的常用方法之一。…     

不同取模法和基托材料对牙槽嵴低平无牙颌义齿修复的影响

目的 观察不同取模法和基托材料对牙槽嵴低平无牙颌患者修复效果的影响。方法 选择全口牙列缺失、牙槽嵴高度不足5mm患者48例，用二次取模法，塑胶基托和铸造不锈钢基托修复，半年后观察修复效果。结果 上下颌塑胶基托修复21例，满意16例，满意率76．2％；上颌塑胶基托，下颌铸造基托修复16例，满意10例，满意率62．5％；上下颌铸造基托修复11例，满意3例，满意率27．3％。结论 牙槽嵴低平的无牙颌患者采用塑料基托较铸造基托固位效果好，咀嚼效率高；用自凝塑胶制作个别托盘比修改初印模制作的个别托盘取模修复效果好。     

先天缺牙的临床处理

通过对１０００例正畸治疗的错Ｈｅ畸形患者进行检查，发现有１１８例先天缺牙，占１１．８０％。分析了缺牙的部位与错Ｈｅ的表现，总结了针对不同部位的先天缺牙与错Ｈｅ表现，采用不同的处理方法，并指出，对先天性缺牙的错Ｈｅ患者，治疗时不仅要考虑上下牙数目的协调问题，更重要的是重新建立正常的咬合关系。     

即刻全口义齿的改良二次取模法

即刻全口义齿是指在患者余留牙尚未拔除以前 ,先取印模 ,预先做好全口义齿 ,待余留牙拔除后 ,就立即戴入义齿。在进行即刻全口义齿修复时 ,若用常规一次法取印模 ,因患者口内尚存留数个余留牙 ,普通托盘与患者具体的牙颌组织之间间隙过大、间隙不均 ,尤其是边缘部位与黏膜反折线之间相差甚多 ,取印模时各部位压力大小不一、印模材料厚薄不均 ,很难获得准确的印模和模型。作者自 1996年起采用改良二次取模法 ,即用印模石膏取初印模作个别托盘 ,再用海藻酸钠盐印模材取终印模 ,据此方法制作即刻全口义齿 56副 ,效果良好 ,具体方法如下 :1　印…     

成人正畸治疗的临床体会(附85例报告)

成人正畸治疗的临床体会（附８５例报告）上海市崇明县中心医院口腔科朱荷兰近年来，笔者对８５例成人的错畸形进行正畸治疗．疗程最短３个月，最长２年，均获得了满意的效果．本文对此进行了小结和初步的研讨．临床资料８５例中男性３１例，女性５４例．年龄自１８～５...     

颌间唇弓式活动矫正器治疗替牙期反He的临床研究

目的 介绍一种临床上行之有效的治疗替期功能性反He矫治方法。方法 选择25例替牙期反Hd的患者。男18例,女7例,平均年龄10.5岁。均为替牙期功能性反He,X线头影测量 量显示部分病例为轻度下颌前突。结果 平均疗程为1个月,SNB、ANB、LI－M经统计学处理有显著性差异。结论 颌间唇弓式矫治器治疗儿童早期功能性反He效果肯定。与其他矫治器比较,具有结构简单,疗程短的优点。     

制取印模之体位与姿势探讨

人民卫生出版社2003年出版的第五版口腔修复学教科书与第四版相比增加了许多新的内容[1,2].在第五章印模与印模技术中,详细介绍了印模操作步骤和方法.其中在调节体位方面有如下描述:调整患者体位和头位,张口印模时最好保持上下颌牙弓( )平面与地面平行,患者头部高度与医生手操作高度相适应,保证医师用手固定托盘时也能保持舒适姿势……预备上颌印模时特别是用流动性较大的印模材,患者头部不应过分后仰,否则印模材向软腭流动,易引起恶心,造成患者紧张.为了描述清楚,作者还同时配合示意图加以说明(图1).     

Non-apneic snoring and the orthodontist: radiographic pharyngeal dimension changes with supine posture and mandibular protrusion

Abstract

Objective: To evaluate the radiographic changes that occur in the pharynx and surrounding structures with alteration of posture from the upright to the supine position and the effect that mandibular protrusion whilst supine has on these dimensions.

Design: Prospective cephalometric study.

Setting: University Dental Hospital and School.

Subjects and method: This prospective study involved 35 consecutively referred adults with proven non-apneic snoring. Lateral skull radiographs were obtained with the subjects upright in occlusion, supine in occlusion and supine with the mandible protruded to the maximum comfortable position. Radiographs were traced and digitized, and the pharyngeal dimensional changes and hyoid position were examined. Males and females were examined separately.

Results: Radiographic pharyngeal dimensions were changed with altered posture, resulting in significant reductions in the minimum post-palatal (p<0.01) and post-lingual (p<0.05) airway measurements in the supine position. Mandibular protrusion whilst in the supine position produced increases in the functioning space for the tongue.

Conclusion: A supine posture results in significant reductions in pharyngeal airway measurements of non-apneic snorers. Mandibular protrusion whilst in the supine position produces an increase in the functioning space for the tongue.     

Non-apneic snoring and the orthodontist: radiographic pharyngeal dimension changes with supine posture and mandibular protrusion

OBJECTIVE: To evaluate the radiographic changes that occur in the pharynx and surrounding structures with alteration of posture from the upright to the supine position and the effect that mandibular protrusion whilst supine has on these dimensions. DESIGN: Prospective cephalometric study. SETTING: University Dental Hospital and School. SUBJECTS AND METHOD: This prospective study involved 35 consecutively referred adults with proven non-apneic snoring. Lateral skull radiographs were obtained with the subjects upright in occlusion, supine in occlusion and supine with the mandible protruded to the maximum comfortable position. Radiographs were traced and digitized, and the pharyngeal dimensional changes and hyoid position were examined. Males and females were examined separately. RESULTS: Radiographic pharyngeal dimensions were changed with altered posture, resulting in significant reductions in the minimum post-palatal (p<0.01) and post-lingual (p<0.05) airway measurements in the supine position. Mandibular protrusion whilst in the supine position produced increases in the functioning space for the tongue. CONCLUSION: A supine posture results in significant reductions in pharyngeal airway measurements of non-apneic snorers. Mandibular protrusion whilst in the supine position produces an increase in the functioning space for the tongue.     

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目的评价硅橡胶加预成胶针精密印模法间接制作铸造桩核的临床效果。方法选取2005年1月至2007年10月广东省深圳牙科医疗中心门诊289例患者的400颗经完善根管治疗的前牙及前磨牙残根、残冠,随机分成试验组(248颗)和对照组(152颗),规范制备根管根面。试验组通过根管内注入硅橡胶并插入预成胶针制取根管根面精确印模,技工室完成铸造桩核。对照组常规以嵌体蜡加金属丝制取根管根面印模并完成桩核铸造。临床试戴,检查桩核的就位性、密合性、固位性。结果试验组242颗临床检查为优秀(97.6%),对照组136颗临床检查为优秀(89.5%),两组修复效果差异有统计学意义(P<0.05)。结论硅橡胶加预成胶针精密印模法间接制作铸造桩核,精密度高,临床效果好,值得推广使用。     

桩核烤瓷冠同步制作的应用

目的：观察联合印模法在桩核烤瓷冠中的应用效果。方法：对26例患者共计34颗残冠，残根用塞天，藻酸盐印模材联合印模法取模，采用间接法制作桩核并随后制作烤瓷冠，进行疗效观察及相关问题的讨论。结果：34例残冠，残根的桩核就位顺利，烤瓷冠边缘密合，结论：联合印模法降低了桩核烤瓷冠门诊医师的操作难度，值得临床推广应用。     

The impression tray--an important factor in impression precision.

The flow behaviour of impression materials during impression taking was first investigated, and reference made to the pressure which occurs in the compound. Individual trays of plastic and shellac-bases which could be softened by heating, and a cold-curing tray material were then also examined: (1) for their distortion by slight loads upon the tray walls; (2) for their ability to retain their shape when stored, and (3) their distortion when temporarily warmed to body temperature. It was found that no tray materials, although graded according to type and thickness, can be considered rigid under experimental conditions, since distortions which were in some cases considerable could be measured. In laboratory experiments, the behaviour of the tray was then measured while taking impressions of models and the precision of the impression was examined at the same time. This confirmed the suspicion that the precision of an impression is to a considerable extent related to the tray material used. The smallest alterations were found when using cold-curing plastic material of a sufficient thickness (greater than 2 mm).     

2种不同印模方法制取间接桩核的临床效果评价

目的比较硅橡胶印模法与琼脂/藻酸盐联合印模法制取铸造间接桩核的临床效果。方法将牙体大面积缺损、根管治疗后要求桩核冠修复的389颗牙随机分为A、B组,A组采用硅橡胶印模法制取间接桩核,B组采用琼脂/藻酸盐联合印模法制取间接桩核,对2种印模法制取间接桩核的效果进行评价。结果硅橡胶印模法制取间接桩核的临床成功率高于琼脂/藻酸盐联合印模法,二者之间差异具有统计学意义（P<0.05）。其中,2种不同印模方法制取前牙间接桩核的成功率之间差异无统计学意义（P>0.05）,制取前磨牙和磨牙间接桩核的成功率之间差异有统计学意义（P<0.05）。结论采用硅橡胶印模法制取间接桩核的临床效果优于琼脂/藻酸盐联合印模法。