FR—1型功能矫治器矫治安氏Ⅱ类1分类错He的牙弓测量

目的 了解ＦＲ－１型矫治器矫治安氏Ⅱ类１分类错Ｈｅ的牙Ｈｅ变化，方法 对２３例生长发育快速期的安氏Ⅱ类，分类错Ｈｅ患者采用ＦＲ－１型矫治器矫治，并对治疗前后模型进行牙弓测量，结果 １．上颌牙弓宽度增加，长度减小；２．下颌牙弓宽度增加，长度增加，Ｓｐｅｅ’ｓ曲线变平，３．前牙覆Ｈｅ，覆盖减小，结论 ＦＲ－１型矫正器，能使上牙弓长，宽，高三维关系发生明显变化，有效地改善安氏Ⅱ类１分类错Ｈｅ。     

垂直载荷下正常He及安氏Ⅱ类错He根尖应力分布规律的光弹研究

目的：探明正常Ｈｅ与安氏Ⅱ类１分类（安氏Ⅱ＾１）错Ｈｅ两种不同Ｈｅ型时各牙根尖在ＩＣＰ时的受力情况，以斯揭示咬合类型对咬合力传导的影响规律。方法：采用透明环氧树脂复制以相同牙排列而成的正常Ｈｅ及安氏Ⅱ＾１咬合的下颌模型，２．０ｋｇ垂直加载后，在国产４０９－Ⅱ型投影式光弹仪上观察测量各牙根尖主应力的大小与方向。结果：正常Ｈｅ各牙根尖主应力谢基本均偏向远中舌侧，安氏Ⅱ类Ｈｅ类则更偏向远中颊侧。安氏Ⅱ＾     

FR-1型功能矫治器矫治安氏Ⅱ类1分类错的牙弓测量

目的了解ＦＲ－１型矫治器矫治安氏Ⅱ类１分类错牙合的牙牙合变化。方法对２３例生长发育快速期的安氏Ⅱ类１分类错牙合患者采用ＦＲ－１型矫治器矫治,并对治疗前后模型进行牙弓测量。结果１．上颌牙弓宽度增加,长度减小;２．下颌牙弓宽度增加,长度增加,Ｓｐｅｅ’ｓ曲线变平;３．前牙覆牙合、覆盖减小。结论ＦＲ－１型矫正器,能使上下牙弓长、宽、高三维关系发生明显变化,有效地改善安氏Ⅱ类１分类错牙合。     

小平He板矫治安氏Ⅱ类2分类错He的临床体会

目的 缩短安氏Ⅱ类２分类错Ｈｅ的矫治时间。方法 采用小平Ｈｅ板与固定矫治器同时使用。结果 １１名患者打开咬Ｈｅ时间１－６个月，平均２．８个月少于对照组。结论小平Ｈｅ板配合固定矫治器矫治安氏Ⅱ类２分类错Ｈｅ是一种快捷有效的方法。     

安氏Ⅱ类Ⅰ分类错He的分型及其高低面角的颅面特征

目的；探讨中国儿童安氏Ⅱ＾１错Ｈｅ各类型的分布及其高低角错Ｈｅ的颅面特征：方法：采用Ｘ线头影测量技术，对１００例恒牙初期安氏Ⅱ＾１错Ｈｅ进行研究，以修正读数后的ＳＮＡ，ＳＮＢ角和ＦＨ－ＭＰ平面为参照从矢状和垂直方向将上下颌对颅底的变异进行分型统计，并抽出高，低角组进一步测量研究。结果：真性上颌前突只占２３％，部分病例上颌后缩，６５％的错Ｈｅ伴有下颌后经空，４５％的存在垂直关系不调；高角组腭平面前部     

骨性安氏Ⅱ1的生长改良治疗

本文通过１６例骨性安氏Ⅱ＾１错Ｈｅ畸开的生长改良治疗,介绍了矫治器的组成及治疗方法。结果表明,颌外牵引有效地抑制了上颌向前的生长发育,斜面导板促进了下颌向前的生长发育,顺时针旋转下颌,改善了颜面外观。作者分析认为：①骨性安氏Ⅱ＾１错Ｈｅ畸形矫治的关键,首先是利用儿童生长发育的潜力,协调上下颌骨间关系,然后在此基础上协调Ｈｅ关系。②骨性安氏Ⅱ＾１的矫治主要是解决了长度和高度不协调,同时,通过改变后牙     

上颌单颌拔牙与双颌拔牙矫治安氏Ⅱ类1分类错He的软硬组织对比研究

目的 探讨上颌单颌拔牙与双颌拔牙矫治安氏Ⅱ类1分类错He的软硬组织改变的差异。方法 选择安氏Ⅱ类1分类患者33例，其中上颌拔除2个前磨牙(甲组)18例，双颌拔除4个前磨牙(乙组)15例，应用X线头影测量技术对其矫治前后的软硬组织的变化进行测量，分析其测量结果。结果 两组SNA、SNB、ANB矫治前后的变化无明显差异。乙组上切牙内收与上唇的变化更为显著，颏前点明显前移，下唇凸度明显减小，乙组面型突度改变较甲组更为显著。结论 上颌单颌拔牙适用于下唇和下切牙凸度小、下颌无拥挤或轻度拥挤的轻中度骨性和牙源性的安氏Ⅱ类1分类患者；双颌拔牙适用于中重度拥挤的中度骨性和牙源性的安氏Ⅱ类1分类患者。     

应用PAR指数评价安氏Ⅱ类1分类错上颌单颌拔牙的矫治效果

目的评估上颌单颌拔牙矫治安氏Ⅱ类1分类错的矫治结果。方法采用PAR指数对19例上颌单颌拔牙的安氏Ⅱ类1分类错患者矫治前后的模型进行评估分析。结果矫治前后PAR总分值减少17.83±6.94,减少百分率为83.08%±9.72%;加权PAR分值减少29.87±10.15,减少百分率为86.01%±12.63%;19例患者中矫治后矫治等级为改善2例,占10.53%,极大改善17例,占89.47%。结论只要适应证选择得当,上颌单颌拔牙矫治安氏Ⅱ类1分类错可以取得满意的疗效。     

功能矫治器矫治安氏Ⅱ类1分类错He后口腔功能间隙变化的？…

目的：探讨用功能矫治器（ＦＲ－Ｉ）矫治安氏Ⅱ类１分类错Ｈｅ畸形后,随着Ｈｅ颌关系改变,口腔功能间隙面积的变化情况,了解口腔功能间隙与牙颌畸形发生的关系。方法：２０例安氏Ⅱ类１分类错Ｈｅ畸形患者,用功能矫治器（ＦＲ－Ｉ型）矫治其错Ｈｅ畸形,采用治疗前后自身对照,研究口腔功能间隙面积的改变。结果：治疗后口腔功能间隙矢状断面面积增大,这是由于治疗后下颌体长度和下颌支高度、前上面高、前下面高和后面高均明显     

上颌单颌拔牙结合小平导板矫治安氏Ⅱ类1分类错

目的探讨采用上颌单颌拔牙模式和小平导板联合矫治成人病例Ⅱ类1分类错牙合的疗效。方法对12例成年人安氏Ⅱ类1分类错牙合患者采用上颌拔除双侧第一双尖牙,下颌不拔牙,方丝弓技术联合小平导板进行矫治,将矫治前后的X线头影测量数据进行统计。结果①上下唇突度分别减少为3.11mm和1.72mm;②1-NA角减小26.53°;③1-1角减小21.79°;④覆牙合平均减少4mm,覆盖平均减少7.89mm。结论上颌单颌拔牙适用于低角覆盖较大的成年安氏Ⅱ类1分类患者,加用小平导板可有助于深覆牙合的改善及疗程的缩短。     

方丝弓技术矫治安氏Ⅱ类1分类错He

OBJECTIVE: To treat class II division 1 extraction cases by means of Edgewise technique. METHODS: 27 skeletal class II division 1 malocclusion patients were extracted 2 upper first premolars and 2 lower second premolars, and treated by Edgewise principles and sequential force system. They aged from 11 to 20. The duration of orthodontic treatment was 25.5 months on average(22-28 months). RESULTS: The patients' profile was much improved; Molar relation changed from class II to class I relationship; Anterior overjet and overbite are normal; Good occlusal intercuspation is also achieved. The ANB angle was significantly changed from 5.6 degrees +/- 2.2 degrees to 3.2 degrees +/- 1.4 degrees; Z angle was altered from 60.8 degrees +/- 5.8 degrees to 76.4 degrees +/- 6.6 degrees; Distance of AO-BO was reduced from 6.8 +/- 2.4 mm to 3.2 +/- 1.1 mm. CONCLUSIONS: Edgewise technique is an effective method for treatment of class II division 1 extraction cases.     

上颌骨前牵引器与正畸联合治疗单侧唇腭裂的评价

目的:对单侧完全性唇腭裂伴上颌骨发育不足的患者,进行面罩式上颌骨前牵引加正畸治疗,探讨其对颌骨发育的影响。方法:14例患者在治疗前、上颌前牵引后及正畸治疗后分别摄X线头颅侧位定位片,通过9个测量指标数据进行治疗前后的比较分析。数据资料用SPSS10.0软件作统计学处理,治疗前后比较用t检验,以确定上颌前牵引及正畸联合治疗对上下颌骨的影响。结果:本组患者经上颌骨前牵引器牵引加后期正畸治疗,获得满意的效果。切牙覆盖达2mm,咬合关系较稳定;侧面呈直面型。SNA角增加,有高度显著性差异,P<0.001。SNB及下颌平面角SN-MP无变化,P>0.05;颌凸角的差值有显著改变(P<0.001)。结论:单侧完全性唇腭裂伴上颌骨发育不足的患者进行整形加正畸治疗,能促进上颌骨的发育,下颌骨未见显著的变化;通过上颌前牙轴倾度增大,下颌前牙轴倾度变小以及舌代偿,上颌前牙前移,覆牙合覆盖改善。这些改变反应在侧貌上,表现为上颌突度增加,上唇变丰满,凹面形变直面形,上下颌协调。     

下颌前伸矫治器-3治疗安氏Ⅱ类错后软组织侧貌变化的研究

目的探讨生长发育期安氏Ⅱ类错患者用下颌前伸矫治器-3(MPA-3)矫治后,软组织侧貌的变化。方法选择12例安氏Ⅱ类1分类错患者,下颌后缩,ANB>5°。使用MPA-36～9个月后(平均7.2个月),测量治疗前后X线头颅定位侧位片,进行统计学分析。结果使用MPA-3后,表示软组织侧面突度的面凸角增加了3.57°,软组织面角增加了1.32°,软组织鼻颏角减小了2.40°,Z角增加了6.53°,下颌凸距增加了1.42mm;体现上下唇关系的上唇角减小了4.67°,上下唇角增加了13.16°,上下唇基角减小了2.61°,下唇基角增加了3.32°,颏厚度增加了2.22mm。结论MPA-3是一种有效的固定式功能性矫治器,可以刺激下颌骨的生长,抑制上颌骨的生长,改善骨性矢状关系的不调,同时还可以协调鼻、唇、颏之间的关系,改善面部软组织侧貌和上下唇关系。     

安氏Ⅱ类1分类错牙合单颌拔牙的临床探讨

目的探讨安氏Ⅱ类1分类错牙合单颌拔牙的治疗指征和适应证。方法收集临床疗效满意的安氏Ⅱ类1分类患者58例,分成两组,其中单颌拔牙组32例（拔除上颌2颗第一前磨牙）,双颌拔牙组26例（拔除上下颌4颗第一前磨牙）。对比两组治疗前后的结果,利用Steiner X线头影测量分析法和牙颌模型分析法进行回顾性比较研究。结果单颌拔牙矫治后U1-SN角度减少,U1-L1角度增加,Z角增加（P〈0.01）,下中切牙长轴与下颌平面交角增加（P〈0.05）,Bolton指数中全牙比增加（P〈0.01）。结论矫治安氏Ⅱ类1分类错牙合时采用单颌拔牙的方法是可行的,但在选择时要综合X线头影测量分析和牙颌模型分析等多种因素而定。     

Ⅱ类1分类错[牙合]正畸治疗前后牙齿移动与软组织侧貌变化的线性相关分析

目的通过对Ⅱ类1分类错[牙合]患者正畸治疗前后的头影测量指标进行相关性分析,探讨影响面部软组织侧貌变化的相关因素。方法选取2012年6月至2017年11月于上海交通大学医学院附属第九人民医院口腔颅颌面科就诊的42例已完成正畸治疗的Ⅱ类1分类错[牙合]患者[男性10例,女性32例,年龄(23.8±6.3)岁,平均矫治时间1.9年],拔除4颗第一前磨牙或2颗上颌第一前磨牙后进行正畸治疗纠正磨牙关系,测量矫治前后硬组织及软组织相关头影测量指标30个,包括上下唇突点、颏唇沟点、软硬组织颏前点及颏顶点的矢状向及垂直向距离、鼻唇角及颏唇角等。对矫治前后各指标变化量进行线性回归分析,根据标准化回归系数(Beta)分析影响上下唇、鼻唇角、颏唇角等面部软组织的主要相关因素。结果30个头影测量指标中18个矫治前后差异均有统计学意义(P<0.05),与矫治前相比,矫治后上中切牙点矢状向距离[(63.87±7.14)mm]、上唇突点矢状向距离[(77.73±7.60)mm]显著减小(P<0.05)。14对头影测量指标变化量间存在线性关系,其中上唇突点矢状向变化量与上中切牙点矢状向变化量强正相关(r=0.649,P<0.01),上唇突点垂直向变化量与上中切牙点垂直向变化量中度正相关(r=0.544,P<0.01),软组织颏顶点矢状向变化量与Y轴角变化量中度负相关(r=0.537,P<0.01)。多元逐步后退回归分析显示,上唇突点内收量与上中切牙点内收量、平面角增大量以及上中切牙角增大量均相关,且与上中切牙点内收量相关性最大(Beta=0.79);上唇突点下移量与上中切牙点下移量、上中切牙角减小量、上颌第一磨牙面中点到腭平面距离减小量以及平面角增大量相关,且与上中切牙点下移量及平面角增大量的相关性最大(Beta均为0.59);下唇突点下移量与上、下中切牙点下移量相关,且与上中切牙点下移量相关性更大(Beta=0.36)。结论Ⅱ类1分类错[牙合]矫治后鼻唇颏关系得到一定改善,切牙的矢状向变化对唇突度的影响最大,且下唇矢状向与垂直向移动与上中切牙的位置关系更密切,牙齿移动对颏部的影响有限。     

Dentoskeletal and soft-tissue changes in growing class II malocclusion patients during nonextraction orthodontic treatment.

An investigation was conducted to determine the outcome of nonextraction edgewise orthodontic treatment of thirty-five caucasian patients with Class II molar relationships (13 division 1 and 22 division 2 cases). Twenty-three females and 12 males aged between 10 and 16 years old were treated using Class II intermaxillary elastics worn with 0.016" x 0.022" stainless steel archwires and without extra-oral traction. Thirty cephalometric landmarks were identified and digitized, and used to calculate 41 parameters. Space analyses were conducted on pretreatment study models. Most of the cases had between 0-4 mm space shortage in both maxillary and mandibular dentitions. Results of this study indicated that the mean SNA angle decreased by 1.580 degrees, and that this change was largely due to posterior movement of point A. The mean pre-treatment ANB value was 4.490 degrees which decreased to a mean posttreatment value of 2.810 degrees (p<0.05). No significant changes in the growth direction of the jaws were found, showing that the use of Class II intermaxillary elastics in this sample had no detrimental effect on this parameter (p<0.05). The SNB angle increased by a mean of 0.110 degrees, which can be attributed to anterior mandibular growth. The dentoalveolar changes included a mean overjet reduction of 3.816mm (mean posttreatment overjet was 2.2mm) and proclination of the lower incisors relative to the APo line and the mandibular plane, probably caused by the use of Class II intermaxillary elastics. The lower lip advanced relatively more than the upper lip, and this contributed to an improvement of the lip relationship. The amount of nose growth observed during the study was normal for this age group, and compared favourably with other data in the literature.     

应用OPA-K直丝弓矫治器单颌减数治疗安氏Ⅱ~1类错的临床研究

目的评价oriental preadjusted appliance-KOSAKA(OPA-K)直丝弓矫治器单颌减数治疗安氏Ⅱ1类错的临床疗效,并探讨其机制和使用方法。方法临床选择17～26岁安氏Ⅱ1类错患者28例,应用OPA-K直丝弓矫治器进行单颌减数治疗,并对治疗前后X线头影测量值的变化进行分析。结果矢状方向上,U1-NA和U1-SN分别减小16.93°和7.06°,U1-NA(mm)减小3.83 mm,U1-L1增加12.94°,L1-NB和L1-MP分别增加2.78°和4.62°,L1-NB(mm)增加1.50 mm,以上差异均具有统计学意义(P<0.05);而SNA、SNB、ANB的变化均无显著性(P>0.05)。垂直方向上,SN-MP和Y轴的变化均无显著性(P>0.05)。结论应用OPA-K直丝弓矫治器单颌减数治疗安氏Ⅱ1类错可取得令人满意的临床效果。     

快速扩弓加前方前牵引治疗恒牙早期安氏Ⅲ类错的临床研究

目的评估快速扩弓加前方前牵引在恒牙早期安氏Ⅲ类错牙合矫治中的效果。方法选择12例恒牙早期安氏Ⅲ类错牙合前牙反牙合患者,用快速扩弓加前方前牵引矫治器进行治疗,治疗前后摄头颅侧位片,对矫治前后的X线头影测量进行分析比较。结果矫治后,SNA角增大3.5°,SNB角减少1.0°,ANB角增大4.5°,覆盖增加5 mm。上唇相对E平面向前,下唇相对E平面更靠后。结论快速扩弓加前方前牵引矫治器,有促进上颌骨向前发育,抑制下颌骨向前发育的作用,使前牙反牙合解除,侧貌得到明显改善。     

Surgical-orthodontic treatment of Class I malocclusion with maxillary vertical excess--a case report

This article describes the treatment of an adult male with vertical maxillary excess, excessive gingival display on smiling, a convex profile, proclined upper and lower incisors, and crowded lower anteriors with severe lip incompetence. The therapy included stages: (1) Pre surgical orthodontics- leveling and aligning of the maxillary and mandibular arch with closure of all extraction spaces. (2) Surgical phase-Lefort I osteotomy for superior maxillary impaction, 5 mm of anterior and 3 mm of posterior impaction ofmaxilla was done. (3) Post surgical orthodontics for finishing and detailing. The treatment lasted 16 months; improved facial esthetics significantly; and resulted in a normal occlusion, overjet, and overbite.     

Premolar and additional first molar extraction effects on soft tissue. Effects on high Angle Class II division 1 patients

OBJECTIVE: To determine the effects of premolar and additional first molar extractions (AFMEs) on soft tissue changes after four premolar extractions in high Angle Class II division 1 patients. MATERIALS AND METHODS: Thirty-three AFME patients, 24 of who had maxillary-only AFME and 9 of who had all-four AFME, were studied by cephalometric analysis and compared with 43 patients treated with four premolar-only extractions (PRMEs) as a control group. Lateral cephalograms taken at four time points-pretreatment, before AFME, posttreatment, and retention-were utilized for statistical analysis by Student's t-test. RESULTS: AFME significantly contributed to the maxillary incisor retraction and subsequent soft tissue change as measured by the Z-angle and lower lip E line. In addition, the bivariate correlation analysis revealed that the soft tissue changes correlated more with maxillary incisor retraction than with mandibular incisor retraction in both the AFME and PRME groups. This finding suggests that, in Class II patients, the lower lip position is most affected by reduction of maxillary incisor proclination. CONCLUSIONS: The AFME approach is useful to improve profiles in severe high Angle Class II division 1 patients who are borderline between PRME treatment and a premolar extraction plus orthognathic surgery approach.