单侧完全性唇腭裂患者咀嚼效能的测定与分析

目的：通过测定单侧完全性唇腭裂患者（ＵＣＬＰ）的咀嚼效能，掌握其口腔咀嚼功能状况，为ＵＣＬＰ患者的临床正畸治疗提供实验依据。方法：以炒花生米作为测试物，用吸光度法测定２８例ＵＣＬＰ患者和４３例正常Ｈｅ者的咀嚼效能，结合模型检查和临床分析，对测量结果进行统计学比较和相关回归分析。结果：①ＵＣＬＰ患者的咀嚼效能明显低于正常Ｈｅ者，约为后者的５３．９７％；②ＵＣＬＰ患者的咀嚼铲能无性别差异；③在规定的时     

单侧完全性唇腭裂患者上颌后牙He力的测定与分析

目的：了解单侧完全性唇腭裂（UCLP）患者的He力水平,借以掌握其口腔功能状况。方法：以MBF－1型He力计测试22名UCLP患者上颌后牙He力和25名正常He者的相应He力,同时测定其咀嚼效能和检查其上颌后牙的咬合接触状况。结果：①UCLP患者上颌后牙He力明显低于正常He者（P＜0.05）;②UCLP患者上颌后牙He力无性别差异。结论：He力水平低下和咬合接触不良是UCLP患者咀嚼效能低下的重要原因。     

不同He力牙尖交错位咬合接触的计算机图像分析

目的：研究不同Ｈｅ力下牙尖交错位咬合接触的变化规律。方法：用硅橡胶印模材料，采集２１名正常Ｈｅ青年人轻度Ｈｅ力、中等Ｈｅ力及紧咬３种条件下的咬合接触记录模型，用计算机图像分析系统进行测量。结果：相同Ｈｅ力下的咬合接触记录具有良好的重复性（配对ｔ检验，Ｐ〉０．５）。Ｈｅ力增加，前牙区颌间距离减小，后牙区咬合接触数目增多。中等Ｈｅ力时，咬合接触主要集中在２０μｍ以下。结论：Ｈｅ增大，接触数目增多，Ｈｅ     

前牙反He矫治的He与颌位探讨

通过对４２例前牙反Ｈｅ反应ＦＲⅢ型功能矫治器、上颌Ｈｅ垫矫治器及方丝弓矫治器的矫治，探讨其功能特点和矫治原则，得出：（１）功能性反Ｈｅ者ＩＣＰ前移，骨性反Ｈｅ者ＩＣＰ正常，两者的临床鉴别不能单纯看下颌能否后退至对刃位；（２）前牙反Ｈｅ矫治的咬合重建，不能以后退接触位为基准，只有在肌位建Ｈｅ才是最符合生理的；（３）固定矫治对反覆Ｈｅ小于３ｍｍ者可不加Ｈｅ垫，固定矫治反覆Ｈｅ大于３ｍｍ者及活动矫治应加     

单侧完全性唇腭裂新生儿术前矫形治疗中上颌各骨段位移轨迹的研究

本研究采用骨内针固位矫治器对一例单侧完全性唇腭裂（ＵｎｉｌａｔｅｒａｌＣｏｍｐｌｅｔｅｄＣｌｅｆｔｏｆＬｉｐａｎｄＰａｌａｔｅ，简称ＵＣＣＬＰ）新生儿头颅新鲜样本进行临床快速矫治。在连续定位Ｘ线片上观测了上颌解剖特征及在矫形力作用下各骨段位移规律。结果表明上颌各骨段明显错位、矫形力使各骨段产生不同方向和量的位移，其位移方向恰与错位方向相反。提示此疗法在唇腭裂系列治疗中具有重要意义。     

个别后牙反He时咀嚼运动轨迹的研究

目的：研究个别后牙Ｈｅ对咀嚼运动轨迹的影响，方法：８名个别后反Ｈｅ者和１２名同龄正常咬合对照者，采用下颌运动轨迹描记仪（ＳＧＧ）记录咀嚼口香糖时的运动轨迹。结果：个别后牙反Ｈｅ者的咀嚼运动环偏离正中矢状面的明显大于正常对照组，有些咀嚼运动环呈现如“８”字形等异常状态，说明后牙的反Ｈｅ关系明显影响了咀嚼运动环的类型和方向。这种影响可能够通过神经反馈机制，增加咀嚼肌负荷，并可进一步影响关节的受力情况。     

唇腭裂术后反He患者口周肌肌电图的研究

通过对２８名正常Ｈｅ，２７名普通反Ｈｅ及２９名单侧完全性唇腭裂术后反Ｈｅ患者的上唇肌及颏肌肌电图的检查，发现唇腭裂术后反Ｈｅ者口周肌肉存在特征性的肌电活动；①患者吞咽唾液时，上唇及颏肌肌电幅显著大于正常Ｈｅ及普通反Ｈｅ组；②唇腭裂组及普通反Ｈｅ组患者姿势位时，刻肌肌电幅大于正常Ｈｅ；③患者在各功能位时，上唇肌肌电活动非对称指数大于正常Ｈｅ及普通反Ｈｅ患者。唇腭裂术后反Ｈｅ患者周肌肉活动的异常，提示     

上颌前牵引对唇腭裂术后反He患者腭咽闭合功能的影响

探讨上颌前牵引对单侧完全性唇腭裂术后反Ｈｅ患者腭咽闭合功能的影响。方法。采用头颅定位侧位Ｘ线片、头颅侧位咽腔造影Ｘ线片及鼻咽纤维镜照相等方法对１０例生长期单侧完全性腭裂术后反Ｈｅ患者上颌前牵引前后结构测量结果及腭咽闭合功能进行对照定量分析。     

上颌前方牵引对面部垂直向影响的初步探讨

目的：探讨上颌后牙Ｈｅ垫联合前方牵引对面部垂直向的影响。方法：采用上颌Ｈｅ垫式矫治器联合前方牵引治疗６例替牙期Ⅲ类错Ｈｅ患者，并作治疗前后Ｘ线头影测量分析。结果：上颌骨轻度逆时针旋转；下颌骨轻度顺时针旋转；前面高明显增加，但前下面高增加不明显，前下面高／前面高及后面高／前面高无明显变化。结论 后牙Ｈｅ垫可减小前方牵引所产生的下颌骨顺时针旋转所致的前下面高增加，对避免前牙开Ｈｅ有帮助。     

唇腭裂手术对上颌骨矢状向生长发育影响的研究

目的：研究唇腭裂手术对单侧完全性唇腭裂患者上颌骨矢状向生长发育的影响。方法：混合牙列期单侧完全性唇腭裂仅修复唇裂患者15例,唇腭裂术后患者18例;16岁以上恒牙列期单侧完全性唇腭裂仅修复唇裂患者15例,唇腭裂术后患者15例。所有患者均拍摄头颅定位侧位片,测量分析矢状方向的线距和角度;分别以相应年龄段的非唇腭裂正常者作为对照,采用SPSS11.0软件包对数据进行单因素方差分析（ANOVA）。结果：混合牙列期单侧完全性唇腭裂仅修复唇裂患者表现为上颌长度缩短,而唇腭裂术后患者除上颌长度的缩短外,还存在上颌位置后缩;16岁以上恒牙列单侧完全性唇腭裂仅修复唇裂患者主要表现为上颌位置后缩,存在明显Ⅲ类倾向,术后患者上颌位置后缩外,上颌长度也缩短。结论：唇裂手术及早期腭裂手术对上颌骨矢状向生长可能有干扰作用。     

Effect of long-lasting clenching on dental occlusion

Durable clenching on a particular occlusal area may affect the masticatory muscle activity and induce transitional deformation of the dentoalveolar, mandibular and temporomandibular tissues. These effects may provide detectable alterations in the occlusal contact pattern. The aim of this study was to evaluate the subsequent effect of clenching on the number and location of occlusal contacts. This study was carried out on 16 volunteers with correct occlusion and sharply demarcated occlusal contact pattern. The patient closed to intercuspal position with maximal biting force and the occlusal contacts were revealed with a 12 microns thick occlusal foil. Then a gnathometer was placed between the upper and lower incisors and the mouth was closed for two minutes with about 50 N closing force. After that the occlusal contacts were evaluated again. Paired t-test was used to evaluate the data. Both before and after clenching the highest average number of contacts was recorded on the surface of first molars. They were followed in decreasing order by the second molars, second premolars, first premolars, and finally the canines. When the number of contacts was compared in tooth groups, the first molars and the second premolars had more contacts than the second molars and the first premolars. On the surfaces of molars more occlusal contacts were registered after clenching than before. Significant differences were found in case of the left second molar only. It was concluded that durable clenching on a particular occlusal area might change transitionally the distribution of occlusal contacts.     

正常接触位、下颌后退接触位咬合接触的计算机图像分析

目的 :研究正常牙合肌接触位及下颌后退接触位咬合接触的基本规律。方法 :采集 35名正常牙合肌接触位及下颌后退接触位的硅橡胶牙合记录 ,进行计算机图像分析。结果 :肌接触位 33人前牙无接触 ,单颌后牙区接触数为 16 .6± 7.2 ,所有受试者均为双侧接触。肌接触位咬合接触均在牙尖交错位重复出现。接触频率超过 5 0 %的部位位于上颌磨牙颊尖和舌尖的远中斜面 ,下颌磨牙颊尖和舌尖的近中斜面。下颌后退接触位所有受试者均为双侧接触 ,有接触的牙齿数目单颌单侧 2 .7± 0 .8,接触点数目单颌 8.0± 2 .3,前牙无接触 ,接触数目及比率从第二磨牙到第一前磨牙依次减少。接触频率超过 40 %以上的斜面上颌为前磨牙舌尖、磨牙远中舌尖及第二磨牙近舌尖的近中颊斜面 ,下颌为前磨牙及第二磨牙颊尖的远中舌斜面。结论 :以硅橡胶为记录材料准确采集到肌接触位及下颌后退接触位牙合记录 ,经计算机图像分析 ,得出其咬合接触的基本特征。     

恒尖牙双尖牙近远中径预测方程

目的：为口腔正畸临床混合牙列间隙分析提供简捷,便利的诊断依据。方法：在模型上测量牙冠近远中径,对测量值进行直线回归与相关分析。结果：下切牙与尖牙,双尖牙近远中径存在直线相关关系。结论：建立了汉族人群上,下颌尖牙双尖牙近远中径观测方程。     

外科矫正骨型下颌后缩畸形的术前术后正畸治疗

以近期连续收治的 17例骨型严重下颌后缩 (已作正颌手术 )的患者为例 ,重点介绍对该类畸形患者的术前准备 ,特别是术前术后正畸治疗及导板的应用。正畸治疗内容包括 :去代偿扩大上牙弓 ,排齐牙齿 ,平整曲线 ,使上下牙弓形态协调 ,恢复平衡重建良好的咬合关系。作者的经验表明 ,对严重骨型下颌后缩患者 ,要获得形态和功能完美结合的理想治疗目标 ,外科和正畸联合治疗 ,特别是术前、术后的正畸准备 ,是保证手术成功的必须和必要的条件。     

老年病人磨牙缺失后前磨牙楔形缺损和面磨耗的临床研究

目的:研究前磨牙楔形缺损和面磨耗在磨牙缺失老年病人的发生情况。方法:收集磨牙缺失而前磨牙保留完整的老年病人22例,共174个前磨牙,观察并记录前磨牙楔形缺损和面磨耗的情况。研究设置对照组,即双侧后牙牙弓完整的老年病人20例,共160个前磨牙。比较两组楔形缺损和面磨耗的发生情况并进行统计学分析。结果:磨牙缺失组中,前磨牙2度以上楔形缺损144个,检出率83%,面磨耗至牙本质暴露112个,检出率64%。对照组中,2度以上楔形缺损的前磨牙81个,检出率为51%,牙合面磨耗至牙本质暴露66个,占检出率41%。统计结果显示:磨牙缺失组前磨牙楔形缺损和面磨耗的检出率明显高于对照组(P<0.05)。结论:老年病人磨牙缺失发生楔形缺损和面磨耗较后牙牙弓完整者可能性高。力过大可能是导致前磨牙楔形缺损和面磨耗加重的一个重要原因。     

Dental arch width stability after quadhelix and edgewise treatment in complete unilateral cleft lip and palate

OBJECTIVE: To evaluate the transverse stability of the dental arch in unilateral cleft lip and palate (UCLP) patients after orthodontic treatment with quadhelix and edgewise appliances. MATERIALS AND METHODS: Twenty repaired complete UCLP patients with posterior crossbites were chosen as the study subjects. All had ceased retention at least 15 months previously. Measurements were carried out directly on the pretreatment, posttreatment, and postretention study models using a three-dimensional dental cast analyzer. The interdental widths were measured for the canines, first premolars, second premolars, first molars, basal bone, and the alveolar arch. Two-way analysis of variance and Fisher's LSD was performed in comparing the difference between intervals. RESULTS: Lower inter-first-premolar width and upper arch widths of each region increased significantly (P < .05) after orthodontic treatment. The expansion was greater in the anterior than the posterior region in the upper arch, and the greatest increase was in the upper first premolar region. The upper arch width decreased after retention, with the decrease of the arch width in the upper canine (1.3 +/- 0.8 mm) and first premolar (1.5 +/- 0.8 mm) regions being statistically significant. The increased upper arch width in each region and the lower inter-first-premolar width maintained significant expansion after retention. CONCLUSIONS: The widths of the dental arch increased significantly after expansion with a quadhelix followed by preadjusted edgewise treatment. Relapse occurred, especially in the upper canine and first premolar region, but most of the treatment effect on the upper arch remained after retention.     

Influence of clenching level on intercuspal contact area in various regions of the dental arch

The purpose of this study was to evaluate the relationship between the clenching level and the intercuspal contact area in different regions of the dental arch. Twenty-five healthy subjects with natural normal dentitions and good occlusal support performed clenching tasks in the intercuspal position at four different levels (10, 30, 70 and 100% levels of maximum voluntary contraction) through EMG visual feedback from bilateral masseter and anterior temporal muscles. Simultaneously, the occlusal contacts were recorded with a silicone occlusal contact checking material (Black Silicone, GC Dental Industrial Corp., Tokyo, Japan). The occlusal records were analysed by an image analyser. Every area of the thickness less than 50 microm was determined to be an occlusal contact area. The occlusal contact areas on the anterior teeth (incisors and canines), the premolars (first and second premolars) and the molars (first and second molars) were calculated separately. The posterior occlusal contact area increased with an increase in the clenching levels but that of the anterior did not. The results of this study indicate that the increase in clenching forces affects the anterior and posterior occlusal contact areas differently.     

Conservative interdisciplinary treatment of a case with multiple facial and condyle fractures

The purpose of this case report is to describe an interdisciplinary approach for a 51‐year‐old male who underwent multiple facial fractures including bilateral condyle fractures. The patient underwent emergency surgery, which included open reduction of the maxilla and mandibular symphysis and closed reduction of the bilateral condyle fractures. Although the patient recovered a comfortable range of mouth opening and alleviation of the temporomandibular joint (TMJ) symptoms after surgery, he suffered from a large anterior–posterior discrepancy due to less stability on the condyle‐fossa relationships and from open bite with contacts only on both second molars and right second premolars. In this case, first, to increase the occlusal contact, comprehensive orthodontic treatment was completed. Second, occlusal equilibration was selectively performed to relieve the interferences and establish a stable range of mandibular movement without any changes in the vertical dimension. Third, both the upper central incisors and left lateral incisor were minimally restored with splinted and single zirconia crowns, which had modified lingual contours to provide adequate anterior guidance permitting the anterior–posterior discrepancy of the posterior teeth during protrusion. This conservative interdisciplinary treatment, including open and closed reduction, orthodontic treatment, occlusal adjustment, and minimal prosthetic restorations, resulted in a stable mandibular position and recovery of mastication function.     

The influence of early orthodontic treatment on the growth of craniofacial complex in deciduous occlusion of unilateral cleft lip and palate patients

This study evaluates dental occlusion and dental arch parameters of 5-6 year old children with unilateral cleft lip and palate (UCLP) treated and untreated orthodonticly before lip plastic with noncleft children. The aim of the study was to verify whether early orthodontic treatment improves deciduous dental arch relationship of children with unilateral cleft lip and palate.135 casts of 5-6 year old children from Riga and Vilnius were evaluated. 90 casts from children with UCLP (45 - got early orthodontic treatment, 45 - without early orthodontic treatment) and 45 casts from noncleft children. All patients with UCLP had surgically closed lip and palate; five-Year-Olds, Index was used to assess dental arch relationship of UCLP patients. Measurements of dental arch length, canine and molar arch width was taken similar to Bland and Altman method. Statistical analysis: the difference of the mean values was tested using t-test between and within groups: UCLP-1 (without early orthodontics), UCLP-2 (treated orthodonticaly before lip plastic) and control group - noncleft children). Measurements were performed by two calibrated orthodontists, mean error was calculated according to the Dalberg method. Measurement error was less than 1 mm. Measurements showed that the occlusion parameters and transverse distance between deciduous molars of UCLP-1 group differed from the occlusion of UCLP-2. Children who had got early orthodontics showed better growth of the maxillae. More cases with positive overjet and meziodistal or distal deciduous molar relationship had treated with early orthodontics. Maxillary width between deciduous molars was statistically significant wider in children with UCLP who had early orthodontic treatment comparing with untreated children. Growth of mandible was not inhibited and did not differ treated and untreated children with UCLP and control group.