改良"摆"式矫治器推磨牙远移12例分析

目的:研究改良"摆"式矫治器对(牙合)和面部骨骼结构的影响.方法:安氏Ⅱ类错(牙合)12例,采用改良"摆"式矫治器治疗.摆式矫治器推磨牙向远中的疗程为2～4个月.进行X线头影测量分析和模型测量分析.结果:①每侧磨牙平均向远中移动2.75 mm,主要为倾斜移动.②切牙牙冠平均向近中移动2.06 mm,主要为近中倾斜移动,前牙覆盖增加1.30 mm.前牙唇倾增加1.9°.③摆式矫治器改良后对面部骨骼结构无直接影响.结论:摆式矫治器能有效地远中移动上颌磨牙,快速矫正磨牙关系,但也可导致磨牙远中倾斜及切牙唇向倾斜移动.     

改良摆形矫治器矫治安氏Ⅱ类错的临床研究

目的评价改良摆形矫治器远移磨牙效果及对牙颌面结构的影响。方法选择11例安氏Ⅱ类错、上牙弓中度以下拥挤患者,采用改良摆形矫治器远移磨牙获得间隙,每一病例在应用改良摆形矫治器前后进行头影测量分析。结果11例患者在9.4±1.7周内上第一磨牙3.76mm、上第二前磨牙1.65mm的远中移动,伴切牙2.37mm的近中移动,同时上第一磨牙、切牙倾斜移动,且上第一磨牙、上第二前磨牙和切牙治疗前后的位置变化在水平方向具有显著性差异,而在垂直方向的差异无显著性。结论改良摆形矫治器具有简便、前牙支抗丢失少的优点,可在临床中广泛应用。     

改良式摆型矫治器配合治疗伴牙列拥挤的功能性前牙反[牙合]

目的评价改良式摆型矫治器与固定矫治器结合治疗恒牙早期功能性反[牙合]伴牙列拥挤的治疗效果。方法选择恒牙早期功能性反[牙合]且上颌牙列拥挤的患者10例，上颌采用改良式摆型矫治器远中移动第一磨牙，同时下颌戴用活动式全牙列骀垫打开咬合，最后全口粘结固定矫治器完成治疗。分别于矫治前（T1）、改良式摆型矫治器治疗后（T2）、固定矫治器治疗后（T3）拍摄正中[牙合]位的X线头颅侧位定位片，进行头影测量分析。结果10例患者经改良式摆型矫治器治疗后上颌第一磨牙平均远中移动3．78mm，远中倾斜3．84°，上前牙平均唇向倾斜移动1．52mm；固定矫治器治疗后前牙反[牙合]解除，牙齿排列整齐，前牙覆[牙合]覆盖正常。结论改良式摆型矫治器能有效地远中移动上颌磨牙；与固定矫治器结合治疗恒牙早期功能性反[牙合]伴牙列拥挤疗效满意。     

摆型矫治器远中移动上颌磨牙矫治安氏II类错

目的　研究改良摆型矫治器对牙和面部骨骼结构的影响。方法　选择安氏Ⅱ类错16例 ,其中女 13例 ,男 3例 ,年龄 9 3～ 2 2 8岁 ,平均 13 6岁。采用摆型磨牙远中移动矫治器治疗。摆型矫治器推磨牙向远中的疗程为 1～ 6个月 ,平均 3 7个月。以X线头影测量分析和模型测量分析为测定手段。结果　①每侧磨牙平均向远中移动 3 5 9mm ,主要为磨牙向远中倾斜移动。②切牙牙冠平均向近中移动 3 2 8mm ,主要为切牙的近中倾斜移动 ,前牙的覆盖增加 ,达 1 5 6mm。③牙列出现较大的间隙 ,双侧分别达 6 70mm和 6 5 9mm。④磨牙垂直向移动较少 ,推磨牙后 ,磨牙平均伸长仅0 6 9mm。⑤磨牙区、双尖牙区与尖牙区的宽度均增加 ,分别达 2 0 3mm、1 6 6mm和 1 10mm。⑥摆型矫治器对面部骨骼结构无明显的直接影响。结论　摆型矫治器能有效地远中移动上颌磨牙 ,快速矫正磨牙关系。但也可导致磨牙倾斜及切牙唇向倾斜移动 ,临床治疗中应予注意     

“摆”式矫治器远中移动上颌磨牙的疗效分析

目的研究"摆"式矫治器远中移动磨牙的效果以及其对面部骨骼和上颌牙齿的影响。方法选择处于替牙期或恒牙早期,上颌牙列轻中度拥挤,磨牙远中关系的病例25例。采用"摆"式矫治器远中移动上颌磨牙。以X线头影测量分析为测定手段。结果①上颌第一、二磨牙均发生了远中倾斜移动;②上颌第一前磨牙发生了近中倾斜移动,上中切牙发生了唇向倾斜移动;③在垂直向上,第一磨牙位置无明显变化,上颌第二磨牙伸长。④前牙覆盖增加,覆减小;⑤MP-SN和前下面高(ANS-Me)增加。结论①"摆"式矫治器可以有效的远中移动上颌磨牙;②"摆"式矫治器主要影响上颌牙齿,而对面部骨骼影响较小;③"摆"式矫治器在远中移动磨牙的同时伴随有上颌磨牙远中倾斜和上颌前部支抗丧失。     

改良摆形矫治器矫治安氏Ⅱ类错[牙合]的临床研究

目的评价改良摆形矫治器远移磨牙效果及对牙颌面结构的影响。方法选择11例安氏Ⅱ类错[牙合]、上牙弓中度以下拥挤患者，采用改良摆形矫治器远移磨牙获得间隙，每一病例在应用改良摆形矫治器前后进行头影测量分析。结果11例患者在9．4±1．7周内上第一磨牙3．76mm、上第二前磨牙1．65mm的远中移动，伴切牙2．37mm的近中移动，同时上第一磨牙、切牙倾斜移动，且上第一磨牙、上第二前磨牙和切牙治疗前后的位置变化在水平方向具有显著性差异，而在垂直方向的差异无显著性。结论改良摆形矫治器具有简便、前牙支抗丢失少的优点，可在临床中广泛应用。     

改良摆型矫治器远移上颌磨牙的疗效分析

［摘要］ 目的 分析改良摆型矫治器远移上颌磨牙的疗效。 方法 选择20例牙源性安氏Ⅱ类错牙合畸形的患者,采用改良摆型矫治器远移上颌磨牙,矫治前后进行X线头影测量和模型测量分析。 结果 4~6个月两侧磨牙平均远移5 mm,获得足够间隙。结论 改良摆型矫治器是一种经济,简便的远移上颌磨牙装置,效果可靠。     

摆形矫治器远移磨牙的矢状方向分析

目的本研究在矢状方向上分析摆形矫治器远移上磨牙的效果及对支抗前磨牙、切牙的交互作用。方法选择14例安氏Ⅱ类错、上牙弓I-Ⅱ°拥挤患者,应用摆形矫治器远移上颌第一磨牙,每一病例治疗前后进行头影测量分析比较。结果14例患者在17.5±7周内上第一磨牙远移3.18±1.62mm,伴有前磨牙1.42±1.16mm、切牙0.97±0.45mm的近中移动,同时注意到上磨牙的远移、第二前磨牙与切牙的近移均是倾斜移动,统计分析显示各评估对象在治疗前后具有显著性差异。结论摆形矫治器是一种简便、对患者依赖少的上磨牙远移装置,可在临床中广泛应用。     

摆形矫治器用于安氏Ⅱ类Ⅰ分类错(牙合)畸形对上颌牙列和骨骼的影响

目的 采用摆形矫治器对上颌磨牙远中移动的同时,观察对上颌前牙及双尖牙的副影响。方法 在临床上收集12名患者,男4名,女8名,平均年龄11.1岁,患者均为安氏Ⅱ类Ⅰ分类错(牙合)畸形,非拔牙矫治,均使用摆形矫治器远中移动磨牙来纠正Ⅱ类磨牙关系为Ⅰ类磨牙关系,牙弓内获得足够的间隙。比较治疗前后的头影测量片。结果 上颌磨牙远中倾斜8.34°(SD=8.37°),远中移动3.37mm(SD=2.10mm);上颌切牙移动2.4mm(SD=4.57);(牙合)平面向前上倾斜1.09°(SD=1.76°);下面高(ANS-Me)增加2.79mm(SD=2.03mm)。结论对摆形矫治器远中移动磨牙的疗效是肯定的,但是在治疗过程中,支抗的丧失,上颌切牙的唇倾、前牙覆(牙合)覆盖增加以及下面高的增加是治疗的副影响,而且磨牙远中移动的过程中,伴有牙冠较大量的远中倾斜。因此,提醒临床医生在使用类似的矫治器时应慎重。     

改良钟摆式矫治器远移上颌磨牙的初步研究

目的 :本实验旨在对改良钟摆式矫治器在远移上颌磨牙的作用及效果进行初步研究。方法 :挑选 13名患者 ,其中男 7名、女 6名 ,年龄在 10～ 14岁之间 ,平均年龄 12 .6岁。患者均为牙性安氏Ⅱ类错 ,恒牙列且下颌牙弓排列较好。改良钟摆式矫治器是我科与杭州西湖生物材料研究所新近研制的一种远移上颌磨牙的装置 ,它包括两个磨牙和两个第一前磨牙 ,其支抗是腭侧的Nance腭托 ,设计有轨道、弹簧及制动螺丝在上颌腭侧连接磨牙与前磨牙。远移磨牙的力在腭侧传递到上颌第一磨牙。本研究采用 15 0 g力的Ni Ti螺旋推簧远移上颌第一磨牙 ,采用头影测量分析治疗前后数值变化及磨牙远移距离。结果 :安氏Ⅱ类错的上颌磨牙平均整体远移 5 .8mm ,平均远移时间为 3～ 4个月 ,在反作用力的影响下上颌第一前磨牙向近中移动 1.7mm ,上切牙向前移动 2 .1mm ,上切牙唇倾度增加 3.8° ,前牙覆减少 2 .9mm ,覆盖增加 3.4mm。远移完成后 ,为防止远中移动的上颌磨牙向近中移动 ,用Nance腭托保持三个月。结论 :1.只要病例选择合适 ,方法应用得当 ,改良钟摆式矫治器就可以在较少的支抗丧失情况下有效的远中移动上颌磨牙。 2 .改良钟摆式矫治器现已有成品生产 ,临床操作简便 ,可减少椅旁操作时间 ,患者易于接受。     

Maxillary molar distalization with a bone-anchored pendulum appliance

To obtain an effective and compliance-free molar distalization without an anchorage loss, we designed the bone-anchored pendulum appliance (BAPA). The aim of this study was to evaluate the stability of the anchoring screw, distalization of the maxillary molars, and the movement of teeth anterior to maxillary first molars. The study group comprised 10 patients (mean age 13.5 +/- 1.8 years) with Class II molar relationship. A conventional pendulum appliance was modified to obtain anchorage from an intraosseous screw instead of the premolars. The screw was placed in the anterior paramedian region of the median palatal suture. Skeletal and dental changes were measured on cephalograms, and dental casts were obtained before and after distalization. A super Class I molar relationship was achieved in a mean period of 7.0 +/- 1.8 months. The maxillary first molars distalized an average of 6.4 +/- 1.3 mm in the region of the dental crown by tipping distally an average of 10.9 degrees +/- 2.8 degrees . Also, the maxillary second premolar and first premolar moved distally an average of 5.4 +/- 1.3 mm and 3.8 +/- 1.1 mm, respectively. The premolars tipped significantly distally. No anterior incisor movement was detected. The BAPA was found to be an effective, minimally invasive, and compliance-free intraoral distalization appliance for achieving both molar and premolar distalization without any anchorage loss.     

Pendulum and modified pendulum appliances for maxillary molar distalization in Class II malocclusion – a systematic review

Objective: The main purpose of the present systematic review was to evaluate the quantitative effects of the pendulum appliance and modified pendulum appliances for maxillary molar distalization in Class II malocclusion.

Materials and methods: Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus and key journals and review articles; the date of the last search was 30 January 2017. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP).

Results: In total, 203 studies were identified for screening, and 25 studies were eligible. The quality assessment rated four (16%) of the study as being of strong quality and 21 (84%) of these studies as being of moderate quality. The pendulum appliances showed mean molar distalization of 2–6.4?mm, distal tipping of molars from 6.67° to 14.50° and anchorage loss with mean premolar and incisor mesial movement of 1.63–3.6?mm and 0.9–6.5?mm, respectively. The bone anchored pendulum appliances (BAPAs) showed mean molar distalization of 4.8–6.4?mm, distal tipping of molars from 9° to 11.3° and mean premolar distalization of 2.7–5.4?mm.

Conclusions: Pendulum and modified pendulum appliances are effective in molar distalization. Pendulum appliance with K-loop modification, implant supported pendulum appliance and BAPA significantly reduced anchorage loss of the anterior teeth and distal tipping of the molar teeth.     

Dentoalveolar and skeletal changes associated with the pendulum appliance.

The purpose of the study was to examine the dentoalveolar and skeletal effects of the pendulum appliance in Class II patients at varying stages of dental development and with varying facial patterns (high, neutral, and low mandibular plane angles). Specifically, the amount and nature of the "distalization" of the maxillary first molars and the reciprocal effects on the anchoring maxillary first premolars and incisors were studied, as were skeletal changes in the sagittal and vertical dimensions of the face. Pretreatment and posttreatment cephalometric radiographs obtained from 13 practitioners were used to document the treatment of 101 patients (45 boys and 56 girls). The average maxillary first molar distalization was 5.7 mm, with a distal tipping of 10.6 degrees. The anchoring anterior teeth moved mesially, as indicated by the 1.8-mm anterior movement of the upper first premolars, with a mesial tipping of 1.5 degrees. The maxillary first molars intruded 0.7 mm, and the first premolars extruded 1.0 mm. Lower anterior facial height increased 2.2 mm; there was no significant difference in lower anterior facial height increase between patients of high, neutral, or low mandibular plane angles. In patients with erupted maxillary second molars, there was a slightly greater increase in lower anterior face height and in the mandibular plane angle and a slightly greater decrease in overbite in comparison to patients with unerupted second molars. Similar findings were observed in patients with second premolar anchorage versus those with second deciduous molar anchorage. The results of this study suggest that the pendulum appliance is effective in moving maxillary molars posteriorly during orthodontic treatment. For maximum maxillary first molar distalization with minimal increase in lower anterior facial height, this appliance is used most effectively in patients with deciduous maxillary second molars for anchorage and unerupted permanent maxillary second molars, although significant bite opening was not a concern in any patient in this study.     

Anchorage quality of deciduous molars versus premolars for molar distalization with a pendulum appliance.

PURPOSE: The aim of this study was to assess dental anchorage qualities when the pendulum appliance is used for distal molar movement. MATERIAL: Thirty adolescents in various dentition stages received a modified pendulum appliance with a distal screw and a specially preactivated pendulum spring for bilateral molar distalization in the maxilla. The subjects were subcategorized into 3 groups of 10 according to the dental anchorage used: deciduous molars, premolars and deciduous molars, or only premolars. Dentoalveolar effects and side effects in the anchorage unit and in the molar area were determined by cephalometric analysis. RESULTS: Statistical analysis of the measurements showed significant differences between groups in the extent of molar distalization and the resulting incisor protrusion. Distal tipping of the 6-year molars was significantly less severe (2.3 degrees +/- 1.58 degrees to the palatal plane and 2.55 degrees +/- 1.52 degrees to the anterior cranial base) in patients with premolar anchorage than in those with deciduous molar anchorage (6.15 degrees +/- 3.42 degrees and 6.35 degrees +/- 3.46 degrees ). Incisor protrusion was significantly more pronounced in patients with deciduous molar anchorage (2.75 +/- 1.4 mm) than in the other 2 groups (1.65 +/- 0.82 mm, mixed deciduous molar and premolar anchorage, and 1.75 +/- 0.75 mm, premolar anchorage). Additionally, incisor protrusion was translatory compared with controlled tipping in subjects with deciduous molar anchorage or premolar and deciduous molar anchorage. CONCLUSIONS: Deciduous molars and premolars can be used for anchorage for molar distalization with a pendulum appliance; however, anchorage with premolars only results in the least pronounced dentoalveolar side effects. The anchorage quality of deciduous molar and mixed deciduous molar/premolar anchorage is limited.     

Effects of a segmented removable appliance in molar distalization

The aim of the present investigation was to evaluate the skeletal and dentoalveolar treatment effects of a segmented removable appliance [removable molar distalizer (RMD)] for molar distalization. The study was conducted on 28 patients (12 females and 16 males), with a mean age of 11.8 years. All presented with a skeletal Class I malocclusion and a bilateral dental Class II molar relationship. The pre- and post-distalization records included lateral head films, study models and standard photographs. The findings were evaluated with a paired samples t-test. The average maxillary first molar distalization with the RMD was 3.98 mm, with 4.61 degrees of distal tipping. The maxillary second premolars drifted distally 2.13 mm on average with 1.54 degrees of distal tipping, while the maxillary first premolars showed 1.23 mm of mesial movement and 1.98 degrees of mesial tipping. The incisors protruded 1.09 mm with 1.27 degrees of labial tipping. The RMD was effective in distal molar movement and all patients attained a bilateral Class I molar relationship in an average period of 4.5 months. Hygiene problems and mucosal irritations, frequently found with fixed intraoral distalization techniques, were not observed during the distalization period.     

Molar distalization with a modified pendulum appliance--in vitro analysis of the force systems and in vivo study in children and adolescents

The standard pendulum appliance was modified by integrating a distal screw into its base and by special preactivation of the pendulum springs. The suitability of this Pendulum K for the translatory distalization of maxillary molars was investigated in an in vitro analysis and in an in vivo study in children and adolescents. The in vitro measurement of the resulting force systems revealed that all forces and moments remained virtually constant over a three-mm simulated distalization increment. The transverse force, Fx, increased from two to 11 cN and the weakly intrusively acting force, Fy, from six to eight cN, but these increases were not statistically significant. The distalization force, Fz, initially 201 cN, was still 199 cN after a three-mm distalization increment. The mesially acting moment, My, rose from 1654 to 1834 cN mm, whereas the palatally acting moment, Mz, declined slightly from 229 to 164 cN mm. The slight, consistent distoinclinatory moment, Mx, initially 306 cN mm, was 310 cN mm after three mm. In parallel, the in vivo study with its collective of 66 patients confirmed that the Pendulum K allows a virtually translatory molar distalization with slight tippings of 4.75 degrees to the palatal plane and 4.25 degrees to the anterior basal plane. Palatal movements of the first molars were avoided. The proportion of molar distalization in the total movement was 73.53%.     

A comparative analysis of distal maxillary molar movement produced by a new lingual intra-arch Ni-Ti coil appliance and a magnetic appliance

The aim of the study was to evaluate cephalometrically the dental and skeletal treatment effects of a new lingual intra-arch Ni-Ti coil appliance for molar distalization and to compare these with those of an established intra-arch appliance that uses repelling magnets for distal molar movement. Two groups of 21 adolescents, all girls, participated in this retrospective study. One group was treated with the new lingual Ni-Ti coil appliance for 6.5 months and the other with the magnetic appliance for 5.8 months. The treatment effects were analysed by measurements on lateral head radiographs at the start of treatment and after the molar distalization was completed. The mean amount of distal molar movement was 2.5 mm (SD 0.69) in the lingual coil group and 2.6 mm (SD 0.51) in the magnet group. A significantly higher degree of distal molar tipping was found in the magnet group, -8.8 degrees, compared with -2.2 degrees for the lingual coil group. Due to anchorage loss, the maxillary incisors moved forwards, and the overjet was increased by an average of 1.2 mm in the lingual coil group and 1.7 mm in the magnet group. The results indicate that the new lingual Ni-Ti coil appliance was better choice than the magnet appliance for distal bodily movement of maxillary molars. The benefits of the new Ni-Ti appliance were due to the design preventing molar tipping and its single activation.