正畸托槽间接粘接的临床应用

目的 探讨正畸托槽的间接粘接技术,以提高托槽定位的准确性。方法 选取南京医科大学附属口腔医院正畸科18名成人正畸患者,采用间接粘接技术粘接托槽,模型粘接和口内粘接均为同一医生进行,技工室压模均由同一技工完成。结果 18例患者的302个托槽在粘接过程中,有13个托槽在压模时发生脱落,1个在口内粘接时脱落。与直接粘接法相比,间接粘接法椅旁操作时间减少,但操作繁琐、总操作时间增加。结论 间接粘接技术托槽放置精确,椅旁操作时间减少,利于初学者培养托槽定位感,适合舌侧矫治器的粘接。     

个性化舌侧托槽的制作与临床应用初探

目的介绍个性化舌侧托槽的制作及其临床应用。方法预成舌侧托槽与个性化托槽底板铸造为一体。使用这种国产个性化舌侧托槽进行正畸治疗,其中安氏Ⅰ类68例,安氏Ⅱ类27例,安氏Ⅲ类9例。错[牙合]问题有：牙弓前突、开[牙合]、深覆[牙合]、反[牙合]、深覆盖、牙齿拥挤、牙齿阻生等。结果近百例舌侧正畸患者矫治效果良好,该方法对舌侧托槽的定位准确,除了可采取间接粘接以外,在二次粘接时可采取直接粘接。结论个性化舌侧托槽粘接精度优于传统的预成舌侧托槽粘接,牙齿排列更加整齐,能够得到满意的治疗效果。     

计算机辅助托槽定位系统的建立

目的 建立基于3D扫描、打印架构下的计算机辅助托槽定位系统(computer aided bracket placement system,CABPS).方法 通过3D扫描获取3D数字化牙颌模型,利用正畸计算机辅助设计(orthodontics computer aided design,Ortho CAD)技术对数字化模型进行牙齿分离,按照正常咬合六项标准进行牙齿排列;基于临床冠中心法和托槽槽沟平直化原则做计算机辅助托槽定位,计算机对已附带托槽定位标尺的牙齿进行原态模型复位,3D打印,压制托槽定位模板,在模拟(牙合)架上进行托槽间接粘接后模拟矫治,验证矫治效果.结果 在3D扫描、打印架构下,基于Ortho CAD技术建立了CABPS.结论 CABPS可提高托槽定位精度,实现了矫治效果可预期、可视.     

MBT托槽光固化粘接与化学固化粘接的临床应用比较

目的比较光固化复合树脂与京津釉质粘接剂临床粘接MBT托槽的效果。方法选择牙列完整的20例非拔牙固定正畸矫治患者的患牙400颗,将2种粘接剂分别用于同一患者的左上颌和右下颌区以及右上颌和左下颌区,比较正畸治疗期间MBT托槽脱落情况。结果使用光固化复合树脂和京津釉质粘接剂粘接MBT托槽的脱落率无统计学意义。结论光固化复合树脂与京津釉质粘接剂粘接强度基本相同,但光固化复合树脂具有临床操作可控性强、MBT托槽粘接准确率高等优点,值得临床广泛应用。     

正畸托槽脱落的原因探讨

目的 探讨在口腔固定矫治中托槽脱落的原因。方法 患者38例,粘接托槽1303个,其中方托槽325个,Begg托槽978个。粘接剂分别为津京釉质粘接剂、TF非调和粘接剂和3M光固化树脂。结果 托槽总脱落率为54．3％（707／1303）,AngleⅠ、Ⅱ类托槽脱落率相近（分别为54．3％和54％）;下颌托槽脱落率63．％（451／707）,上颌托槽脱落率为36．2％（256／707）。统计学分析,光固化与津京釉质粘接剂和TF非调和粘接剂比较,脱落率差别非常显著（χ^2值分别为24．39和8．63,P＜0．01）,而后两者比较差异不显著（χ2＝1．48,P＞0．05）。结论 托槽粘合成败,受多因素影响。3种粘接剂比较,以光固化权脂的脱落率最低。     

美观托槽的研究进展与临床应用

随着人们对正畸治疗中的美观要求不断增加,美观托槽的临床应用日益增多.美观托槽主要有陶瓷托槽和塑料托槽,美观托槽的最新发展主要体现在美观托槽的材料、设计以及临床应用等方面.近年来.随着新材料的不断涌现和新技术的不断发展.美观托槽正逐渐克服材料本身的各种缺陷,但也存在一些尚待解决的问题.美观托槽的临床应用例如粘结、去除、再粘结也不断改进.但仍需进一步的基础研究和临床试验,证明其能否达到理想的临床要求.     

Damon Q自锁托槽在数字化牙颌模型上的模拟定位研究

目的 探讨数字化托槽模拟定位的准确性。方法 对15例数字化牙颌模型上的牙齿（每例28颗）进行托槽模拟定位,定位方法分别采用托槽高度定位法和含牙根信息托槽定位法。采用OrthoRx软件形成矫治后的最终状态;采用美国正畸目标评分系统（ABO-OGS）评估矫治结果,测量指标包括牙齿排齐、后牙边缘嵴高度及牙根平行度3项。结果 1）虚拟矫治后两种托槽定位方法的边缘嵴高度扣分均小于治疗前（P<0.05）,但两种方法虚拟矫治后边缘嵴高度扣分没有统计学差异（P>0.05）。2）含牙根信息托槽定位法虚拟矫治后牙根平行度扣分小于托槽高度定位法,但两种方法虚拟矫治前后牙根平行度未发生明显改善。3）在牙齿排齐及3项总扣分方面,两种托槽定位方法在虚拟矫治前后扣分的差异有统计学意义,矫治后扣分均小于治疗前,含牙根信息托槽定位法矫治后的扣分小于托槽高度定位法（P<0.05）。结论 在重建的包含牙根的三维数字化模型上,采用OrthoRx软件,通过托槽高度定位法及含牙根信息定位法进行托槽定位,模拟矫治均有效果;通过含牙根信息托槽定位法的模拟矫治效果更好。     

正畸托槽间接粘接技术的应用

正畸托槽间接粘接技术的应用暨南大学医学院附属医院（５１０６３０）林巍，钟梅，肖文辉正畸托槽的粘接可分直接和间接两种方法，后者指先将托槽粘接在病人的石膏牙模上，通过转移托盘将托槽转移到病人口中，同时将托槽粘接在患者整个牙弓的牙面上［１］。此法具有托槽定...     

数字化整合模型技术在DamonQ自锁托槽间接粘接中的初步应用研究

目的探索应用数字化整合模型进行托槽虚拟定位,利用计算机辅助制造托槽间接粘接转移托盘,并试用于临床。方法应用激光扫描的牙冠与CBCT重建的牙根和颌骨整合,建立包括牙冠、牙根和颌骨在内的三维数字化牙颌模型,在整合模型上利用OrthoRx软件进行托槽虚拟定位,并制作托槽间接粘接转移托盘,在临床上通过转移托盘粘接托槽进行矫治。结果OrthoRx软件的托槽虚拟定位,其排牙效果良好,计算机辅助制造产生的间接粘接转移托盘可将托槽转移至患者口中,且托槽粘接稳固。结论 OrthoRx软件可进行托槽在牙面上的虚拟定位,并可呈现排牙后的效果,通过计算机辅助可设计出用于托槽定位的个体化转移托盘,可应用于临床上。     

Propex根管测量仪临床应用操作分析

目的:探讨Propex根管测量仪临床操作中的具体细节,为更好的临床实践提供依据.方法:选取重度牙周炎需拔除的前牙150颗,分为三组:A组:牙髓活力正常者84例;B1组:牙髓无活力根尖周组织正常者37例;B2组:牙髓无活力根尖周组织有破坏者29例.以Propex根管测量仪和15号手用不锈钢K型锉测量工作长度,带锉拍摄X线片,拔牙后,观测锉尖端在根尖区位置.结果:锉尖端至解剖性根尖孔距离在A组与B1组两组间差别无统计学意义(P>0.05),两组在距解剖性根尖孔0.5mm-1mm;锉尖端至解剖性根尖孔距离A组与B2组以及B1组与B2组间差别均差异具有统计学意义(P<0.01),B2组即牙髓坏死合并根尖周组织有破坏时,距解剖性根尖孔大部分P<0.5mm,甚至穿出解剖性根尖孔.结论:Propex可准确定位生理性根尖孔,牙髓有无活力对定位无影响,但根尖周破坏时准确性降低.     

A randomized clinical trial comparing the accuracy of direct versus indirect bracket placement

Abstract

Objective: To determine the accuracy of direct or indirect bracket placement.

Design: A prospective, randomized comparison of 2 different methods of bracket placement.

Setting: Queens Hospital, Burton upon Trent, UK between February and May 2001.

Materials and method: Twenty-six consecutive patients requiring upper and lower MBT? pre-adjusted Edgewise appliances had their labial segments bonded directly or indirectly according to a split mouth system of allocation. Before and after bond-up all brackets were photographed and measured from tracings to determine positional differences from the ideal.

Results: Using ANOVA (General Linear Model), vertical errors were found to be greater than those in the horizontal plane, which in turn were greater than angular errors (p<0.05). Errors were greater in the maxillary arch than in the mandibular arch. There was no significant difference between the mean errors produced by the two methods of bracket placement.

Conclusions: Mean bracket placement errors were similar with both techniques.     

The rationale,evolution and clinical application of the self-ligating bracket

There is ample evidence in the literature that conventional orthodontic mechanics while intended to move teeth efficiently rarely achieve atraumatic remodeling of periodontal tissues. The vascular supply is often interrupted, which in turn affects the oxidative metabolism. Moreover, teeth splinted in groups do not appear to move as efficiently as single teeth. The novel bracket design and treatment regimen described in this report allow teeth to move individually, yet stay within a group. The self-ligating bracket design allows for rapid leveling because teeth drift along the path of least resistance with little or no friction between the bracket and slot of the wire. The hinge mechanism eliminates much of the friction created by the conventional wire or latex ties used to secure the archwire in the bracket slot. Thus, sliding mechanics is achieved in the true sense of the word. This system is capable of increasing the appointment intervals, and possibly reducing the overall treatment time.     

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目的    探讨多次黏结对金属托槽槽沟及其滑动摩擦力的影响。方法    本研究于2004年9月至2006年3月在福建医科大学附属口腔医院及福州大学测试中心进行。选择因正畸治疗拔除的上颌双尖牙40颗,MBTTM迷你直丝弓托槽10个,采用高温灼烧后电解抛光的方法处理脱落的金属托槽,对托槽进行多次黏结。扫描电镜下观察槽沟底金属表面结构的变化,并检测托槽宽度和槽沟宽度。应用三角函数的原理推算出托槽弓丝接触角 θc的公式,分别计算出多次黏结前后托槽指数、入槽指数及θc的变化。结果    随着黏结次数的增加,槽沟底金属表面结构愈显粗糙;托槽宽度逐渐减小,与首次黏结相比,第二次黏结的变化无统计学意义（P > 0.05）,第三、第四次黏结的变化具有统计学意义（P < 0.01）。随着黏结次数的增加,槽沟宽度、θc均依次增大,托槽入槽指数、托槽指数显著减小,与首次黏结相比,各组差异均有统计学意义（P < 0.01）。结论    入槽指数的减小虽然有利于缓解滑动阻力,但多次黏结会引起金属托槽槽沟表面粗糙、托槽弓丝接触角θc增大,均有可能导致槽沟滑动摩擦力增加,因此,在正畸临床矫治过程中对托槽的多次黏结应慎重。而托槽指数的变化对托槽与弓丝间滑动摩擦力的影响还有待于进一步的研究。     

Accuracy of an electronic apex locator under controlled clinical conditions

Abstract Clinical guidelines essential for accurate use of the electronic apex locator were developed. Common causes for inaccurate readings are described as well as ways to minimize inaccuracies. While strictly adhering to the developed clinical routines, the apex locator was used in a controlled experiment. The lengths of 127 root canals in human teeth, irrespective of diagnosis, were measured. With the instrument placed at the apical foramen, as assessed by the apex locator, a radiograph was taken with a parallelling technique. In 90.6% of the canals the tip of the instrument was assessed to be within 0.5 mm of the radio-graphic outline of the tooth. In 7% of the canals the instrument was 1 to 2 mm short. Only 2.4% of the instruments were up to 1 mm long. Under the strict clinical guidelines used, the apex locator was (bund to be a valuable aid both in routine endodontic treatment and in special clinical situations where the use of radiographs was not feasible.     

locator种植覆盖义齿在下颌无牙颌修复中的应用

目的：探讨locator附着体种植覆盖义齿在下颌无牙颌修复中的临床应用效果。方法：对12例下颌无牙颌患者,每名患者下颌植入2枚种植体,共24枚,3~4个月后完成locator附着体覆盖义齿修复。术后2年期间进行随访。结果：24枚种植体均无松动,骨无明显吸收,患者对义齿咀嚼及固位满意。结论：locator附着体固位的种植覆盖义齿是下颌无牙颌患者理想的修复方式。     

根管长度电测仪在老年人根管治疗中的临床应用

目的初步探讨RootZX根管长度电测仪测定老年人根管工作长度的准确性及不同根髓状态对其测量准确性的影响。方法选择老年患者需作根管治疗的患牙204颗,根管373个,随机分为电测法组和手感法组,分别测定根管的工作长度后预备根管,X线片试尖测定牙齿的长度,比较电测法组和手感法组测定根管工作长度的准确率。以及不同根髓状态对电测法测定根管工作长度准确率的影响。结果电测法组、手感法组准确率分别为93.75%、67.96%。经χ2检验,两组间有显著性差异。电测法中活髓根管准确率为93.81%,死髓根管的准确率为93.68%。经χ2检验,两组准确率无显著性差异。结论RootZX测量老年人根管工作长度的准确率明显高于手感法,其准确性不受根髓状态的影响。     

Accuracy of apex locator

Abstract An evaluation of the accuracy of the “Root ZX” apex locator was conducted on 20 single-rooted teeth that had been extracted because of severe disease or orthodontic treatment. After the pulp chamber had been accessed and the tooth length determined using the Root ZX apparatus, the file was fixed to the tooth with light-cured composite resin. After extraction, the tooth was longitudinally ground with a diamond bur until the file was visible. The distance between the file tip and the apical foramen was measured under a microscope (×100). The results showed that the tip of the instrument reached the apical foramen in all teeth.