正畸与修复联合治疗成人前牙列散在间隙的临床分析

目的:评价成人患者应用正畸及修复联合治疗前牙列散在间隙的临床疗效。方法:对31例曾经进行直接修复法修复前牙列散在间隙不满意患者,废弃原有修复体,实施固定正畸及修复联合治疗方案,先期正畸方法排齐整平牙列,集中牙列间隙,调整咬合关系,根据正畸后的牙列情况进行修复治疗。结果:通过正畸与修复联合治疗,所有病例前牙形态正常,上下前牙中线与面中线一致,不仅达到了良好的咬合功能,而且达到了美观的效果。结论:成人采用正畸与修复联合治疗,矫治时注意成人患者的心理,生理特点,制定治疗方案,能够较好地达到恢复患者咬合功能,同时获得前牙美容效果的治疗目标。     

成人前牙深覆(牙合)深覆盖的正畸修复联合治疗

目的：探讨正畸联合烤瓷固定修复治疗成人前牙深覆耠深覆盖的临床效果。方法：对前牙深覆[牙合]深覆盖成人患者,采用固定矫治技术整平下颌牙弓,解除深覆[牙合],为上前牙内收获得有效间隙后,行上前牙的改向烤瓷固定修复。结果：治疗后上前牙平均内收5.0mm,下颌spee氏曲线降低1.5mm-2.0mm,患者的面部侧貌得到改善,牙列形态与咬合恢复满意,咀嚼功能良好,随访6～20个月无复发。结论：对前牙深覆[牙合]深覆盖的成人患者采用正畸：联合固定修复进行治疗,既可有效的改善患者的咀嚼功能与美观,又可使下颌牙的牙体组织得以保存,达到更好的口腔修复效果。     

口腔正畸与修复联合治疗伴有牙列缺损的成人错畸形

目的 :通过对已完成的口腔正畸与修复联合治疗成人错畸形 2病例分析 ,探讨伴有牙列缺损错畸形的综合治疗途径。方法 :应用方丝弓矫治技术对伴有牙列缺损的成人错畸形作修复前的牙列正畸治疗 ,创造良好的牙列及基牙条件 ,以便选择合适的修复手段 ,恢复牙列的完整及功能。结果 :例 1通过方丝弓矫治技术 ,使深覆、正锁得以矫治 ,伸长的后牙压低 ,失去的颌间距离重新获得 ,游离端牙列缺损通过铸造托牙得到良好的修复。例 2牙列缺失散在间隙、深覆 ,通过方丝弓技术集中间隙 ,打开咬合 ,创造良好的基本条件 ,采用烤瓷固定桥修复 ,结论 :口腔正畸与修复联合治疗成人伴有牙列缺损的错畸形疗效得到整个提高 ,使一些复杂的需要修复治疗的错畸形患者得到较高质量的综合治疗。     

伸长磨牙的正畸-修复联合治疗

目的 探讨伸长磨牙正畸-修复联合治疗的临床效果。方法 选取12例因磨牙伸长无法镶牙患者,先通过正畸矫治将伸长磨牙及牙槽骨压低,待缺牙区镶复高度足够时行修复治疗。结果 所有患者经正畸治疗后伸长磨牙及牙槽骨均被成功压低,修复治疗后磨牙可正常行使咀嚼功能。结论 正畸-修复联合治疗是治疗伸长磨牙的有效方法,修复前正畸治疗可为缺失牙修复提供有效间隙,使修复体及牙列在功能和美观两方面都达到满意的效果。     

正畸结合种植义齿治疗牙列稀疏的临床研究

目的 :探讨正畸开辟间隙法与种植义齿结合治疗个别牙缺失和牙列稀疏错牙合畸形的临床效果。方法 :利用正畸开辟间隙法结合种植义齿修复对 2 0例牙缺失或先天牙列稀疏的病例进行矫治。结果 :2 0例经治疗后均达到理想的临床效果。结论 ;对个别牙缺失和牙列稀疏病例 ,利用正畸开辟间隙法结合种植义齿修复能实现最大限度的美观、功能及稳定。     

成人前牙排列不齐的烤瓷冠美容修复

个别前牙错位、牙间隙致使牙排列不齐,牙列拥挤影响美观,其临床表现多种多样。在治疗上应以正畸治疗为首选,但成人因错过矫治器矫正的良好时机,增加了矫治难度。故临床上,部分患者为了美观,要求采用修复治疗方法来解决前牙排列不齐的问题。作者自1998年起,采用烤瓷冠修复的方法,矫治成人前牙排列不齐,收到良好的效果。现报告如下:1　临床资料及方法1.1　临床资料26例患者(男2例、女24例),年龄22～43岁。个别牙错位8例,前牙散在间隙3例,轻、中度牙列拥挤15例。前牙间隙、牙列拥挤患者,后牙牙合关系为中性或轻度近、远中关系,覆牙合2～8mm、超…     

固定义齿与正畸联合治疗伴错(牙合)畸形的牙列缺损

临床上常见伴发错[牙合]畸形的牙列缺损病例，用常规的修复方法，虽然能够修复缺失牙余留的间隙，但很难达到美观、功能、稳定兼顾的效果。作者对12例伴发错[牙合]畸形的牙列缺损患者，采用正畸与固定修复联合治疗的方法，先正畸矫治错[牙合]畸形，调整咬合关系，调整余留牙与缺失牙在牙弓中的位置，以获得固定修复的适应症，然后对牙列缺损进行固定修复，取得了良好的治疗效果。     

病例报告：成人正畸与修复治疗结合病例

成人患者口腔情况较儿童复杂，常常有牙体缺损、颜色异常以及牙齿缺失与错袷畸形并存的情况。近些年来，随着人们的生活水平不断提高，对功能与美观的追求也越来越高。对于存在错验畸形的患者单纯修复治疗不能解决间隙不足，咬合紊乱等问题，可酉通过正畸治疗首先纠正牙齿位置异常，使之形成良好的咬合关系，再进行修复，恢复完整牙列，而成人正畸往往由于生长发育已停止，上下颌骨关系不理想，或不希望矫治时间过长等原因难以达到理想的矫治效果，而正畸医师与修复医师配合可以使一些复杂的成人错袷畸形通过较为简单快捷的方法得到理想的结果。     

先天性牙缺失患者的单纯正畸治疗与正畸-修复联合治疗浅探

目的:探讨先天失牙患者的缺牙特征及单纯正畸或正畸修复联合治疗的临床效果。方法:收集2006~2014年在我科矫治的先天失牙患者24人,拍全口曲面断层片、颞下颌关节开闭口位片及头颅定位侧位片,并根据面型及牙列拥挤度等决定治疗方案,通过正畸治疗将间隙集中后再义齿修复,观察临床疗效。结果:24例先天失牙患者采用上述方法进行治疗,均获得正常覆盖、覆牙合关系,面型协调,软组织侧貌得到改善。结论:先天缺失1~2牙的错牙合畸形, 根据面型、错牙合情况、缺牙数目设计不同矫治治疗方案, 能够获得满意的矫治效果。多牙先天牙缺失,常需正畸-修复联合治疗才能获得较好疗效。     

正畸与种植技术在前牙缺失散在间隙修复中的临床应用

目的：探讨正畸与种植技术在前牙缺失散在间隙修复中的应用特点。方法：选取前牙缺失伴散在间隙病例17例,前期采用正畸技术集中和开拓修复间隙,矫正缺隙两侧倾斜扭转牙,调整咬合关系及中线;后期运用种植技术恢复牙列的完整,并视种植修复后的牙列情况采用正畸治疗进行相应的精细调整。结果：17例前牙缺失散在间隙患者经正畸与种植修复后,均获得良好的修复效果。结论：采用正畸与种植技术联合治疗前牙缺失散在间隙的患者,能够实现最大限度的美观、功能及稳定,提高修复效果。     

Restoring esthetics using adjunctive orthodontics – Case reports

Pre-restorative orthodontic alignment has definite advantages especially in patients with mal-aligned dentition seeking prosthetic rehabilitation. As adult orthodontics has gained popularity, orthodontic practices have seen a change in the patient population they encounter on a day-to-day basis. From completely dentulous adolescents, this population has widened to encompass adult dentitions with worn or abraded teeth, peg-shaped lateral incisors, fractured teeth, gummy smiles, multiple edentulous spaces, or other restorative needs that often require tooth positioning that is slightly different from non restored, nonabraded, adolescent teeth. In such instances, an interdisciplinary approach is necessary to evaluate, diagnose, and resolve esthetic problems using a combination of orthodontic, periodontic, endodontic and prosthodontic treatments. The aim of the article is to emphasize the importance of adjunctive orthodontics in such interdisciplinary treatment protocols, through two case reports.     

The orthodontic–periodontic interrelationship in integrated treatment challenges: a systematic review

Summary Orthodontic treatment aims at providing an acceptable functional and aesthetic occlusion with appropriate tooth movements. These movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, because of the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems. Aesthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory periodontal diseases should be considered in orthodontic treatment planning. Furthermore, in cases with severe periodontitis, orthodontics may improve the possibilities of saving and restoring a deteriorated dentition. In modern clinical practice, the contribution of the orthodontist, the periodontist and the general dentist is essential for optimized treatment outcomes. The purpose of this systematic review is to highlight the relationship between orthodontics and periodontics in clinical practice and to improve the level of cooperation between dental practitioners. Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic–periodontal clinical problems are discussed.     

成人骨性反畸形的手术前后正畸

目的:以本院近期收治10例骨性反的患者为例,介绍采用正畸正颌手术联合治疗的手术前后正畸及术前的准备工作。方法:正畸主要是去代偿,矫正上下颌前牙唇舌倾斜,后牙的颊舌倾斜,排齐牙齿,协调上下牙弓,平整曲线,建立正颌术前良好的牙关系。术前准备主要是:术前电脑模拟手术,模拟外科,板制作。结果:正颌治疗后患者建立了良好的咬颌关系,协调的上下颌骨关系,获得面容的美观。结论:治疗颌面部的骨性畸形,经过术前正畸正颌手术术后正畸的过程,其中每一步都很重要,术前电脑模拟手术,模型外科,板制作可以使正颌治疗更精确。     

OHIP对成人正畸治疗结果的应答性

目的：观察成人正畸患者治疗前后生活质量的变化;分析OHIP（Oral Health Impcat Profile）对正畸治疗的应答性。方法：从正畸临床病人中随机挑选120位成人正畸患者,分别在正畸前后填写汉语化的OHIP问卷,并在治疗后对治疗结果的满意度进行自我评估。结果：治疗后患者的OHIP值比治疗前显著降低,几个域尤其是功能限制治疗前后均值也有显著变化。治疗前后OHIP均值差及统计效应值也与患者的自我满意度方向一致,呈渐进性变化。结论：OHIP对正畸治疗具有明显的应答性,提示关于生活质量的评估方法能用于评价成人正畸治疗效果。     

Dental and orthodontic management of patients with Apert and Crouzon syndromes

Patients with Crouzon and Apert syndromes exhibit particular orofacial features in combination with the craniofacial skeletal discrepancy that requires reconstructive surgical maneuvers at various stages of development. To maximize positive surgical outcomes and patient satisfaction, an interdisciplinary approach, including pediatric dentistry and orthodontics, within a developmental context is needed. Routine dental care is provided in conjunction with ongoing surgical and orthodontic treatment during all phases of the reconstructive process. The goal of orthodontic treatment in the mixed dentition is to resolve issues related to the aberrant eruption of the permanent teeth and favorably influence the occlusion when early midface advancement is planned. Orthodontic treatment during adolescence always is needed to prepare these patients for orthognathic surgery, which usually involves extraction orthodontics within the maxillary arch. Postsurgical orthodontic management is an important component of the definitive occlusal correction after orthognathic surgical procedures.     

Pre-prosthetic orthodontics

For some patients, pre-prosthetic orthodontic intervention is necessary to optimize both esthetic and functional aspects of dental treatment. This review will focus on the following topics: orthodontics treatment with multiple missing teeth, correction of anterior deep vertical overlap, anterior worn dentition, up-righting of tilted teeth, and orthodontic crown lengthening. This review will aid restorative dentists in identifying which patients could benefit from orthodontic intervention, and in understanding how orthodontic treatment can be utilized to improve patient prognosis in restorative treatment.     

Northcroft lecture: how has the spectrum of orthodontics changed over the past decades?

Three aspects have had a significant impact on orthodontics during the last few decades: the appliances being used, the anchorage being used and finally the distribution of patients being treated. Firstly, the marketing of appliances is increasingly leading the orthodontist to outsource important aspects of treatment such as wirebending and bracket positioning. Brackets and wires are being presented as the solution to all problems and metaphysical terms such as 'intelligent design,' 'working brackets' and 'intelligent wires' are dominating advertising and reducing the impact of evidence-based treatment approaches. Secondly, the introduction of skeletal anchorage has potentially widened the spectrum of orthodontics, allowing for treatments that could not be done with conventional appliances. Biomechanical knowledge is, however, mandatory if we agree that the system should not be abused. Thirdly, the orthodontic population comprises an increasing number of adult patients, many of whom are characterized by a degenerated dentition. The treatment of these patients requires a thorough knowledge not only of biomechanics but also of the reaction of the periodontal tissues to various types of loading. They can be treated only with custom-made appliances adapting the force systems and magnitude to the patient-specific treatment goal. In summary, the orthodontic world is being split between 'appliance-driven fast-food orthodontics' where the results to a large extent are dependent on both growth and function and 'orthodontist-driven' 'slow-food' treatments attempting to push the limits of the possible in relation to complicated problems and reversal of degeneration in adult patients. The latter treatments are performed with individualized appliances adapting the force system to the patient. This paper will attempt to summarize the bearing of these factors on present orthodontics.     

Northcroft Lecture: How has the spectrum of orthodontics changed over the past decades?

Abstract

Three aspects have had a significant impact on orthodontics during the last few decades: the appliances being used, the anchorage being used and finally the distribution of patients being treated.

Firstly, the marketing of appliances is increasingly leading the orthodontist to outsource important aspects of treatment such as wirebending and bracket positioning. Brackets and wires are being presented as the solution to all problems and metaphysical terms such as ‘intelligent design,’ ‘working brackets’ and ‘intelligent wires’ are dominating advertising and reducing the impact of evidence-based treatment approaches.

Secondly, the introduction of skeletal anchorage has potentially widened the spectrum of orthodontics, allowing for treatments that could not be done with conventional appliances. Biomechanical knowledge is, however, mandatory if we agree that the system should not be abused.

Thirdly, the orthodontic population comprises an increasing number of adult patients, many of whom are characterized by a degenerated dentition. The treatment of these patients requires a thorough knowledge not only of biomechanics but also of the reaction of the periodontal tissues to various types of loading. They can be treated only with custom-made appliances adapting the force systems and magnitude to the patient-specific treatment goal.

In summary, the orthodontic world is being split between ‘appliance-driven fast-food orthodontics’ where the results to a large extent are dependent on both growth and function and ‘orthodontist-driven’ ‘slow-food’ treatments attempting to push the limits of the possible in relation to complicated problems and reversal of degeneration in adult patients. The latter treatments are performed with individualized appliances adapting the force system to the patient. This paper will attempt to summarize the bearing of these factors on present orthodontics.     

Role of interceptive orthodontics in early mixed dentition

Early orthodontic interventions are often initiated in the developing dentition to promote favourable developmental changes and remove or suppress those that are unfavourable. Early interceptive orthodontics can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, overall treatment time and cost. It also improves self-esteem in the subjects and parental satisfaction. Early detection and appropriate referral of cases requiring interceptive orthodontics are important. However, lack of awareness among school children, parents and primary-care personnel (dental nurses and dental officers) may result in patients not being referred for timely interceptive intervention. This article presents a general view of the scope of interceptive orthodontics that can be carried out in early mixed dentition, i.e. when the permanent incisors and molars are erupting into the oral cavity.     

成人骨性安氏Ⅱ类1分类错(牙合)的正颌-正畸联合治疗

目的采用正畸-正颌手术联合治疗骨性安氏Ⅱ类Ⅰ分类错(牙合)患者,介绍手术前后正畸及术前的准备工作.方法11例成人骨性安氏Ⅱ类Ⅰ分类错(牙合)患者,均经术前正畸-正颌手术-术后正畸的治疗过程.手术前后正畸目的是矫正上下颌前牙前突,排齐牙列,协调上下牙弓,平整牙(牙合)曲线,建立正颌术后良好的咬合关系.术前准备包括术前电脑模拟手术、模型外科、(牙合)板制作.结果11例患者建立了良好的咬合关系及协调的上下颌骨关系,面容美观改善.结论骨性错(牙合)畸形患者采用正畸-正颌联合治疗,能获得功能和美观的满意效果,术前正畸、电脑模拟手术、模型外科、(牙合)板制作及术后正畸,每一操作步骤的精确到位均十分重要.