片段弓治疗深覆(牙合)前后根尖吸收的临床评价

目的:探讨片段弓矫治重度深覆牙合过程中对根尖吸收的作用情况及影响因素。方法:对16名成人高角的重度深覆牙合患者(覆牙合>II度),用片段弓来打开咬合,并在根尖定位片上对咬合打开前后的根尖吸收情况进行观察,用Ridit检验评价治疗前后根尖变化情况。结果:戴用片段弓3～6个月(平均4.5月)后,覆牙合达到正常,压低后虽然牙根呈1级吸收的比率增加(治疗前1级吸收的比率为13%,治疗后为25%),但差别无统计学意义。结论:片段弓矫治深覆牙合时,在合适的力、力点及力作用时间内,对根吸收的影响较小。     

改良片段弓技术压低上前牙对深覆矫治效果的临床观察

目的:探讨改良片段弓技术压低上前牙对深覆矫治的临床疗效及其作用机制。方法:选择15例前牙深覆患者,采用直丝固定矫治器结合改良片段弓技术打开其咬合,通过X线头影测量分析患者矫治前、后前牙深覆的改变情况,评价其治疗效果。结果:患者治疗后上前牙获得垂直向压入,前牙咬合打开,深覆得到矫治,后牙垂直向及矢状向无明显变化。结论:改良片段弓技术能压低前牙段,同时控制后牙段的伸长,有利于深覆特别是高角、露龈笑或成年深覆患者的矫治;其压低辅弓适宜的初始加载力值为50g左右。     

平面导板配合“T”型曲矫治成人安氏Ⅰ类深覆[牙合]重造的疗效分析

目的：探讨成人深覆[牙合]的特点和临床矫治要点,为临床矫治成人深覆[牙合]提供参考。方法：对18例青年重度深覆[牙合]患者,用固定平面导板打开咬合,方丝“T”型曲压低上前牙并控制转矩,对矫治前后X线头颅侧位片进行测量分析。测量结果应用SPSS15．0软件进行t检验。结果：矫治结束后咬合关系良好,前牙覆[牙合]、覆盖基本正常。矫治前后骨面型的变化无统计学意义。矫治前后上下前牙的唇倾度、牙槽高度的变化有统计学意义。结论：应用平面导板加方丝“T”型曲在成人深覆牙合矫治中主要是通过下前牙的唇倾、上下前牙的压低来改善深覆[牙合],对成人深覆[牙合]的矫治有良好的效果。     

应用多曲方丝弓技术矫治成人前牙重度深覆(牙合)

目的 探讨多曲方丝弓技术在治疗成人前牙重度深覆(牙合)中的作用.方法 选择20例成人前牙重度深覆(牙合)患者,使用多曲方丝弓矫治深覆(牙合).治疗前后拍摄X线头颅侧位定位片,并进行X线头影测量分析.结果 U1A-PP平均减小了1.75 mm,L1A-MP平均减小了1.67 mm,U6-PP平均增加了1.53 mm,L6-MP平均增加了1.53 mm,说明多曲方丝弓能压低前牙,升高后牙.结论 应用多曲方丝弓技术,能压低前牙,升高后牙,对于成人前牙重度深覆(牙合)是一种快速、有效整平牙弓的方法 .     

两种方法治疗深覆(牙合)前后根尖吸收的临床比较研究

目的:评价片段弓、高位J钩在矫治重度深覆(牙合)过程中对根尖吸收的影响.方法:随机选择41例经过标准方丝弓技术治疗的成人女性高角的重度深覆(牙合)患者(覆(牙合)＞Ⅱ°),其中25例在咬合打开阶段应用高位J钩配合治疗,1 6例用片段弓配合治疗,并在根尖定位片上对咬合打开前后的根尖吸收情况进行观察,分别测量两组治疗前后上颌4个上切牙的牙根吸收等级,用Ridit检验分析各组治疗前后根尖吸收等级,用x2检验分析两组治疗后的吸收情况.结果:两组正畸治疗后均可见牙根吸收,治疗前后的牙根吸收等级比较,片段弓组无显著性差异(P＞0.05),高位J钩组有显著性差异(P＜0.01).治疗后两组间牙根吸收等级比较,差异呈显著性(P＜0.01),标准方丝弓配合高位J钧组还出现了极重度吸收.结论:标准方丝弓配合高位J钩在正畸治疗中较单纯使用标准方丝弓技术更易产生严重的牙根吸收.标准方丝弓配合片段弓矫治深覆(牙合)时,在合适的力、力点及力作用时间内,对根吸收的影响是较小的;标准方丝弓配合高位J钩在正畸治疗中较易产生严重的牙根吸收.     

多用途弓在矫治安氏Ⅱ^1类高角深覆[牙合]中的临床应用

目的：探讨多用途弓在矫治安氏II1类打开咬合中的作用机理。方法：选择30例安氏Ⅱ1类错[牙合]、前牙深覆[牙合]达Ⅱ度以上的高角正畸病例,平均年龄13.8岁。在矫治中使用多用途弓打开咬合,咬合打开的时间平均3.9个月。对矫治前后的X线头影测量结果进行统计学分析和比较。结果：患者的ANB角减小1.2°;U1-PP距减小0.85mm;LI-MP距减小1.05mm;OB减小4.6mm（P〈0.05）,差异有统计学意义,而患者的U6-PP距增加0.72mm;L6-MP距增加0.54mm;GoGn-SN增加0.83°;后前面高的比值（S-Go/N-Me）增加1.6%;下前面高的比值（ANS-Me/N-Me）增加2.8%（P〉0.05）。结论：多用途弓在安氏Ⅱ1高角深覆病例的矫治中,能快速有效地压低前牙,打开咬合,上下颌磨牙的垂直高度、面下1/3高度无明显增加。     

对成年人深覆He采用“T“型曲打开咬合的临床效果探讨

目的：探讨成人前牙Ⅲ^0深覆He患者打下咬合的有效方法。方法：选择前牙深覆He为Ⅲ^0的，AngleⅡ类Ⅰ分类错He畸形成人患者19例，年龄19-35岁，在方丝弓矫治器上，用澳丝弯制“T”型曲，通过压低上下切牙来打开咬合。结果：19例Ⅲ^0深覆He患者打开咬合最短时间为3.5个月，最长为5个月，平均4.2个月，X线头影测量结果，反映切牙垂直位置的1↓--PP，1↑--MP距矫治后均有高度显著性变化。结论：对成人深覆He患者，采用“T”型曲压低上下切牙来打开咬合是可行的，值得推广应用。     

骨性安氏Ⅱ类1分类错的拔牙矫治

目的:通过X线头影测量探讨方丝弓技术拔牙矫治恒牙期骨性安氏Ⅱ类1分类错的临床疗效。方法:对10名前牙深覆盖达到8～11mm且ANB平均为7.4°伴Ⅲ°深覆的恒牙期患者,采用方丝弓技术进行矫治,均拔除4个第一双尖牙,并对所有患者正畸治疗前后进行头影测量分析。结果:10例患者治疗后覆盖、覆牙合均达到正常,NA-PA平均减少4.4°,ANB减小2.3°,SNA减小1.9°。下颌Spee氏曲线与上颌补偿曲线明显整平。结论:应用方丝弓矫治技术拔牙治疗方法可以有效矫治恒牙期骨性安氏II类1分类错,其改善的关键在于上切牙内收前深覆的矫治。     

两种方法压低下前牙的效果及牙根吸收状况的临床研究

目的：比较使用微种植钉支抗和平面导板两种方法压低下前牙打开咬合的矫治效果以及下前牙牙根吸收的差异。方法：选取济宁医学院附属医院正畸科深覆牙合患者40例,随机分为两组。A组采用微种植钉支抗,B组采用平面导板压低下前牙。将A、B两组患者压低前,压低后CBCT图像资料导入Dolphin三维重建软件进行三维重建,评估下前牙的压低效果,并测量两组患者牙根根尖外吸收量。结果：两组患者均达到了正常覆牙合,A、B组覆牙合分别平均减小了3.4 mm、3.2 mm(P<0.001),组间比较差异无统计学意义（P>0.05）;下切牙的阻抗中心点分别降低了3.1 mm、2.8 mm(P<0.001),组间比较差异无统计学意义（P>0.05）。两组的下切牙分别唇倾了5.2°、6°（P<0.05）,组间比较差异无统计学意义（P>0.05）。A组垂直向骨性测量指标MP-SN、FMA值未发生显著性改变（P>0.05）,B组MP-SN、FMA值分别增加了0.7°和0.8°（P<0.05）。B组中切牙、侧切牙的牙根吸收分别为(0.98±0.30) mm、(0.94±0.20...     

应用多曲方丝弓技术矫治成人前牙重度深覆

目的探讨多曲方丝弓技术在治疗成人前牙重度深覆中的作用。方法选择20例成人前牙重度深覆患者,使用多曲方丝弓矫治深覆。治疗前后拍摄X线头颅侧位定位片,并进行X线头影测量分析。结果U1A—PP平均减小了1.75 mm,L1A—MP平均减小了1.67 mm,U6—PP平均增加了1.53 mm,L6—MP平均增加了1.53 mm,说明多曲方丝弓能压低前牙,升高后牙。结论应用多曲方丝弓技术,能压低前牙,升高后牙,对于成人前牙重度深覆是一种快速、有效整平牙弓的方法。     

微小种植体支抗压低前牙改善露龈笑的临床研究

目的：评价利用微小种植体作为支抗压低前牙改善露龈笑的临床效果。方法：选取我科室9例（男5例,女4例）前牙过长,开唇露齿露龈笑的深覆病例,年龄18.6～28.3岁,平均24.7岁。9例患者前牙区存在II度或III度深覆,5例病例伴有不同程度的牙列前突。9例患者在佩戴固定戴矫治器后在上、下颌前牙区相应部位植入微小种植体,治疗前后拍摄全口曲面断层片进行测量对比,观察切牙的变化和改善露龈笑的情况。结果：9例患者治疗前后上下颌前牙均有不同程度的压低,上颌前牙平均压低3.8mm,下颌切牙平均压低3.0mm,深覆得到有效的治疗,同时露龈笑有一定程度的改善。其中2例患者出现一定程度的牙根吸收。结论：利用微小种植体支抗能有效地治疗前牙过长开唇露齿,达到真正压低前牙解除深覆的效果。     

Evaluation of the soft and hard tissue changes after anterior segmental osteotomy on the maxilla and mandible.

PURPOSE: The purpose of this study was to determine the relationship between the changes of soft and hard tissues after modified anterior segmental osteotomy on the maxilla and mandible and to evaluate unintended facial changes using cephalometric and photometric analyses. MATERIALS AND METHODS: The subjects included 29 women and 1 man (22 to 50 years of age) who were diagnosed as bialveolar or bimaxillary protrusion and underwent modified anterior segmental osteotomy on the maxilla and mandible. Lateral cephalograms and lateral and frontal photographs taken preoperatively and postoperatively were analyzed. RESULTS: There was a significant change in all soft and hard tissue parameters except the labiomental angle. The ratio of upper lip to maxillary incisor retraction was 0.67:1 and the ratio of lower lip to mandibular incisor retraction was 0.89:1. Nasolabial angle and philtrum length were increased, and vermilion length and lip width were decreased. Nasal change could be kept as small as possible, although slight widening of the nasal width and anti-tip rotation of the nasal tip were observed. CONCLUSION: Anterior segmental osteotomy might be recommended as the treatment modality of choice in patients with bimaxillary and/or dentoalveolar protrusion. Because the technique is simple, postoperative complications are minimal, relapse is limited, and soft tissue changes in response to surgery are more predictable.     

微种植体支抗压低磨牙的临床研究

目的:探讨微种植体支抗在压低磨牙中的疗效。方法:选择7例需要压低磨牙的患者(包括5例开牙合患者和2例因对牙合牙缺失而致磨牙伸长的修复前正畸患者),使用微种植体支抗压低磨牙,治疗前后拍摄头颅定位侧位片,测量并比较磨牙在矫治前后的压低量。结果:矫治结束后开牙合患者前牙达到正常的覆牙合、覆盖,修复前正畸患者矫治至缺牙区能进行常规修复。磨牙压低范围2～4mm。结论:应用微种植体支抗能有效地压低磨牙,为磨牙伸长的修复前正畸和开牙合畸形的矫治提供了思路。     

下唇动脉弓岛状红唇瓣修复上唇红唇缺损

目的探讨双侧唇裂术后继发上唇红唇部分缺损畸形的修复方法。方法采用下唇动脉弓为血管蒂的移位岛状红唇瓣,一次手术修复上唇部分红唇缺损,红唇瓣面积最小为1.5cm×1.5cm,最大为1.5cm×2.0cm的楔形。结果自1993年以来,应用本术式修复上唇的红唇缺损15例,成活良好,外观满意。结论应用下唇动脉弓岛状红唇瓣,修复双侧先天性唇裂术后继发上唇红唇组织缺损畸形,具有较强的适应证。     

The ��bikini lip reduction��: A detailed approach to hypertrophic lips

Excessively large lips represent an occasional but significant challenge in aesthetic surgery. Previously described techniques focus largely on the simple excision of a strip of tissue to reduce the lips, without specific attention to the resultant lip contour or to the volume relationship between the lips. The present paper describes a new technique for lip reduction, called the ‘bikini lip reduction’. This technique not only reduces the volume of the lips, but also restores an attractive labial contour, as well as an ideal volume relationship between the upper and lower lips. Because it is based on aesthetic analysis, this technique consistently yields both smaller and more aesthetically appealing lips. Simply stated, the bikini lip reduction consists of excision of a ‘bikini top’ (two cups and a middle strap) from the upper lip and a ‘bikini bottom’ (a triangle) from the lower lip. The aesthetic results and the patient satisfaction achieved through the bikini lip reduction technique have been very satisfactory.     

SanderⅡ矫治器治疗下颌后缩的临床研究

目的：利用SanderⅡ功能矫治器的腭导杆、上颌镍钛螺旋扩弓簧和下颌扩弓簧、分体式的独特设计,矫治AngleⅡ类1分类患者生长高峰前期或高峰期、替牙晚期或恒牙早期的深覆拾、深覆盖患者。方法：病例纳入标准为AngleⅡ类1分类生长高峰前期或高峰期、替牙晚期或恒牙早期的深覆枪深覆盖患者,下颌平面角为均角或底角。共有13人配戴SanderⅡ功能矫治器1年,拍治疗前后头颅定位侧位片。用西安交通大学口腔医院正畸科X线头影测量分析方法分析治疗前后X线测量数据,并用SPSSl8．0软件配对t检验进行统计学处理。结果：ANB°、ANS-Ptm、Co-Pg、U1-APg、L1-NB距、L1-NB角、L6-MP、UL-E1ine、∠N＇Sn-Pg〈0．01有非常显著统计学意义;Wits值、NA-Pg、U1-SN角、U6-PP、∠N’-Pg＇-FH,P〈0．05有显著统计学意义。结论：上下颌骨相对位置改变明显,导下颌前伸明显、上颌基骨长度有增长;下颌基骨长度增长显著;面凸角变小;上颌前牙内收明显,上下第一磨牙仲长,下面高增长,但相对全面高协调。软组织上唇突度减小、颏部前移,软组织侧貌与骨组织改建一致。     

Persistent endodontic lesion due to complex cementodentinal tears in a maxillary central incisor--a case report.

The cementodentinal tear is rarely detected by noninvasive procedures owing to its clinical picture simulating a root fracture or a periodontal or endodontic lesion. We present a case of complex cementodentinal tears in a 79-year-old woman who presented a repeated swelling at the labial mucosa of the left maxillary central incisor for 6 months. Periapical radiographs demonstrated a vertical radiolucent fracture line extending from the root apex along the mesial aspect of the root to near the middle portion of the root of the left maxillary central incisor. Because endodontic re-treatment failed to cure the disease, periapical surgery was performed, and 2 fractured U-shaped root fragments around the apical root surface were removed. Histologic examination showed that the 2 fractured root fragments were composed mainly of the dentin covered by a thin layer of the cementum and overlying periodontal ligament tissue, suggesting cementodentinal tears. A swelling recurred 8 months after the initial operation. Therefore, a second periapical surgery was performed. Although no obvious fracture line was observed around the root surface, the second surgery did not cure the disease, either. A persistent small swelling was noted at the alveolar mucosa of the affected tooth during the follow-up. We conclude that although a cementodentinal tear can be detected by a careful radiographic examination, its clinical outcome is not predictable by surgical removal only.     

Lip Augmentation with AlloDerm Acellular Allogenic Dermal Graft and Fat Autograft: A Comparison with Autologous Fat Injection Alone

Many surgical options exist for lip augmentation, none of which consistently provide safe, lasting, and predictable volume gains. We describe and evaluate the use of AlloDerm acellular allogenic dermal graft in combination with fat autograft and compare the postoperative results with those of autologous fat injection alone. Analysis of the preoperative and 1- and 3-month postoperative photographs was done using digital imaging software. Outcome measures included vermilion show and horizontal lip projection from the soft tissue pogonion–subnasale plane. A 61% mean increase in vermilion show was observed in lips augmented with AlloDerm/fat injection, in comparison to a mean increase of 13% in lips augmented with fat injection alone. Lip projection demonstrated a mean increase of 1 mm in AlloDerm/fat lips at 3 months. Postoperatively, no evidence of resorption was seen in lips augmented with AlloDerm/fat between the 1- and the 3-month follow-ups, however, a 9% decrease in vermilion show occurred in lips augmented with fat injection over the same period. No complications occurred in either group. We conclude that AlloDerm in conjunction with autologous fat injection constitutes a safe, reliable, and lasting method of lip augmentation providing increased vermilion show compared to that with autologous fat injection alone.     

改良Black术式修复完全性双侧唇裂畸形

目的 探讨采用改良Black术式修复先天完全性双侧唇裂畸形效果.方法 应用改良的Black术式修复先天完全性双侧唇裂畸形36例,其中前唇组织特别短小者19例,皮肤、唇珠组织不足,均采用裂隙侧唇组织修复.结果 术后随访全部受术者3个月至3年,前唇部唇高正常,两侧唇高对称,唇珠丰满,唇弓静态及动态自然,上唇无明显过长、过紧,唇珠与红唇颜色无差异,切口瘢痕不明显,效果满意.结论 改良术式弥补了Black术式修复双侧完全性唇裂前唇组织特别短小的患者时,出现中央唇高不足、唇珠不够丰满的缺陷,使修复的上唇功能及美容效果更佳,值得临床推广.     

改良Black术式修复完全性双侧唇裂畸形

目的 探讨采用改良Black术式修复先天完全性双侧唇裂畸形效果.方法 应用改良的Black术式修复先天完全性双侧唇裂畸形36例,其中前唇组织特别短小者19例,皮肤、唇珠组织不足,均采用裂隙侧唇组织修复.结果 术后随访全部受术者3个月至3年,前唇部唇高正常,两侧唇高对称,唇珠丰满,唇弓静态及动态自然,上唇无明显过长、过紧,唇珠与红唇颜色无差异,切口瘢痕不明显,效果满意.结论 改良术式弥补了Black术式修复双侧完全性唇裂前唇组织特别短小的患者时,出现中央唇高不足、唇珠不够丰满的缺陷,使修复的上唇功能及美容效果更佳,值得临床推广.