Hawley保持器与热压膜保持器对成人正畸患者中文语音发音影响的临床随机对照研究

目的 探索Hawley保持器与热压膜保持器两种常用的正畸保持器对成人正畸患者中文语音发音的影响。方法 采用临床随机对照的形式,将20名研究对象随机分为两组,每组10名,A组戴用Hawley保持器,B组戴用热压膜保持器。分别于戴入保持器前（T0）、刚戴入保持器时（T1）、戴入后1 d（T2）、戴入后1周（T3）、戴入后1个月（T4）共5个时间点进行5次中文语音音频资料的采集,运用Praat 5.4.21语音分析软件和SPSS 19.0对采集的语音资料进行语音参数分析。结果 两种正畸保持器均能引起单元音/e/、/i/、/ü/,辅音/s/、/f/、/x/、/t/、/j/和/q/的语音参数变化,其中Hawley保持器对/i/、/ü/、/s/音的影响持续时间可达1个月以上,热压膜保持器对语音的影响多可在1个月内恢复正常发音。结论 两组正畸保持器均可影响成人正畸后中文语音的发音,其中Hawley保持器对语音的影响更大,而热压膜保持器对语音的影响多可较快恢复正常。     

常用正畸保持器的对比研究

［摘要］　正畸治疗结束后仍有很多因素容易导致错合畸形的复发,所以保持器的佩戴是必须的。临床上常用的保持器有：压膜保持器及其改良式、Hawley保持器和舌侧固定保持器。本文从保持效果、患者接受度及依从性、保持器对牙周组织的影响这三个方面对各个类型的保持器做一对比,期望对医师临床选择保持器有指导意义。     

Effect of direct retainer and major connector designs on RPD and abutment tooth movement dynamics

Designs of removable partial dentures are suggested to affect the mobility of abutment teeth and removable partial denture (RPD) during oral functions. This study aimed to examine the effect of direct retainer and major connector designs on RPD dynamics under simulated loading. Six different Kennedy class II maxillary RPDs were fabricated on a maxillary model. These dentures involved 3 different direct retainers (wrought-wire clasp, RPA clasp, and conical crown telescopic retainer) and 2 different major connectors (Co-Cr major connector and heat-cured acrylic resin with a metal strengthener). Using an experimental model with simulated periodontal ligaments and mucosa that were fabricated using silicone impression material, three-dimensional displacements of the RPDs were measured under a simulated 30-N loading with a displacement transducer type M-3. Significant effects of "direct retainer design" on bucco-palatal displacements and "major connector" on mesio-distal displacements were revealed by 2 x 3 two-way analysis of variance of abutment teeth movements (P < 0.001 and P = 0.002, respectively). Additionally, analysis of variance of RPD displacements revealed significant effects of "direct retainer design" on corono-apical displacements and "major connector" on mesio-distal displacements (P = 0.001 and P = 0.028, respectively). Rigid direct retainers and rigid major connectors decrease the movements of both abutment tooth and RPD.     

正畸治疗及戴固定保持器对牙龈健康的影响

目的 评估口腔正畸治疗及戴固定保持器与牙龈健康的关联性.方法 本研究回顾性调查62例受试者,其中34例接受过正畸治疗.测量全部受试者牙龈健康相关参数,包括牙菌斑指数、牙龈退缩、探诊深度和探诊出血,分析各参数与正畸治疗的相关性.结果 与未正畸人群比较,正畸人群的唇侧牙龈退缩更明显[（0.13±0.27）mm vs（0.05±0.16）mm,P=0.03）];在正畸人群中,与未戴保持器的牙弓比较,戴保持器的牙弓发生舌侧牙龈退缩者更明显[（0.09±0.18）mm vs（0.01±0.08）mm,P=0.005）],菌斑指数、探诊出血亦显示相同的差异.正畸人群中,舌面牙菌斑与舌/腭侧牙龈退缩之间有正相关性（r=0.34,P=0.015）.结论 正畸治疗及治疗后戴固定保持器与牙龈退缩、菌斑滞留及探诊出血有关联性,口腔自我护理的重点应放在祛除菌斑上.     

根内固位体联合冠外固位体修复后牙大部分牙体缺损的效果

目的 观察根内固位体联合冠外固位体修复后牙大部分牙体缺损的效果。方法 选取2018年 1月-2023年4月于我院行修复治疗的120例后牙大部分牙体缺损患者为研究对象,采用随机数字表法分为参 照组和研究组,各组60例。参照组采用冠外固位体修复,研究组采用根内固位体联合冠外固位体修复,比 较两组临床效果、牙周健康评分、疼痛（VAS）评分、牙体表面缺损评分。结果 研究组治疗总有效率为 96.67%,高于参照组的83.33%（P ＜0.05）;两组治疗后牙周健康评分均低于治疗前,且研究组低于参照组 （P ＜0.05）;两组治疗后牙体表面缺损评分均低于治疗前,且研究组低于参照组（P ＜0.05）;两组治疗 6、24 h后VAS评分均低于治疗前,且研究组低于参照组（P＜0.05）。结论 根内固位体联合冠外固位体修 复后牙大部分牙体缺损的效果确切,可减轻患者疼痛,改善牙周健康,降低牙体缺损评分,是一种有效的 联合治疗方案。     

The Effect of Material Type and Location of an Orthodontic Retainer in Resisting Axial or Buccal Forces

The purpose of this study was to investigate the effect of retainer material and retainer position on a tooth to resist movement of the tooth in a simulation model. Bidirectional continuous glass fiber-reinforced composite (FRC) retainers and control retainers of steel wires were tested. The FRC retainers had a polymer matrix of bisphenol-A-glycidyldimethacrylate (bis-GMA) and poly(methylmethacrylate) (PMMA), and it was cured with a photoinitiator system. The retainers were adhered to a lower jaw Frasaco model in two different positions. Resistance against the movement of one tooth was measured from two directions. The average load values within the FRC retainer groups were higher than within the metal retainer groups. The load values for the groups loaded from the axial direction were higher than those loaded from the buccal direction. FRC retainers, which were located 1–2 mm from the incisal edge, showed higher load values than those located 4–5 mm from the incisal edge. There was a significant difference in load values between FRC retainers and metal retainers (p < 0.01). The wire position and the direction of force also had significant effects (p < 0.01). There were no significant differences between metal retainer groups. The results of this study suggest that metal retainers are more flexible, allowing for tooth movements of larger magnitude than with FRC retainers.     

铸造桩核临床应用观察

目的：探讨铸造桩核修复残根残冠以保留患牙的方法临床应用中,哪种方式有效延长患牙修复寿命保留患牙,预防根折的发生。方法：选择132例患者209颗前牙进行完善的根管治疗后,进行铸造桩核临床修复残冠残根。结合临床表现以及X线片检查随访观察5年,根据牙根折断或松动发生率和患者满意度来评价不同桩核修复牙体缺失的临床治疗效果。结果：结合临床和X线检查发现铸造桩核有3颗修复体出现牙根折断松动脱落。结论：铸造桩核不易折断和松动,造成根折的发生率明显低,且美学效果好,患者满意度高,是成品根管桩钉的良好替代品。     

pH值对磁性固位体耐蚀性能的影响

目的　研究人工唾液的酸碱度在偏酸性的条件下,3种磁性固位体外包裹容器的耐腐蚀能力的改变。方法　将3种磁性固位体浸泡于人工唾液中,介质pH值分为5·6和7·0两组,实验温度36·5℃,时间6个月。采用恒电位法测定极化曲线实验、浸泡实验及扫描电镜方法,分析材料的耐腐蚀能力。结果　pH值下降,磁性固位体外包裹容器---不锈钢中铁离子的溶出量提高近10倍。表明在偏酸性的环境中,3种材料的腐蚀速度都加快。结论　磁性固位体的耐酸性能力相对较差,这将影响他们的使用寿命。     

对全冠修复体外弹性固位体的临床评价

目的对全冠修复体外的弹性卡环型冠外固位体进行临床评价。方法对全冠修复体上的弹性卡环，按主、客观各3项指标，与金属卡环相比较，并进行卡方检验。结果经2年多应用，弹性卡环与金属卡环的总体满意率分别为90．7％和74．65％，P〈0．01，提示二者间存在极显著的统计学差异。结论就全冠修复体上的卡环型固位体而言，弹性材料为目前的首选，与金属卡环相比，兼具美观、稳固、舒适、易于接受的特点。     

改良Hawley氏保持器的临床疗效观察

目的　介绍一种改良Hawley氏保持器 ,其结构简单并且可以有效地防止矫治后复发。 方法　对 12 8例固定矫治器正畸治疗结束后的病人 ,随机分为两组 ,分别使用改良Hawley氏保持器和传统Hawley保持器 ,并对保持效果进行 2年定期回访及临床疗效观察。结果　改良保持器能够促进带环遗留间隙闭合 ,防止双尖牙颊向移位以及拔牙间隙不易复发 ,并且患者佩戴舒适 ,固位力良好 ,保持效果稳定。结论　改良Hawley氏保持器是一种能较好地满足临床需要的保持器。