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正畸治疗后是否应该进行调[牙合]是一个颇具争议的问题,其主要原因之一是目前对正常[牙合]的标准尚未达成共识,因此,正畸后调[牙合]治疗的目标尚不明确。本文根据笔者的临床工作体会,阐述了正畸结束时进行调[牙合]治疗的必要性以及调[牙合]治疗的指征、时机和注意事项。     

Corticotomy facilitated orthodontics: Review of a technique

Corticotomy found to be effective in accelerating orthodontic treatment. The most important factors in the success of this technique is proper case selection and careful surgical and orthodontic treatment.Corticotomy facilitated orthodontics advocated for comprehensive fixed orthodontic appliances in conjunction with full thickness flaps and labial and lingual corticotomies around teeth to be moved. Bone graft should be applied directly over the bone cuts and the flap sutured in place. Tooth movement should be initiated two weeks after the surgery, and every two weeks thereafter by activation of the orthodontic appliance.Orthodontic treatment time with this technique will be reduced to one-third the time of conventional orthodontics. Alveolar augmentation of labial and lingual cortical plates were used in an effort to enhance and strengthen the periodontium, reasoning that the addition of bone to alveolar housing of the teeth, using modern bone grafting techniques, ensures root coverage as the dental arch expanded.Corticotomy facilitated orthodontics is promising procedure but only few cases were reported in the literature. Controlled clinical and histological studies are needed to understand the biology of tooth movement with this procedure, the effect on teeth and bone, post-retention stability, measuring the volume of mature bone formation, and determining the status of the periodontium and roots after treatment.     

A 100th anniversary: Sandstedt’s experiments on tissue changes during tooth movement

Abstract

In 2004, it is 100 years since the experiments by Carl Sandstedt on tissue changes during orthodontic tooth movement were published in an international journal, shortly after his early death.     

Pyogenic granuloma: a rare side complication from an orthodontic appliance

Abstract

This case report discusses a rare side effect associated with the use of a fixed quad helix orthodontic appliance. A 14-year-old healthy girl presented with a painful enlarging mass on her tongue, which was causing distress to both her and her parents. Investigations confirmed that the mass was a pyogenic granuloma and management involved surgical excision of the mass and removal of the quad helix appliance. At least once previous case associated with an orthodontic quad helix appliance has been reported in the literature.     

Molar Band Re-use and Decontamination: a survey of specialists

Abstract

Objective: To determine the pattern of use and re-use of orthodontic molar bands, and examine infection control measures in a sample of UK orthodontists.

Design: Questionnaire survey.

Subjects and methods: Questionnaires were sent to 204 individuals selected at random from the UK Specialist Orthodontist list. Follow-up questionnaires were sent to those that had not replied within 8 weeks. An overall response rate of 74.5% was achieved.

Main outcome measures: Orthodontic band use and re-use and cross-infection control.

Results: The reported rates of pre-sterilization cleaning and sterilization of orthodontic instruments were 92 and 100%, respectively. Of the respondents, 90% were using bands for molar teeth with the remainder routinely used bonded attachments. Most clinicians (95%) using bands routinely re-used them after being tried-in with 5% discarding them. Pre-sterilization cleaning of re-used molar bands was carried out by 92% of respondents who reclaimed bands. Sterilization of these bands was then carried out by most specialists apart from 2.

Conclusions: The majority of UK specialist orthodontists who responded to the questionnaire are adhering to universal precautions for cross-infection control and are carrying out approved decontamination procedures. The majority are also reusing orthodontic bands that have been tried in the mouth, but found to be the wrong size. The great diversity of reported procedures for decontamination of instruments and bands suggest that more research is required to provide guidelines into the most effective method.     

The occlusal effects of digit sucking habits amongst school children in Northamptonshire (UK)

Abstract

Objective: To compare the occlusal characteristics of persistent digit suckers with those of a group of individuals who reported never to have sucked their thumb or finger.

Setting: School children and regular attenders to four general dental practices in Kettering, UK.

Design: Cross‐sectional, observational.

Outcome measures: Prevalence of anterior open bite, posterior crossbite, size of overjet, overbite and buccal segment relationship.

Subjects and methods: The exposed group consisted of 7–13‐year‐old children with a persistent digit sucking habit or those who had given up the habit less than 2?years previously, compared with an unexposed group of children who had never reported a history of the habit. Upper and lower alginate impressions were taken and the resultant study models were used to measure occlusal differences between the two groups.

Results: Following exclusions, 39 digit suckers were compared to 36 non‐suckers. The odds of a reduced overbite being present were significantly higher in the digit sucking group compared to the non‐suckers (OR: 5·6, 95% CI: 1·6–20·8). The prevalence of anterior open bites was higher in the digit suckers (P<0·001). Although the overjet was slightly increased in the digit suckers compared with the non‐suckers (mean difference: 1?mm, P?=?0·036), this result needs to be interpreted with caution. No significant differences were seen in the presence of posterior crossbites or buccal segment relationships between the two groups.

Conclusions: This study has shown that reduced overbite and anterior open bites were significantly more prevalent in digit suckers. The orthodontic management of anterior open bites can involve complex and prolonged treatment. Early intervention to eliminate digit sucking habits is therefore recommended on both oral health and health economic grounds.     

An evaluation of CASES – an educational audit programme for orthodontists

A regional approach to a national clinical audit programme in orthodontics in the UK is described and evaluated. The programme was designed using the CRISIS criteria for effective continuing education. Programme participants completed duplicate questionnaires on 6 simulated patient scenarios, chosen for their relevance to everyday practice while posing important clinical dilemmas. The participation rate was 77% from hospital-based practitioners and 29% from specialist practitioners. Feedback to programme participants was given in the form of histograms, and provided a snapshot of national approaches to patient investigation, treatment and expected outcomes. A commentary on the data and references to appropriate articles in the literature were included. Evaluation of the programme by questionnaire survey showed that it was extensively used by hospital-based practitioners. It is concluded that the model used provided an effective and efficient framework for conducting clinical audit and delivering continuing education to the hospital-based group.     

谈口腔正畸学中的网络教育

从分析我国目前口腔正畸学的教育现状入手,结合网络教育的优势,阐述了网络教育在口腔正畸学教育领域的应用前景以及目前实现口腔正畸学网络教育所面临的一些问题.     

拔牙矫治对面部容貌的影响

目的:研究拔牙矫治对牙弓宽度及所带来的美学的影响。方法:选正畸临床非拔牙病例和拔除4颗第一双尖牙病例各64例,分别对其矫治前和矫治后模型下颌尖牙间和上颌尖牙间的牙弓宽度进行测量,测量点为尖牙牙根齿槽部之最突点,测量数据进行统计学分析。结果:矫治前两组病例的下颌及上颌牙弓宽度均无统计学差异(P>0.05)。矫治后,非拔牙组下颌宽度增加了0.68m(mP<0.05),上颌宽度增加了0.87m(mP<0.05);而拔牙组下颌宽度增加了2.49m(mP<0.001),上颌宽度增加了2.39mm(P<0.001)。矫治后,拔牙组比非拔牙组下颌宽度增加了1.51m(mP<0.001),上颌宽度增加了1.92m(mP<0.001)。结论:拔牙矫治比非拔牙矫治上下颌牙弓宽度不但未降低,反而有明显的增宽。拔牙矫治导致牙弓缩窄、从而影响美观的结论不成立。     

替硝唑含漱液治疗固定正畸中牙周组织炎症的疗效观察

目的观察替硝唑含漱液治疗固定正畸中牙周组织炎症的疗效。方法选取11～18岁青少年固定正畸患者100名，随机分成治疗组50例（使用替硝唑含漱液和常规口腔卫生保健措施）和对照组50例（常规口腔卫生保健措施），在放置固定矫治器前后分别以牙龈指数（GI）、菌斑指数（PLI）和龈沟出血指数（SBI）测定上下颌双侧前磨牙和第一磨牙的牙周情况，并进行统计学分析。结果固定正畸治疗前、后1周两组牙周临床指标GI、PLI和SBI值无明显差异；治疗1个月后治疗组牙周临床指标值无明显变化，对照组患者牙周临床指标值开始升高；3个月后对照组患者GI、PLI和SBI值分别达2．34±0．18、2．84±0．38和2．83±0．46，5个月后分别达到3．32±0．78、3．16±0．12和3．71±0．75，经统计学处理，与治疗组有显著性差异（P〈0．05）。结论替硝唑含漱液能有效降低固定正畸治疗中牙周组织炎症的发生率。