成人上颌扩弓后牙颌结构的变化

目的探讨上颌扩弓对成人牙颌结构的影响。方法成人上颌扩弓组11例和非上颌扩弓矫治组(对照组)17例。测量矫治前、主动矫治结束时及保持2年时双侧上颌第一磨牙交角、临床牙冠高度、上颌第一磨牙间宽距、上颌中切牙根尖点宽距、上颌宽距、下颌平面角以及前下面高。结果保持2年较矫治前扩弓组上颌第一磨牙交角减小7.50±10.21°,对照组减小0.64±5.06°;扩弓组第一前磨牙临床牙冠高度增加0.61±0.45 m m,对照组增加0.21±0.51 mm;扩弓组上颌第一磨牙间宽距增加7.30±0.56mm,上颌中切牙根尖点宽距增加0.91±0.28mm,上颌宽距增加2.75±0.35mm;对照组上颌第一磨牙间宽距增加0.32±0.21mm,上颌中切牙根尖点宽距减少0.25±0.18mm,上颌宽距增加0.89±0.25mm,两组相比5项指标均具有显著性差异。结论成人上颌扩弓可以有效扩大上颌牙弓及上颌宽距,不会导致明显的下颌后下旋转和牙龈退缩。     

掩饰性治疗对成人骨性Ⅱ类错患者上气道及周围结构影响的研究

目的研究拔牙与非拔牙矫正对成人骨性Ⅱ类错气道及周围结构的影响,并分析可能的原因。方法选择36例成人骨性Ⅱ类错正畸结束病例,拔牙组20例,非拔牙组16例。用正颌外科模拟预测系统(CASSOS)软件测量患者治疗前后X线头颅侧位片,并对数据进行配对t检验。结果拔牙组与非拔牙组的腭后气道(Phw1-psp)与舌后气道(Phw2-Tb)在正畸前后均无显著变化(P>0.05)。非拔牙组的前颌间距离(Ant.ln Mx.Ht)与颌间面积(ln Mx Area)有所增加,差异有统计学意义。结论成人骨性Ⅱ类错畸形的掩饰性治疗,不论是否减数,在下前牙不过分内收的情况下,气道在矢状向的变化并不显著。     

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。     

Bolton指数指导正畸的临床应用

正畸治疗的目标就是要达到口颌系统功能的平衡,以及实现牙齿、颅、面型的美观和理想的咬合。Bolton于20世纪提出前牙比和全牙比的概念,并被广泛采纳和接受,成为错畸形的诊断、设计和预测错畸形治疗的一个常规指标和重要方法。Bolton指数还受很多因素的影响,但其决定因素还有待研究。     

近中水平阻生下颌第三磨牙的矫治探索

目的探索保存和利用近中水平阻生下颌第三磨牙的矫治方法,以期保留更多的近中水平阻生的下颌第三磨牙。方法利用自行研制的磨牙胎面正轴装置及磨牙远中正轴装置,配合下颌固定矫治器,对近中水平阻生的下颌第三磨牙进行矫治。结果利用本研究方法对10例11颗近中水平阻生的下颌第三磨牙进行17．26个月矫治,均取得第三磨牙直立、稳定、覆胎覆盖关系正常的预期目标。结论利用磨牙殆面正轴装置及磨牙远中正轴装置,可快速、安全、高效地完成对近中水平阻生下颌第三磨牙的矫治。     

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目的    探讨大鼠实验性牙齿移动中不同正畸力对牙槽骨核因子κB受体活化因子配基（RANKL）表达的影响。方法    本研究于2010年9—12月在山西医科大学寄生虫实验室完成。选用健康雄性Wistar大鼠36只,随机分为对照组、轻力组、中力组、大力组（各9只）,分别施加0、0.29、0.49、0.98 N正畸力,建立大鼠牙齿移动模型。免疫组化法检测大鼠牙周组织压力侧RANKL的表达。结果    对照组RANKL有少量表达,主要分布于破骨细胞的胞核,正畸加力各组RANKL表达主要分布于压力侧牙周膜及骨改建区的破骨细胞,在基质细胞和牙周膜成纤维细胞也有表达,且其黄染程度强于对照组。各实验组牙周组织压力侧不同程度地出现血管被挤压、玻璃样变区和骨吸收陷窝。正畸力与RANKL的表达呈正相关（r = 0.834,P < 0.01）。结论    正畸力与大鼠牙槽骨压力侧RANKL的表达呈正相关,且0.49 N为促进RANKL表达的最佳力值。     

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口腔正畸学和牙周病学有着较广泛的联系。本文将从错牙合畸形对牙周组织的影响、牙周病患者在正畸治疗中的注意事项以及治疗后保持3个方面阐述正畸治疗与牙周病的关系,以期为牙周病患者的正畸治疗提供参考。     

Effects of orthodontic magnets on cutaneous epithelial thickness and tibial bone growth in rats

The use of permanent magnets in orthodontic treatment has increased significantly over the past years, triggered by the introduction of rare earth magnetic alloys. Concerns about possible side effects have been expressed relating to their use in orthodontic treatment. In previous experimental studies evidence of a reduction in bone formation and epithelial turnover close to rare earth magnets has been presented. The aim of the present study was twofold: to confirm earlier results and to study whether the observed changes are reversible. One hind leg in each of 45 rats was fitted with aluminum rings with Co₅Sm magnets, whereas the other hind leg was fitted with sham rings. After 8 weeks 25 rats were killed, and the rings in the remaining rats were removed. The latter group was killed after another 11 weeks. The epithelial and bone reactions were evaluated histomorphometrically. Previous results showing thinner epithelium and retarded rate of bone formation close to Co₅Sm magnets were confirmed. These effects were also shown to be largely reversible. It was concluded on the basis of this and the magnitude of the effects that any local side effects from orthodontic rare earth magnets appear negligible when extrapolated to the clinical situation.     

Orally Administered Liposomal Lactoferrin Inhibits Inflammation‐Related Bone Breakdown Without Interrupting Orthodontic Tooth Movement

Background: Bovine lactoferrin (bLF) modulates the production of tumor necrosis factor‐alpha (TNF‐α) and inhibits alveolar bone breakdown associated with periodontitis. This study is designed to examine the effects of orally administered liposomal bLF (LbLF) on orthodontic force (OF)‐induced alveolar bone remodeling during experimental tooth movement. Methods: Two groups of male Wistar rats were treated with either LbLF or control solution in drinking water 7 days before OF application. Lipopolysaccharide (LPS) was injected into the gingival sulcus in half the rats in each group. Thus, four groups: OF, OF+LbLF, OF+LPS, and OF+LPS+LbLF were established. Results: Orally administered LbLF significantly reduced apical migration of junctional epithelium in the OF and OF+LPS groups. In OF+LPS, osteoclast number in the alveolar crestal area was increased by LPS treatment, whereas osteoclast number was significantly reduced in OF+LPS+LbLF through suppression of TNF‐α production. Osteoclastic induction in the middle part, mainly from OF application, was not affected by LbLF administration. Inhibition of tooth movement was not induced by LbLF. Conclusions: Orally administered LbLF significantly inhibits LPS‐induced alveolar bone resorption but not OF‐induced bone remodeling. LbLF could be a potent therapeutic and preventive agent to control periodontal inflammation in patients undergoing orthodontic treatment.