磨牙竖直模型在口腔正畸学实验教学中的应用

目的:通过磨牙竖直模型在口腔医学本科教学中的应用,探索改革口腔正畸学有关固定矫治技术的实验教学方法。方法:在皖南医学院2009级口腔医学专业学生中随机选择两个小班(各30人)分别设为实验组和对照组。实验组进行磨牙竖直实验,对照组进行常规固定矫治器的实验。对托槽的粘贴、矫治弓丝的弯制和作用及运用、牙齿移动及移动类型、支抗的认识、辅助正畸的了解以及学习兴趣等几方面进行了问卷调查并进行统计学分析。结果:实验组在对矫治弓丝作用及运用、支抗的理解、牙齿移动及移动类型以及对辅助性正畸的认识与对照组的差别有统计学意义,在托槽的粘贴、弓丝的弯制以及对正畸学的学习兴趣方面的差别没有统计学意义。结论:口腔正畸学固定矫治技术的实验教学中运用磨牙竖直模型训练学生能够更好地让学生理解和掌握支抗、矫治弓丝的运用、牙齿的移动、牙齿移动的种类以及辅助性正畸治疗。     

Bone regeneration after surgical repositioning of impacted mandibular second molars: a case report

Abstract  – A case is presented where the mesially impacted mandibular second molar teeth were surgically uprighted in an 11-year-old female patient. Bone regeneration is shown in the areas occupied by the impacted second molars with maturation of bone and cortication of the crest of the alveolar bone. The probing depths are also normal with no residual bony defects. This healing was achieved with no bone grafting procedure, emphasizing two important factors: to prevent/minimize any trauma to the tissues at the site of elevation and uprighting of the tooth (i.e. maintaining viable periodontal ligament cells and minimal cementum damage); and to obtain primary closure whilst allowing the tissue in the mesial defect to reorganize against the scaffold of bone. However, the procedure on the one side was complicated with necrosis and infection of the pulp space with external inflammatory root resorption. Endodontic therapy of this tooth proved to be successful with periradicular healing radiographically and re-establishment of the lamina dura. At the 3-year follow-up, the endodontically treated tooth showed no clinical and radiographic signs of pathology. The left second mandibular molar had no pulpal or periodontal postsurgical complications, which may be attributed to apparently more open apices allowing for pulp revascularization after manipulation at the time of surgery. This report illustrates unassisted wound healing that occurs in the area of uprighting with complete reconstitution of periodontal anatomy without additional regenerative procedures to augment bone.     

磨牙后区微种植体支抗竖直下颌近中阻生第二磨牙的临床应用

目的探讨磨牙后区微种植体应用于下颌近中阻生第二磨牙竖直的正畸治疗方法,评估其效果。方法选择南京医科大学附属口腔医院正畸科2011—2014年门诊下颌第二磨牙近中阻生的患者13例23颗患牙,采用磨牙后区植入微种植体,牵引23颗患牙向远中移动,引导其竖直、萌出。结果 23颗阻生的下颌第二磨牙全部竖直萌出并建立良好的咬合。竖直治疗平均时间为6.5个月。结论磨牙后区微种植体支抗能简单有效地竖直下颌阻生的第二磨牙,并且可以控制磨牙的垂直向高度,避免对相邻牙齿产生不良影响。     

Autotransplantation and surgical uprighting of impacted or retained teeth: A retrospective clinical study and evaluation of patient satisfaction

Abstract

Objectives. This retrospective clinical study aimed to determine the success rate of autotransplanted impacted or retained teeth along with a patient satisfaction survey and to analyze the influence of relevant clinical and radiographic parameters. Subjects and methods. Fifty-seven teeth (37 canines, 10 molars, seven premolars, three incisors) in 45 patients (median 15 years) were evaluated over a mean of 1.6 years. The success criteria were pocket probing depth ≤3.5 mm, mobility grade ≤ II, Periotest ≤30 and complete alveolar bone healing. The influencing parameters were oral hygiene, smoking, periodontal screening index, occlusal/proximal contacts, horizontal position, dental age, pulp obliteration and degree of displacement. Furthermore, bone height was measured. Results. The overall success rate was 74%, along with a high patient satisfaction. The survival rate was 96% after a mean follow-up of 1.6 years. The favorable factors were proper oral hygiene, non-smoking, good general periodontal condition, proximal contacts and pulp obliteration. An increase in or maintenance of bone level was found in 96%. Conclusions. Autotransplantation of impacted or retained teeth is an appropriate treatment, if orthodontic alignment has failed, especially in growing patients.     

改良舌弓矫治下颌第二磨牙近中倾斜的临床应用

目的 评价改良舌弓矫治下颌近中倾斜第二磨牙的疗效。 方法 选择5例下颌第二磨牙近中倾斜病例,采用改良舌弓远中牵引、直立近中倾斜的第二磨牙,观察其临床效果,通过曲面断层片测量评价其疗效。 结果 5例近中倾斜磨牙均远中直立,建立了良好咬合关系,平均疗程5个月。 结论 改良舌弓能有效直立近中倾斜的第二磨牙。     

微种植体支抗对下颌第二磨牙严重近中倾斜阻生正畸治疗1例报告及文献复习

观察采用微种植体支抗对下颌第二磨牙严重近中倾斜阻生患者的正畸治疗效果,为临床正畸医生治疗该类患者提供临床依据。     

正畸治疗中磨牙的拔除和保留(四)——高频电刀在低位阻生磨牙导萌术中的应用

目的：总结高频电刀在正畸导萌低位阻生磨牙开窗术中的应用。方法：在正畸导萌埋伏磨牙的开窗术中对比应用高频电刀切除阻生磨牙殆面软组织及应用常规手术刀切开阻生磨牙牙龈并翻瓣后粘接正畸附件,以牵引竖直磨牙的临床效果。结果：应用高频电刀切除阻生磨牙殆面软组织的方法能简便手术操作,有利于正畸附件的粘接,减少了术后并发症的发生。结论：在正畸导萌埋伏磨牙的开窗术中应用高频电刀切除磨牙殆面软组织是临床上值得推广的方法。     

片段弓联合微种植体支抗直立倾斜磨牙

目的 评价用片段弓联合微种植体支抗直立倾斜磨牙临床效果.方法 选择24例（28颗）邻牙缺失磨牙近中倾斜的患者,使用片段弓联合微种植体支抗直立倾斜磨牙,通过模型测量评价疗效.结果 治疗后第一磨牙磨牙水平移位（1.92±0.98） mm,近中倾斜角减小（20.67±5.14）°;第二磨牙水平移位（2.60± 1.09） mm,近中倾斜角减小（25.36±6.57）°,均有明显的竖直效果.结论 片段弓联合微种植体支抗直立倾斜磨牙是一种简便、舒适、有效的方法.     

2种竖直下颌前倾第二磨牙方法的比较研究

目的 介绍2种竖直下颌前倾第二磨牙的正畸方法,评价其临床疗效的差别。方法 选择12例下颌第二磨牙前倾阻生的安氏Ⅰ类错牙合患者,共16颗前倾阻生的下颌第二磨牙。按照随机化原则分成2组,每组8颗磨牙。A组采用下颌第一磨牙带环焊支架的方法,通过橡皮链连接支架与下颌第二磨牙牙合面上粘结的舌侧扣,控制力值在2.5～3.0 N,拉第二磨牙向远中直至完全竖直;B组采用下颌第一磨牙带环焊双曲或三曲推簧的方法,将推簧放置于下颌第二磨牙牙合面粘结的舌侧扣的近中,推第二磨牙向远中直至完全竖直,力值与A组相同。对2种方法矫治时间的差别及矫治结束后第二磨牙近中牙槽嵴的改建情况进行比较分析。 结果 A组8颗前倾阻生的下颌第二磨牙完全直立所需的矫治时间为4.5～8.4个月,平均6.3个月,B组为6.5～11.5个月,平均8.5个月,2组数据比较P<0.01,有统计学意义;A组下颌第二磨牙完全直立后近中牙槽嵴高度增加的平均值为4.8 mm,B组为5.0 mm,2组比较P＞0.5。 结论 2种矫治方法都成功地竖直了前倾阻生的下颌第二磨牙,并且使第二磨牙的近中牙槽嵴高度增加,A组的方法矫治时间更短。