骨性Ⅱ类上颌前突下颌后缩手术边缘病例的审美评价

发布时间：2018-01-02 06:34

本文关键词：骨性Ⅱ类上颌前突下颌后缩手术边缘病例的审美评价　出处：《重庆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:对成人骨性II类上颌前突下颌后缩手术边缘病例进行审美评价,包括以下两个方面:一、探索该类患者正畸代偿治疗中有利于侧貌美学的切牙定位方式;二、分析该类患者不同治疗方式(正畸代偿治疗、正畸结合颏成型、正畸正颌治疗)的侧貌美学。方法:选取一例成年女性骨性II类上颌前突下颌后缩手术边缘病例作为研究对象,拍摄头颅侧位片和侧貌照片。1.分别以Tweed、Andrews理论为指导对切牙位置进行不同方式定位,采用Photoshop软件进行处理,得到12张侧貌图。选取专业和非专业人员对其评分,以探索骨性II类上颌前突下颌后缩患者正畸代偿治疗中有利于侧貌美学的切牙定位方式。2.通过Photoshop软件处理得到正畸结合颏成型、正畸正颌治疗的效果侧貌图,同时选取实验第一部分得分最高的图片作为正畸代偿治疗的效果代表,总共得到6张侧貌图。选取专业和非专业人员对其评分,研究骨性II类上颌前突下颌后缩手术边缘病例不同治疗方式(正畸代偿治疗、正畸结合颏成型、正畸正颌治疗)的侧貌美学。结果1.正畸代偿治疗中,专业组非专业两组均认为比较美观的侧貌为下切牙直立的3号图片(90°)和轻度唇倾代偿的5号图片(92.5°),以及上前牙FA点落于GALL线后方-2mm的4号图片和-1mm的6号图片,这4张图片之间差异无统计学意义,与其余图片比较差异有统计学意义(p0.05)。而下切牙过度唇倾代偿的11号图片(100°),以及上前牙fa点落于gall线前方+1mm的10号图片和+2mm的12号图片均被认为是不美观的,与其余图片比较差异有统计学意义(p0.05)。2.骨性ii类患者正畸代偿治疗结合颏成型术合适的颏凸度,专业组非专业两组均认为比较美观的颏部前移量为+4mm(图片c),与其余图片比较差异有统计学意义(p0.05)。而颏部前移接近下唇前缘过程中(图片d、e)逐渐变得不美观,与其余图片比较差异有统计学意义(p0.05)。3.比较正畸代偿治疗和正畸正颌治疗美学效果发现,专业和非专业两组均认为正畸正颌治疗后侧貌(图片f)较正畸代偿治疗后侧貌(图片a)更为美观,差异有统计学意义(p0.05)。4.正畸结合颏成型治疗的美学评价结果显示,正畸结合颏成型治疗后侧貌(图片c)较单纯正畸治疗后侧貌(图片a)更为美观(p0.05)。但与正畸正颌治疗后侧貌(图片f)比较仍有差距(p0.05)。且专业组和非专业组都有相同的认识。结论:1.成人上颌前突下颌后缩的骨性ii患者正畸代偿治疗中,需要上下切牙相互代偿,即上切牙需要在andrews理论认为的标准值基础上进行内收舌倾代偿,fa点落于gall线后方-1mm或-2mm。下切牙在tweed理论认为的标准值基础上进行唇倾代偿,但是下切牙只是轻度的唇倾代偿处于于90°到95°之间,下切牙的过度唇倾代偿有损侧貌的美观。2.“骨性II类患者颏成型应控制颏部前移不超过下唇缘”这一原则对于中国成年女性患者同样适用,对骨性II类上颌前突下颌后缩患者行正畸结合颏成型治疗术时,适当保留颏部相对靠后的状态,更有利于面部整体的协调。3.骨性II类手术边缘患者,正畸正颌治疗较正畸代偿治疗术后效果美观,且专业组和非专业人员有共同的认识。4.正畸掩饰治疗结合颏成型较单纯正畸代偿治疗美观方面有了显著地提高,表明对于骨性II类患者,通过颏成型术可以达到改善面下1/3比例,视觉上削弱下颌后缩不调。但正畸结合颏成型效果跟正畸正颌治疗效果比较仍有差距,颏成型只是一种掩饰手段,能够在正畸代偿治疗的基础上提高面部协调性,但美学效果不能与正畸正颌治疗相媲美。
[Abstract]:Objective: to adult skeletal class II maxillary protrusion mandibular surgical margins were aesthetic evaluation, including the following two aspects: first, to explore a way to locate incisor profile aesthetic of the orthodontic treatment in two, compensation; analysis of different treatment methods of the patients (orthodontic treatment combined with orthodontic compensation, genioplasty orthodontic treatment), the profile of aesthetics. Methods: a case of female adult skeletal class II maxillary protrusion mandibular surgical margins were as the research object, cephalometric film and profile photo.1. respectively with Tweed, Andrews theory for different ways of positioning the position of the incisors were adopted to guide Photoshop software, a 12 profile map. Selection of professional and non professional personnel to score, to explore the skeletal class II maxillary protrusion patients with mandibular retrusion treated with orthodontic tooth cutting compensation positioning method for profile aesthetic.2. Get the orthodontic treatment with genioplasty by Photoshop software, the effect of profile diagram of orthodontic treatment, and selecting the first part of the experiment, the highest score of the picture as a representative of the orthodontic compensation treatment effect, a total of 6 pieces of profile map. Selection of professional and non professional personnel to score, study on skeletal class II mandibular maxillary protrusion after shrinking surgical margins of different treatment cases (orthodontic treatment combined with orthodontic compensation, genioplasty, orthodontic treatment) of the profile esthetics. Results 1. orthodontic treatment of compensatory non professional, professional group of two groups were considered more beautiful profile for lower incisors upright 3 pictures (90 degrees) and mild proclined the compensation of No. 5 pictures (92.5 degrees), and anterior teeth FA falls on GALL -2mm behind the line No. 4 No. 6 pictures and -1mm pictures, there was no significant difference between the 4 pictures, compared with the rest of the picture was significant (P0.05). The lower incisors proclined over compensatory 11 pictures (100 degrees), and anterior teeth FA falls on gall front +1mm 10 pictures and +2mm No. 12 pictures are considered unsightly, compared with the rest of the picture was statistically significant (P0.05).2. class II malocclusion orthodontic compensation treatment combined angioplasty right chin chin convexity, the professional group of two non professional groups that chin antedisplacement of the beauty of +4mm (photo C), compared with the rest of the picture was significant (P0.05). While the chin moved forward close to the front of the lower lip (D, e) gradually become unsightly, compared with the rest of the picture was significant (P0.05) found.3. orthodontic treatment and orthodontic treatment of compensatory aesthetic effect, professional and non professional two groups that orthodontic treatment of posterior appearance (Figure f) compared with the orthodontic treatment of posterior compensatory appearance (figure a) is more beautiful, the difference was statistically The significance of.4. (P0.05) combined with orthodontic treatment genioplasty aesthetic evaluation results show that the combined orthodontic treatment of posterior chin forming appearance (Figure C) than the pure orthodontic treatment of lateral Outlook (figure a) is more beautiful (P0.05). But the appearance and orthodontic treatment of posterior (image f) is still relatively poor distance (P0.05) and professional and non professional groups have the same understanding. Conclusion: orthodontic treatment of skeletal II compensatory 1. adult patients with maxillary protrusion mandibular retrusion in the upper and lower incisors to compensate for each other, namely the upper incisor needed in the Andrews theory that the standard value on the basis of the adduction of lingual inclination compensation, FA falls on gall behind the line of -1mm or -2mm. in the lower incisor tweed theory suggests that the standard value on the basis of the labial inclination of lower incisors compensation, but only slightly proclined in compensatory 90 degrees to 95 degrees between the excessive lip incisor inclination compensatory loss profile.2. skeletal class II patients should be genioplasty Control does not exceed the lower lip of the chin moved forward "this principle is also suitable for Chinese adult female patients of skeletal class II maxillary protrusion mandibular retrusion patients with orthodontic therapy combined with genioplasty, appropriate to retain the chin by the relative state, more conducive to the overall coordination of the.3. facial skeletal class II patients with surgical margins. Orthodontic treatment of orthodontic treatment of postoperative appearance of a compensatory effect, and professional and non professional personnel have a common understanding of orthodontic treatment combined with.4. mask genioplasty than simple orthodontic compensatory treatment appearance has been significantly increased, that for skeletal class II patients, through the mental molding operation can improve the proportion of under 1/3, vision on the weakening of mandibular retrusion. But not orthodontic treatment with genioplasty effect with orthodontic treatment effect is still a gap, genioplasty is just a disguise means can based on the treatment of orthodontic compensation It can improve facial coordination, but the aesthetic effect can not be compared with orthodontic orthodontic treatment.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R783.5

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