病例报告：PASS技术矫治牙列重度拥挤患者两例

发布时间：2018-04-26 11:41

本文选题：PASS技术 + 鄈平面　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:探讨应用PASS技术矫治两例牙列重度拥挤患者的临床效果病例与方法:选取2015年1月至2016年1月,于大连医科大学附属第一医院就诊患者两例,一例为女性,一例为男性。患者一,18岁女性,恒牙列,双侧磨牙关系为近中关系,且第一磨牙近中倾斜较严重,即生理支抗丧失明显。ANB=8.5,II类骨面型,下颌角示高角,牙列重度拥挤,前牙开(?),口腔卫生一般,上颌前、后牙(?)平面较平坦。患者二,16岁男性,恒牙列,双侧磨牙关系为近中关系,ANB=5,II类骨面型,下颌角示高角,牙列重度拥挤,前牙覆盖较大。上颌前牙(?)平面较平坦,因上颌第二磨牙萌出高度明显不足故可发现后牙(?)平面较陡峭。经过对该两例患者资料的系统分析和讨论得出治疗方案。两例患者治疗方案大致相同:一、首选正畸正颌联合治疗,二、正畸掩饰治疗。因两位患者及家属均拒绝手术治疗,故两位患者均选择正畸掩饰治疗。两位患者均拔除四颗第二前磨牙并且采用PASS矫治技术。通过对治疗中与治疗前头影测量数值分析、稳定结果重叠和草耙分析,对治疗效果进行讨论。结果分析:患者一自接诊至今,疗程共22个月,虽ANB未发生变化,即骨性问题并没有得到解决,但是效果依旧显著,U1-NA(mm)由4变为0,U1-NA(°)由28变为13,U1-SN(°)由110变为94说明上颌唇倾切牙回收效果明显,L1-NB(mm)由10变为9,L1-NB(°)由32变为29,说明下颌切牙略有轻微直立,Y轴角由72变为73,说明下颌骨略有轻微顺时针旋转。EL-UL值由3变为0,EL-LL值由6.5变为4,Z角(°)测量值由52变为55,说明患者面型改善。治疗前,前牙(?)平面为4°,较正常值10±3.58(°)偏小,治疗后变为19°,通过头影测量可发现切牙较正常值有一定舌倾,治疗前后牙(?)平面角度为13°,虽然在正常值范围14.9±3.85(°)之内,但发现该患者上下颌第一第二磨牙均有不同程度的生理支抗丧失,治疗后,后牙(?)平面角度为16°,在正常值范围之内,发现在矫治后牙(?)平面的同时,第一磨牙、第二磨牙发生后倾,有效改善磨牙轴倾度,从而减少生理支抗的丢失。患者二自接诊至今,疗程共9个月,同患者一,ANB并未发生变化,U1-NA(mm)测量值由8变为3,U1-NA(°)测量值由33变为20,U1-SN(°)测量值由114变为100说明上颌唇倾切牙得到回收且效果明显,L1-NB(mm)测量值由9变为8,L1-NB(°)测量值由38变为33,说明下颌切牙略有轻微直立,Y轴角由72变为70,说明下颌骨略有轻微逆时针旋转。虽然EL-UL值和EL-LL值均未发生改变,但Z角(°)测量值由55变为58,仍说明患者面型改善,由凸面型变成直面型。治疗前,前牙(?)平面为11°,于正常值范围之内,现阶段前牙(?)平面为12°,未发生明显改变,患者治疗前后牙(?)平面为24°,较为陡峭,治疗后后牙(?)平面角度为17°,较之前大为改善,上颌第二前磨牙、第一磨牙、第二磨牙均发生向前向下生长,第二磨牙较之前近中倾斜且生长量较大,有效改善之前较为陡峭的后牙(?)平面。通过重叠可见,在陡峭的后牙(?)平面发生改善的过程中,下颌骨也发生了较大幅度的向前向下的生长,由于后牙(?)平面较之前变得平坦,故下颌骨发生了逆时针旋转,患者治疗效果明显。结论:1.患者一:针对此成年女性患者,PASS技术解除开(?)、牙列拥挤拥挤迅速,改善凸面型,维持后牙(?)平面于正常范围2.患者二:针对此处于生长发育期男性患者,PASS技术解除拥挤迅速,改善后牙陡峭的(?)平面的同时使下颌骨发生逆时针旋转。
[Abstract]:Objective: To investigate the clinical effects and methods of two cases of severe crowding in dentition by using PASS technique: two cases were selected from January 2015 to January 2016 in the First Affiliated Hospital of Dalian Medical University, one was female, one was male. The one, 18 year old female, permanent tooth column, bilateral molar relationship were closely related, and the first molar was the first molar. The near middle tilt is more serious, that is, the loss of.ANB=8.5, II type of bone face, high angle of the mandibular angle, high angle of mandibular angle, severe crowding of the teeth, the anterior teeth open (?), the oral hygiene general, the maxillary front, and the posterior teeth (?) flat plane. The two, 16 year old male, the permanent dentition, and the bilateral teeth are closely related, the ANB=5, II type, the angle of the mandible, the high angle of the mandibular angle, and the severe crowding of the teeth. The front teeth were more flat. The maxillary front tooth (?) plane was flat. The posterior teeth (?) was more steep because of the obvious deficiency of the second molar eruption. After the systematic analysis and discussion of the data of the two cases, the treatment scheme was obtained. Two patients were treated roughly the same as the orthodontic orthodontic combined treatment, two, orthodontic mask. Treatment. Two patients and their families refused surgical treatment, so two patients all chose orthodontic mask treatment. Two patients all removed four second premolars and adopted the PASS correction technique. Through the numerical analysis of the treatment and treatment before the treatment, the stability results overlap and the hay rake analysis, the results were discussed. The course of treatment was 22 months. Although ANB did not change, the bone problem was not solved, but the effect was still significant, U1-NA (mm) changed from 4 to 0, U1-NA (degree) changed from 28 to 13, U1-SN (degree) changed from 110 to 94, and L1-NB (mm) changed from 10 to 9, L1-NB (degree) changed from 32 to 29, indicating mandibular cutting. The teeth were slightly erect, and the Y axis angle changed from 72 to 73, indicating that the.EL-UL value of the mandible slightly clockwise rotation was changed from 3 to 0, EL-LL value changed from 6.5 to 4, Z angle (degree) changed from 52 to 55, indicating that the patient's face shape was improved. Before treatment, the front tooth (?) plane was 4 degrees, compared with the normal value 10 + 3.58 (degree), after treatment, it became 19 degree, through cephalometric measurement can be found tangent. The tooth (?) tooth (?) plane angle was 13 degrees before and after treatment. Although it was within the normal range of 14.9 + 3.85 (degree), it was found that the first second molar of the patient had different degree of physiological support loss. After treatment, the plane angle of the posterior teeth (?) was 16 degrees, within the normal range, it was found in the same plane of the posterior teeth. At the time of the first molar and the second molar, the inclination of the molar was effectively improved and the loss of the physiological support was reduced. The course of treatment was 9 months for the patient for a total of 9 months. The U1-NA (mm) measurement value changed from 8 to 3, the measurement value of U1-NA (degree) changed from 33 to 20, and the measurement value of U1-SN (degree) changed from 114 to 100 to explain the upper lip tilting. The L1-NB (mm) measured value changed from 9 to 8, and the measurement value of L1-NB (degree) changed from 38 to 33, indicating that the mandibular incisors were slightly erect and the Y axis angle changed from 72 to 70, indicating that the mandible was slightly reverse clockwise rotation. Although the EL-UL value and EL-LL value were not changed, the measurement value of Z angle (degree) changed from 55 to 58, which still indicated the improvement of the patient's face shape. Before treatment, the front tooth (?) plane was 11 degrees before the treatment. The front tooth (?) plane was 12 degrees at the present stage. The front tooth (?) plane was 24 degree, the angle of the posterior teeth (?) was 17 degrees before and after treatment, and the maxillary second premolar, the first molar and second molar. The second molars are inclined and grow larger than before, and the more steep posterior teeth (?) planes are effectively improved. In the process of improvement of the steep posterior teeth (?), the mandible also grows larger and downward, as the posterior (?) plane becomes flat. Therefore, the mandible was reversed clockwise rotation, and the treatment effect of the patients was obvious. Conclusion: 1. patients one: for this adult female patient, PASS technology is lifted (?), the teeth are crowded and crowded quickly, the convex surface is improved, the posterior teeth (?) in the normal range of 2. patients is two: the needle is in the growth stage male patients, the PASS technique is relieved quickly, To improve the posterior plane of the posterior teeth, the mandible is rotated counterclockwise.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.5

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