应用MEAW技术治疗成人低角双颌前突病例
发布时间：2018-08-07 08:40
【摘要】：目的:采用MEAW(Multiloop Edgewise Arch Wire,多曲方丝弓)技术调整陡峭的后牙(?)平面,使倾斜的磨牙直立获得微小的间隙,来矫治成人低角双(?)前突错(?)畸形患者。材料及方法:选择大连医科大学附属第二医院口腔门诊正畸科矫治的一例成人低角双颌前突患者为病例,患者为27岁成年女性,曾于2015年有过短暂的非拔牙正畸治疗史,但矫治一年后上下颌前牙更为前突。2016年1月经过再次诊断分析,重新制定矫治方案,开始正畸治疗。患者的口腔卫生状态良好,牙周组织无明显异常,但患者自述易发生口腔溃疡,患者无口呼吸及咬下唇等不良习惯。患者左右两侧尖牙关系为II类关系,右侧磨牙关系为安氏II类关系(磨牙尖对尖,远中错(?)),左侧磨牙关系为安氏I类关系。下颌右侧尖牙与第一前磨牙之间有约1mm的间隙,上下颌牙列均无拥挤、具有陡峭的后牙(?)平面、有浅度Spee曲线。前牙覆盖程度较深为3.2mm、覆(?)程度为I度深覆(?),约为4.47mm。上下颌中线正,位于正中,上下颌前牙均唇倾,有轻微的开唇露齿,软组织侧貌为凸面型。该病例经过模型分析和X线头影测量分析后设计的治疗计划为:拔除上颌双侧第二前磨牙及下颌第三磨牙,粘接上颌4个前牙直丝托槽,其余牙齿使用方丝弓托槽,在上下颌牙列整平排齐后,使用MEAW弓丝加力使下颌磨牙直立,同时利用有效牵引使下颌前牙后移为上颌的拔牙间隙关闭打下基础。完成阶段上下颌均使用多曲方丝弓来调整咬合关系,改善覆(?)覆盖程度,以求得到良好的矫治结果。最后使用保持器保持牙齿稳定、美观的正畸治疗效果。同时进行治疗前后的模型及头颅侧位片对比分析。结果:预想设计的总治疗过程为20个月。治疗结束的时候期望的矫治效果如下:(一)唇倾的前牙回收接近直立,突出的侧貌改善为直面型,双唇凸度减小,鼻唇角增大,改善开唇露齿,可以自然闭唇,增加美观程度。磨牙直立后获得平坦的后牙(?)平面以及稳定咬合关系。上下颌牙列排齐整平,前牙覆盖和覆(?)在正常范围内,双侧磨牙关系为完全远中关系,尖牙达到中性关系,上颌拔牙间隙完全关闭,上下颌中线对正,位于正中。(二)治疗前后X线对比分析:1.对比治疗前后的曲面断层片可见,下颌前倾的磨牙直立,浅度的spee曲线改善,牙齿牙根基本平行,牙根未见明显吸收,牙槽骨、牙周、牙体组织健康。2.对比治疗前后的X线头影测量数据分析结果:1)ODI,APDI,CF数据对比基本没有变化。2)IIA角由102.51度增加到122.26度,U1-FH角由129.86度减小到120.22度,L1-MP角唇倾度105.45度减小到98.12度。3)POP为9.57度,数据明显变小。以上结果表明上下颌过度唇倾的前牙被回收,开唇露齿情况得到改善,软组织侧貌变为直面型。而下颌应用MEAW多曲弓丝调整后牙(?)平面使磨牙直立,同时压低下前牙,整平Spee曲线,取得了良好的下颌不拔牙矫治效果。结论:(1)对于成人低角双(?)前突错(?)畸形患者的矫正治疗,采用MEAW技术使倾斜的磨牙直立获得微小的间隙,有利于获得下颌前牙后移所需的间隙,回收前突的牙齿。进而使患者下颌采用非拔牙矫治的可能性提高。(2)用MEAW多曲方丝弓技术可以使陡峭的后牙(?)平面变成平坦的后(?)平面。可以更好的调整咬合关系达到更好的效果。
[Abstract]:Objective: to adjust the steep posterior teeth (?) plane by using MEAW (Multiloop Edgewise Arch Wire, multiple curved square arch) technique to make the tilted molar straight to a small gap to correct the deformity of adult low angle double (?) protrusion (?) malformation. Materials and methods: a case of orthodontic orthodontists in the Second Affiliated Hospital of Dalian Medical University, orthodontic orthodontists The patient with low angle dimaxillary protrusion was a case of 27 year old female, who had a history of transient non extraction orthodontic treatment in 2015, but after a year, the anterior and lower mandibular anterior teeth were rediagnosed and analyzed again in January.2016 years, and the orthodontic treatment began to be reformulated. The patient's oral hygiene was good and the periodontium had no obvious difference. Often, the patient is prone to oral ulcers, the patients have no mouth breathing and bad habit of biting the lower lip. The relationship between the left and right sides of the canine is II relationship, the right molar relationship is the II relationship of the ANS (apex to apex, far middle and wrong), the left molar is the I class relationship. There is a gap of about 1mm between the right canine and the first premolar. There is no crowding in the upper and lower jaw teeth, with a steep posterior teeth (?) plane with a shallow Spee curve. The front teeth are covered with a deeper level of 3.2mm, the overlying (?) degree is I degree overlying (?), about the middle and lower jaw line of the 4.47mm., in the middle of the upper and lower mandibular teeth, a slight open lip, and the soft tissue on the convex surface. The case is analyzed by model analysis and X-ray. The treatment plan after cephalometric analysis was designed to remove the maxillary bilateral second premolars and mandibular third molars, adhere to the maxillary 4 anterior teeth straight wire brackets, and the rest of the teeth using a square arch bracket. After the leveling of the upper and lower jaw teeth, the mandibular molar was upright with the MEAW bow force, and the mandibular anterior teeth were moved up with effective traction. The gap between the teeth of the jaw is closed. The multiple curved arch is used to adjust the occlusion relationship and improve the coverage of the overlay. In order to get good correction results. Finally, the retention device is used to keep the tooth stable and the orthodontic treatment effect. At the same time, the model and the lateral head of the head before and after the treatment are compared. Results: the total treatment process of the preconceived design is 20 months. The desired effect of treatment at the end of the treatment is as follows: (1) the reclaim of the lip of the anterior teeth is close to the upright, the prominent side looks to the straight face, the lips are reduced, the nose and lip are increased, the lip is improved, the lip is improved, the lip is naturally closed, and the beauty is increased. After the molar is upright, a flat posterior tooth (?) is obtained upright after the molar is erect. Plane and stable occlusal relationship. The upper and lower jaw teeth are leveled, the front teeth cover and overlay (?) in the normal range, the bilateral molar relationship is completely far and middle relation, the canine reaches the neutral relation, the maxillary extraction gap is completely closed, the upper and lower middle line is right in the middle. (two) the X-ray contrast analysis and analysis before and after treatment: 1. contrast the curved surface fault before and after treatment It was seen that the mandibular premolars were upright, the shallow spee curves improved, the root of the teeth were basically parallel, the root of the teeth were not obviously absorbed, the alveolar bone, the periodontium and the tissue health of the teeth were compared with the X-ray cephalometric data before and after the treatment of.2.: 1) ODI, APDI, and CF data were basically unchanged.2) IIA angle increased from 102.51 degrees to 122.26 degrees, U1-FH angle. From 129.86 degrees to 120.22 degrees, the L1-MP angle lip dropped from 105.45 degrees to 98.12.3), POP was 9.57 degrees, and the data was significantly smaller. The above results showed that the anterior teeth of the overlip overlips were recovered, the open lip teeth were improved and the soft tissue profile changed into a straight face. The mandible applied the MEAW multiple arch wire to adjust the posterior teeth to make the molar stand upright, At the same time, the lower anterior teeth were lowered and the Spee curve was leveled out. Conclusion: (1) for the correction treatment of the adult with low angle double (?) protrusion (?) malformation (?) malformation, the MEAW technique was used to make the tilted molars get vertical clearance, which was favorable for the clearance of the posterior mandibular teeth, and the recovery of the teeth of the protrusion. The possibility of the patient's mandible is improved by non extraction. (2) the MEAW multi curved wire technique can make the steep posterior teeth (?) plane into a flat back (?) plane. It can better adjust the occlusion relationship to achieve better results.
【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
，
本文编号：2169493
[Abstract]:Objective: to adjust the steep posterior teeth (?) plane by using MEAW (Multiloop Edgewise Arch Wire, multiple curved square arch) technique to make the tilted molar straight to a small gap to correct the deformity of adult low angle double (?) protrusion (?) malformation. Materials and methods: a case of orthodontic orthodontists in the Second Affiliated Hospital of Dalian Medical University, orthodontic orthodontists The patient with low angle dimaxillary protrusion was a case of 27 year old female, who had a history of transient non extraction orthodontic treatment in 2015, but after a year, the anterior and lower mandibular anterior teeth were rediagnosed and analyzed again in January.2016 years, and the orthodontic treatment began to be reformulated. The patient's oral hygiene was good and the periodontium had no obvious difference. Often, the patient is prone to oral ulcers, the patients have no mouth breathing and bad habit of biting the lower lip. The relationship between the left and right sides of the canine is II relationship, the right molar relationship is the II relationship of the ANS (apex to apex, far middle and wrong), the left molar is the I class relationship. There is a gap of about 1mm between the right canine and the first premolar. There is no crowding in the upper and lower jaw teeth, with a steep posterior teeth (?) plane with a shallow Spee curve. The front teeth are covered with a deeper level of 3.2mm, the overlying (?) degree is I degree overlying (?), about the middle and lower jaw line of the 4.47mm., in the middle of the upper and lower mandibular teeth, a slight open lip, and the soft tissue on the convex surface. The case is analyzed by model analysis and X-ray. The treatment plan after cephalometric analysis was designed to remove the maxillary bilateral second premolars and mandibular third molars, adhere to the maxillary 4 anterior teeth straight wire brackets, and the rest of the teeth using a square arch bracket. After the leveling of the upper and lower jaw teeth, the mandibular molar was upright with the MEAW bow force, and the mandibular anterior teeth were moved up with effective traction. The gap between the teeth of the jaw is closed. The multiple curved arch is used to adjust the occlusion relationship and improve the coverage of the overlay. In order to get good correction results. Finally, the retention device is used to keep the tooth stable and the orthodontic treatment effect. At the same time, the model and the lateral head of the head before and after the treatment are compared. Results: the total treatment process of the preconceived design is 20 months. The desired effect of treatment at the end of the treatment is as follows: (1) the reclaim of the lip of the anterior teeth is close to the upright, the prominent side looks to the straight face, the lips are reduced, the nose and lip are increased, the lip is improved, the lip is improved, the lip is naturally closed, and the beauty is increased. After the molar is upright, a flat posterior tooth (?) is obtained upright after the molar is erect. Plane and stable occlusal relationship. The upper and lower jaw teeth are leveled, the front teeth cover and overlay (?) in the normal range, the bilateral molar relationship is completely far and middle relation, the canine reaches the neutral relation, the maxillary extraction gap is completely closed, the upper and lower middle line is right in the middle. (two) the X-ray contrast analysis and analysis before and after treatment: 1. contrast the curved surface fault before and after treatment It was seen that the mandibular premolars were upright, the shallow spee curves improved, the root of the teeth were basically parallel, the root of the teeth were not obviously absorbed, the alveolar bone, the periodontium and the tissue health of the teeth were compared with the X-ray cephalometric data before and after the treatment of.2.: 1) ODI, APDI, and CF data were basically unchanged.2) IIA angle increased from 102.51 degrees to 122.26 degrees, U1-FH angle. From 129.86 degrees to 120.22 degrees, the L1-MP angle lip dropped from 105.45 degrees to 98.12.3), POP was 9.57 degrees, and the data was significantly smaller. The above results showed that the anterior teeth of the overlip overlips were recovered, the open lip teeth were improved and the soft tissue profile changed into a straight face. The mandible applied the MEAW multiple arch wire to adjust the posterior teeth to make the molar stand upright, At the same time, the lower anterior teeth were lowered and the Spee curve was leveled out. Conclusion: (1) for the correction treatment of the adult with low angle double (?) protrusion (?) malformation (?) malformation, the MEAW technique was used to make the tilted molars get vertical clearance, which was favorable for the clearance of the posterior mandibular teeth, and the recovery of the teeth of the protrusion. The possibility of the patient's mandible is improved by non extraction. (2) the MEAW multi curved wire technique can make the steep posterior teeth (?) plane into a flat back (?) plane. It can better adjust the occlusion relationship to achieve better results.
【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
，
本文编号：2169493
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