Tweed-Merrifield定向力矫治技术用于成人安氏Ⅲ~S类错（牙合）畸形的拔牙矫治

发布时间：2018-10-24 10:41

【摘要】：目的:通过对成人安氏IIIS类错牙合患者拔牙矫治并内收前牙，探讨Tweed-Merr-ifield定向力矫治技术疗效以及矫治结束后唇齿关系的变化,评价该技术对于唇部美观的影响。材料和方法:选取2012年3月大连奥索口腔来诊的成人患者一例，诊断为安氏IIIS类错牙合，女性，年龄22周岁，凸面型，左侧磨牙关系为中性,右侧磨牙关系为近中尖对尖，，前牙对刃，拥挤度分析上、下牙列均为中度拥挤，上颌中线左偏2mm。通过对患者矫治前的口腔检查、X线头颅侧位片和曲面断层片分析、模型分析，最终矫治方案为拔除15、24、34、44、18、28、38、48应用Tweed-Merrifield定向力矫治技术。在矫治前后一周内拍摄X线头颅侧位片，选取Tweed头影测量分析法中的测量项目以及与唇部相关的软组织测量项目，并进行矫治前后头影测量重叠分析，来评价治疗前后的变化。结果:矫治疗程21个月。该患者治疗前后分析比较:上、下颌牙齿排齐；上颌中线左偏得到纠正；前牙切对切关系得到矫正；右侧磨牙近中尖对尖关系得到矫正；上下颌咬合关系良好，达到正常的尖窝交错咬合关系。矫治后的全口曲面断层片显示该患者根尖未见明显吸收，牙根排列基本平行；牙周组织及牙槽骨未见异常；髁状突未见吸收，对称性良好。头颅侧位片显示下颌逆时针旋转，下颌平面角减小(FMA由30°减小为28°)，下切牙竖直(IMPA由95°减小为82°)，侧貌得到改善（Z ANGLE由66°增大为75°；下唇突点-H线的距离由3mm变化为0mm），患者获得美观和谐的唇部形态，患者对矫治结果比较满意。结论:拔牙矫治成人安氏IIIS类错牙合患者，应用Tweed-Merrifield定向力矫治技术内收前牙，在三维方向控制牙齿的精确移动，可以使唇齿关系得到改变,使患者唇部获得美观的效果。
[Abstract]:Objective: to investigate the effect of IIIS orthodontic technique and the relationship between lip and teeth after Tweed-Merr-ifield directional force correction in adult patients with IIIS malocclusion and to evaluate the effect of this technique on the beauty of lip. Materials and methods: a case of adult Oso oral malocclusion diagnosed as IIIS malocclusion, female, aged 22 years, with convex shape, was selected. The relationship between left molar and right molar was neutral, and the right molar was proximal cusp to cusp. According to the analysis of the edge of the anterior teeth and the degree of crowding, the lower dentition was moderately crowded and the maxillary midline was 2mm left. According to the oral examination before treatment, the analysis of lateral radiographs and curved surface tomograms of the patients, and the model analysis, the final treatment plan was to remove 15244C 34C, 4C4C, 288848, and to apply the Tweed-Merrifield directional force correction technique. The lateral radiographs of the head were taken within one week before and after orthodontic treatment. The measurement items in Tweed cephalometric analysis and the soft tissue measurement items related to the lips were selected, and the overlap analysis of cephalometric measurements before and after correction was carried out to evaluate the changes before and after treatment. Results: the course of treatment was 21 months. Before and after treatment, the patients were analyzed and compared: the upper and lower teeth were aligned; the left deviation of the maxillary midline was corrected; the anterior incisor was corrected; the right molar was corrected near the middle tip to the tip; the maxillary and mandibular occlusion was good. To reach the normal point fossa staggered occlusal relationship. The results showed that there was no apparent absorption at the root tip, the root arrangement was basically parallel, the periodontal tissue and alveolar bone were not abnormal, the condylar process was not absorbed, and the symmetry was good. Lateral cranial radiography showed that the mandible rotated counterclockwise, the mandibular plane angle decreased (FMA decreased from 30 掳to 28 掳), the lower incisor vertical (IMPA decreased from 95 掳to 82 掳), and the lateral appearance was improved from 66 掳to 75 掳. The distance between the point of the lower lip and H line changed from 3mm to 0mm. The patients obtained beautiful and harmonious lip shape. The patients were satisfied with the treatment results. Conclusion: extraction of teeth for adult patients with IIIS malocclusion can change the relationship between lips and teeth and make the lip of the patient obtain beautiful results. The technique of Tweed-Merrifield directional force is used to correct the anterior teeth and to control the accurate movement of the teeth in three dimensional direction.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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