成人骨性Ⅱ类正畸治疗后面部软硬组织的变化分析

发布时间：2018-12-06 07:01

【摘要】：目的：通过对成人骨性II类患者进行正畸矫治，，对比矫治前后评价软组织侧貌美学指标的变化及相关硬组织测量指标的变化情况，对骨性II类的成年患者正畸治疗后面部软硬组织的变化进行探讨。方法：选取沈阳市口腔医院2007年4月收治的成人骨性II类患者一例，女性，23岁，上颌右侧第一磨牙和左侧第二前磨牙因龋拔除，下牙弓拥挤53湥把郎罡惭篮螴°、深覆盖II°，下颌中线右偏23湥庋涝吨泄叵担也嗄パ莱试吨屑舛约夤叵怠；颊呃凑镏魉哐莱莶黄搿⒆焱梗敫纳泼嫘停虼送ü云浣辛俅部谀凇⑼饧癤线检查，结合头颅侧位片所测量数据和患者想改善面型的强烈愿望，制定拔除35和45的矫治方案，排齐整平牙列，利用种植体支抗，关闭拔牙间隙，最大程度回收前牙，调整磨牙咬合关系。矫治前后拍摄X线头颅侧位片。选取E线,33项软、硬组织测量指标及侧貌美学指标判断方程,对比矫治前后软、硬组织的变化情况。结果：矫治疗程28个月。治疗结束后患者前牙覆牙合覆盖关系正常，牙齿排列整齐，牙齿中线与面中线一致，居中对齐，双侧尖牙中性关系；双侧颞下颌关节检查未见异常，开口度及开口型正常，全口牙齿达尖窝相对咬合关系、无干扰。通过正畸治疗许多美学指标及其相关的硬组织测量指标发生了变化：（1）U1-SN、U1-NA、L1-MP、L1-NB均减小（2）MP-FH、MP-SN、Y轴角增加（3）UL-EP、LL-EP、鼻唇沟深度、颏唇沟深度、上唇位置、下唇位置、下唇凹点厚度均减小（4）鼻唇角、上唇倾角、下唇倾角、Z角、颏唇沟倾角、面凸角、颏唇角、软组织面角均增大。正畸治疗后软组织侧貌由凸趋于直，侧貌改善至美观，患者满意。结论：（1）正畸治疗可以使成人骨性II类患者侧貌明显改善。（2）成人患者正畸治疗后侧貌改善主要与上下前牙的位置相关；上下颌骨矢状向位置未发生变化。（3）成人骨性II类患者应用种植体支抗可以实现最大程度的内收前牙，改善面型。
[Abstract]:Objective: to evaluate the changes of soft tissue side appearance aesthetic indexes and related hard tissue indexes before and after orthodontic treatment in adult patients with bone II. To investigate the changes of soft and hard facial tissues after orthodontic treatment in adult patients with bone II. Methods: a female, aged 23, with right first molar of maxilla and left second premolar, was selected from adult bone II group admitted in Shenyang Stomatology Hospital in April, 2007. Lang Gang baskets with deep coverage of II 掳, right deviation of the central line of the mandible 23? Such as waterlogging and waterlogging? It is not easy to see if you are too busy. Er, to add up to the evil spirit of the river, and to make sure that you have 19 Yan stems? Bonaparte Lett stop? A day? Wun Yun? On the basis of the data measured by the lateral cephalic film and the patient's strong desire to improve the facial shape, he formulated a correction plan for removing 35 and 45 teeth, leveling the dentition, using implant Anchorage, and closing the extraction space. To maximize the recovery of the anterior teeth, adjust the molar occlusion relationship. Lateral radiographs were taken before and after orthodontic treatment. The E line, 33 items of soft and hard tissue and the judgment equation of side appearance aesthetic index were selected to compare the changes of soft and hard tissue before and after treatment. Results: the treatment course was 28 months. After the treatment, the overbite and overbite of the anterior teeth were normal, the teeth were arranged neatly, the midline of the teeth was consistent with the midline of the face, the center of the teeth was aligned, and the neutral relationship of the bilateral canine teeth was found. The bilateral temporomandibular joint was not abnormal, the degree of opening and the type of opening were normal, and the whole teeth had a relative occlusal relation to the apical fossa, and there was no interference. Through orthodontic treatment, many aesthetic indexes and their related hard tissue measurements have been changed: (1) U1-SNU1-NAA L1-MPL1-NB decreased (2) MP-FH,MP-SN,Y axis angle increased (3) UL-EP, The depth of LL-EP, nasolabial sulcus, the depth of genial-labial sulcus, the position of upper lip, the thickness of lower lip concave point were all decreased (4) nasal lip angle, upper lip inclination angle, lower lip inclination angle, Z angle, geniolabial groove inclination angle, face convex angle, chin lip angle. The soft tissue facial angle increased. After orthodontic treatment, the soft tissue profile changed from convex to straight and improved to beautiful. Conclusion: (1) Orthodontic treatment can significantly improve the lateral appearance of adult patients with bone II. (2) the improvement of posterior side appearance of adult patients with orthodontic treatment is mainly related to the position of upper and lower anterior teeth. The sagittal position of the upper and lower bones did not change. (3) Implant Anchorage could achieve maximum adductive anterior teeth and improve facial shape in adult patients with II.
【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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