成人双颌前突的拔牙矫治
发布时间：2018-12-21 09:03
【摘要】：目的:探讨应用自锁托槽、直丝弓矫治技术,采用舌弓、后牙组牙强支抗矫治双颌前突成人患者的治疗效果。方法:选取大连市博士口腔诊所2011年8月收治的双颌前突成人患者一例。女性,23岁,初诊时已于外院拔除四颗第一前磨牙。口腔一般检查:处于恒牙牙合期,轻度牙龈炎,两侧磨牙为开始安氏Ⅲ类关系,上颌中线位于正中,下颌中线左偏1mm,上下颌前牙的唇倾度较大;模型检查测量结果:Spee曲线曲度稍深,3.5mm,上下颌牙列拥挤度7.5mm、11.5mm,为中、重度拥挤,覆牙合、覆盖正常;软组织正、侧面观:为凸面型,唇部较突,唇颏部肌肉紧张,颏部稍显后缩;x线头影测量分析结果:SNA为78.5°,SNB为79.5°,数值均在正常值范围内,ANB为-1°,为轻度Ⅲ类骨面型;上牙轴U1-SN为120°,U1-NA为42°,下牙轴L1-MP为106.5°,下牙轴L1-NB为41.5°,均大于正常值范围,上下前牙唇倾度均较大;既往史:三年前接受非拔牙正畸治疗,否认口腔不良习惯。家族遗传史:父亲牙齿不齐。根据以上各项测量结果分析,决定采用自锁托槽、直丝弓矫治技术,拔除四颗第一前磨牙的拔牙模式,上颌后牙组牙支抗防止磨牙伸长及过度近中移动,下颌舌杆竖直磨牙并作为强支抗;滑动法关闭拔牙间隙,最后达到正常的覆颌覆盖及安氏Ⅰ类尖牙、磨牙关系。结果:矫治时间共29个月,治疗结束时可见上下颌牙列解除拥挤,排齐整平;上下颌中线居中对齐;覆牙合、覆盖正常;尖牙、磨牙均为安氏Ⅰ类关系。治疗前后X线头颅侧位片对比分析结果显示:矫治后的SNA减小了1°,SNB减小了1.5°,ANB增大了0.5°,患者上下颌基骨并未发生较大的变化,但轻度的数值变化仍使Ⅲ类骨性关系得到了改善。唇倾的上下前牙得到了较好的回收:U1-SN由120°到104°,减小了16°,U1-NA由42°到27°,减小了15°,L1-MP由106.5°到91°,减小了15.5°,下牙轴L1-NB由41.5°到25°,减小了16.5°。软组织突度也有较大改善。角度变化:鼻唇角NLA由91°到94°,增大3°;上唇倾角由62°到67°,增大了5°;下唇倾角由52°到59°,增大了7°;距离变化:上唇突度从7mm降低到4.5mm,减小了2.5mm,下唇突度由9.5mm降低到4.5mm,减小了5mm,以上数值反映上下唇突度均有明显减小;UL-EP由1mm到-2mm减小了3mm,LL-EP由5mm到0mm,减小了5mm,上下唇均达到审美线内,前突的唇部得到了回收;颏沟倾角(PosBs-FH)由105°到92°,减小了13°;Z角由66°到74°,增大了8°;H角由14°到9°,减小了5°;侧面角(G-Sn-Pos)由170°到173.5°,增大了3.5°,以上数据均向好的方向变化,且矫治后测量值均在正常值范围内,提示唇颏关系协调。结论:本病例应用自锁托槽、直丝弓矫治技术,采用拔除四个第一前磨牙的矫治方法,结合舌弓、后牙组牙强支抗矫治成人双颌前突,可以达到充分利用拔牙间隙回收前牙的目的,从而改善患者软组织侧貌,使之达到协调平衡的状态。
[Abstract]:Objective: to investigate the effect of using self-locking bracket and straight wire arch in the treatment of adult patients with bimaxillary protrusion by using tongue arch and posterior teeth with strong Anchorage. Methods: a case of adult patients with bimaxillary protrusion was selected from Dalian Doctor Stomatology Clinic in August 2011. Female, 23 years old, had four first premolars extracted from the external hospital at first visit. General oral examination: in permanent teeth, mild gingivitis, bilateral molars for the start of the class III relationship, the maxillary median line located in the middle, left side of the mandibular midline 1 mm, the upper and mandibular anterior teeth of a greater degree of labial inclination; The results of model examination were as follows: the curve of Spee curve was slightly deeper (3.5 mm), the crowding degree of upper and lower dentition was 7.5 mm and 11.5 mm, which was moderate and severe crowding, overbite and normal overbite. Soft tissue positive, lateral view: convex type, lip more protruding, lip chin muscle tension, chin slightly retraction; The results of X-ray cephalometric analysis showed that SNA was 78.5 掳and SNB was 79.5 掳. All the values were within the normal range. ANB was -1 掳, which was mild type 鈪，
本文编号：2388694
[Abstract]:Objective: to investigate the effect of using self-locking bracket and straight wire arch in the treatment of adult patients with bimaxillary protrusion by using tongue arch and posterior teeth with strong Anchorage. Methods: a case of adult patients with bimaxillary protrusion was selected from Dalian Doctor Stomatology Clinic in August 2011. Female, 23 years old, had four first premolars extracted from the external hospital at first visit. General oral examination: in permanent teeth, mild gingivitis, bilateral molars for the start of the class III relationship, the maxillary median line located in the middle, left side of the mandibular midline 1 mm, the upper and mandibular anterior teeth of a greater degree of labial inclination; The results of model examination were as follows: the curve of Spee curve was slightly deeper (3.5 mm), the crowding degree of upper and lower dentition was 7.5 mm and 11.5 mm, which was moderate and severe crowding, overbite and normal overbite. Soft tissue positive, lateral view: convex type, lip more protruding, lip chin muscle tension, chin slightly retraction; The results of X-ray cephalometric analysis showed that SNA was 78.5 掳and SNB was 79.5 掳. All the values were within the normal range. ANB was -1 掳, which was mild type 鈪，
本文编号：2388694
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