改良Pendulum摆型矫治器在牙性安氏Ⅱ类错（牙合）中远移上颌磨牙对牙齿和骨骼影响的研究
发布时间：2018-12-28 19:10
【摘要】：思路随着人类的进化和人们饮食习惯的变化,颌骨发育不断退化,而牙齿退化并不明显,从而颌骨的大小不能够顺利容纳所有的牙齿,错牙合畸形的发病率就越来越更加普遍,以及人们对口腔牙齿美容和牙齿健康功能需求的不断提升,越来越多的人选择牙齿矫正。拔牙矫正技术和非拔牙矫正技术一直是口腔正畸界研究和争论的焦点,尤其是许多牙性拥挤的边缘性病例,越来越多的学者倾向于选择非拔牙矫正技术,他们研究如何增加骨量开拓牙弓中的间隙,其中推磨牙向远中是最多的增加骨量的方法之一。传统的推上颌磨牙向远中移动技术对患者合作的依赖程度较大,或者在制作及操作上较为麻烦,且效果不够稳定,1992年Hilgers发明了经典的Pendulum摆型矫治器,本研究旨在经典的Pendulum摆型矫治器的基础上加以改良,通过头颅定位侧位片描点、测量常见的骨性及牙性指标的变化,研究改良Pendulum摆型矫治器最佳适应症的选择,以及临床操作中值得注意的一些操作事项,更好地应用于临床。 目的口腔正畸临床上由于患者上颌乳磨牙早失、上颌乳牙先天缺失等原因导致上颌磨牙萌出后向近中移位的安氏Ⅱ类错牙合,上颌前部牙列拥挤、前突等需要开拓牙弓中间隙,而上颌骨发育尚可,可以通过增加骨量,尤其通过推上颌磨牙向远中移位,并同时能够矫正磨牙的Ⅱ类错牙合关系。本研究对经典的Pendulum摆型矫治器加以改良,在牙性安氏Ⅱ类错牙合中远中移动上颌磨牙对牙槽和骨骼结构的影响,以研究其作用机制并更好地应用于口腔正畸临床。 方法选择安徽省口腔医院正畸科临床中年轻恒牙牙合牙性安氏Ⅱ类错牙合21例,其中男9例,女12例,年龄10.6-14.5岁,平均12.8岁。使用改良Pendulum摆型矫治器远中移动上颌磨牙3.2-5.7个月,平均4.38个月。改良Pendulum摆型矫治器远中移动上颌磨牙前和后拍摄X线头颅定位侧位片,使用硫酸纸重叠描点、测量,对于前后牙性及骨性指标的变化采用配对T检验进行分析。 结果X线头颅定位侧位片上显示每侧后牙区牙弓中平均开出7.31m m的间隙,其中双侧上颌第一磨牙后移占开出间隙的64.8%,牙冠向后倾斜平均增加为18.640,平均每月向后移动为1.27mm。上颌第一磨牙平均压低0.69mm,上颌前磨牙平均伸长1.02mm,面下垂直距离平均增加2.19mm。上颌中切牙唇倾平均增加3.39°和切端唇展平均增加1.13mm。 结论改良Pendulum摆型矫治器是一种能够快速有效的远中移动上颌磨牙的装置,能够快速矫正磨牙安氏Ⅱ类错牙合关系,同时能够开拓牙弓中所需要的间隙,以能够解除牙弓中的拥挤以及能够内收前牙所需要的间隙,并且能够改善患者的面型。但是,在口腔正畸临床中我们需要注意的是,改良Pendulum摆型矫治器在推上颌磨牙向远中移动的同时也可以导致上颌第一磨牙向远中倾斜移动、切牙唇向倾斜移动、以及面下1/3高度的增加,下颌骨轻微的顺时针旋转。
[Abstract]:With the evolution of human and the change of people's eating habits, the development of the jaw is deteriorating, and the degeneration of the teeth is not obvious, so that the size of the jaw is not able to accommodate all the teeth smoothly, and the incidence of the malocclusion is more and more common. as well as the increasing demand for oral and dental care and dental health, more and more people choose to correct their teeth. The technique of tooth extraction and the technique of non-extraction of tooth extraction have been the focus of the study and debate of the oral orthodontics, especially the borderline cases of many dental crowding, and more and more scholars tend to choose non-tooth extraction and correction techniques, and they study how to increase the amount of bone to develop the gap in the dental arch. in which the molar is one of the most effective ways to increase the amount of bone in the distal direction. The traditional push-to-maxillary molar is more dependent on the patient's cooperation, or is more troublesome in the manufacture and operation, and the effect is not stable. In 1992, Hilgers invented the classical Pendulum-type appliance, which is aimed at the improvement of the classical Pendulum-type appliance. The choice of the best indication for the modified Pendulum pendulum appliance and some of the operational matters to be noted in clinical operation can be better applied to the clinical application. Objective To study the clinical effect of oral orthodontics, such as the early loss of the maxillary first molars, the congenital absence of the maxillary deciduous teeth, and the other causes, such as the second malocclusion of the maxillary molars, the crowding of the anterior teeth of the maxillary anterior teeth, the anterior process and the like, and the need to develop the gap in the dental arch, while the development of the maxilla can, by increasing the amount of bone, especially by pushing the maxillary first molar in the distal direction, and at the same time be able to correct the type II, wrong-tooth closing of the molar, This study is to improve the classical Pendulum-type appliance, and to move the effect of the maxillary molar on the tooth and bone structure in the tooth-and-tooth type 鈪，
本文编号：2394315
[Abstract]:With the evolution of human and the change of people's eating habits, the development of the jaw is deteriorating, and the degeneration of the teeth is not obvious, so that the size of the jaw is not able to accommodate all the teeth smoothly, and the incidence of the malocclusion is more and more common. as well as the increasing demand for oral and dental care and dental health, more and more people choose to correct their teeth. The technique of tooth extraction and the technique of non-extraction of tooth extraction have been the focus of the study and debate of the oral orthodontics, especially the borderline cases of many dental crowding, and more and more scholars tend to choose non-tooth extraction and correction techniques, and they study how to increase the amount of bone to develop the gap in the dental arch. in which the molar is one of the most effective ways to increase the amount of bone in the distal direction. The traditional push-to-maxillary molar is more dependent on the patient's cooperation, or is more troublesome in the manufacture and operation, and the effect is not stable. In 1992, Hilgers invented the classical Pendulum-type appliance, which is aimed at the improvement of the classical Pendulum-type appliance. The choice of the best indication for the modified Pendulum pendulum appliance and some of the operational matters to be noted in clinical operation can be better applied to the clinical application. Objective To study the clinical effect of oral orthodontics, such as the early loss of the maxillary first molars, the congenital absence of the maxillary deciduous teeth, and the other causes, such as the second malocclusion of the maxillary molars, the crowding of the anterior teeth of the maxillary anterior teeth, the anterior process and the like, and the need to develop the gap in the dental arch, while the development of the maxilla can, by increasing the amount of bone, especially by pushing the maxillary first molar in the distal direction, and at the same time be able to correct the type II, wrong-tooth closing of the molar, This study is to improve the classical Pendulum-type appliance, and to move the effect of the maxillary molar on the tooth and bone structure in the tooth-and-tooth type 鈪，
本文编号：2394315
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