成人骨性Ⅲ类错（牙合）术前正畸治疗
发布时间：2019-06-25 08:41
【摘要】：目的：探讨正畸正颌联合治疗成人骨性Ⅲ类错（牙合）的临床矫治效果。 方法：选取大连医科大学附属第二医院2009年11月收治的骨性Ⅲ类下颌前突患者一例，男性，27岁，恒牙（牙合），双侧磨牙、尖牙为完全近中关系，前牙反（牙合），，前牙覆盖-1mm，上颌中线正，下颌中线右偏约2mm，Spee曲线略深。正面观为均面，面部对称，无偏斜；侧貌为凹面型，面中1/3凹陷，上唇部正常，下颌前突。采用正畸与正颌的联合治疗，术前正畸上颌减数两个第一前磨牙，使用闭合曲内收上前牙，直立上前牙牙轴，下颌不拔牙，采用弓丝上打欧米茄曲去除牙代偿性舌倾；术后正畸使用三角形牵引来调整咬合关系，并对治疗前后的头颅侧位片及模型进行比较分析。 结果：矫治疗程共为35个月。对该病例治疗前后进行比较：（1）SNA,A-NaPerp.在治疗前后无变化，SNB从88°减小到83°，Po-NaPerp.值从14mm减小到9mm,ANB从-4°增大到1°，Wits值从-10mm增大到-2mm,使颌骨矢状关系由Ⅲ类变为Ⅰ类，且FMA减小2°，ANS-Me减小4mm，面轴角（Ba-N）-（Ptm-Gn）从3°减小到-1°,表明面下1／3的高度减小，下颌骨逆时针旋转。（2）上牙轴改善明显，U1-SN从116°减小到108°，U1-NA从32.5°减小到24°，U1-NA减小3mm，上切牙突距治疗后较治疗前减小了1.5mm;而L1-NB和U1-L1在治疗前后无明显变化，但IMPA从70°增加到79°，表明下中切牙长轴与眶耳平面的交角趋向合理，下中切牙的舌倾得到了显著的改善。(3)软组织的侧貌变化非常显著，矫治完成后测量结果发现由于软组织颏前点Pos后退，使Ｅ审美线顺时针后移，上唇突度，UL-EP略增加，鼻唇角从76°增大到83°，面凸角从6°增大到11°，而下唇突度，LL-EP减小，表明下唇后移，改善患者面貌的不协调，患者对治疗结果很满意。 结论：（1）对于骨性Ⅲ类错（牙合）的成人患者，单纯的正畸或外科治疗无法取得良好的治疗效果，而通过正颌外科的联合治疗，在功能和美观上都取得了较好的效果。（2）术前正畸是以正颌手术目标为基础的，只有充分去除牙代偿，使上下前牙直立于上下颌骨中合适的位置，才能在术后将颌骨再定位到理想位置。
[Abstract]:Objective: to explore orthodontic? Clinical effect of orthodontic combined treatment of adult osseous class III malocclusion (occlusal). Methods: a male, 27 years old, permanent teeth (occlusal), bilateral molars and fangs were selected from the second affiliated Hospital of Dalian Medical University in November 2009. the anterior teeth covered with-1mm, the maxillary midline was positive, and the right side of the middle mandibular line was about 2mm, and the Spee curve was slightly deeper than that of the anterior teeth (occlusal), the anterior teeth were covered with-1mm, the middle maxillary line was about 2mm, and the right side of the mandibular middle line was about 2mm, and the Spee curve was slightly deeper. The front view is homogeneous, the face is symmetrical, there is no deviation, the side appearance is concave, the middle face is 1 鈮
本文编号：2505551
[Abstract]:Objective: to explore orthodontic? Clinical effect of orthodontic combined treatment of adult osseous class III malocclusion (occlusal). Methods: a male, 27 years old, permanent teeth (occlusal), bilateral molars and fangs were selected from the second affiliated Hospital of Dalian Medical University in November 2009. the anterior teeth covered with-1mm, the maxillary midline was positive, and the right side of the middle mandibular line was about 2mm, and the Spee curve was slightly deeper than that of the anterior teeth (occlusal), the anterior teeth were covered with-1mm, the middle maxillary line was about 2mm, and the right side of the mandibular middle line was about 2mm, and the Spee curve was slightly deeper. The front view is homogeneous, the face is symmetrical, there is no deviation, the side appearance is concave, the middle face is 1 鈮
本文编号：2505551
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