Twinblock及直丝弓固定正畸联合矫治安氏Ⅱ类错临床体会(1)
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[摘要] 目的 Twin block矫治器及直丝弓固定正畸联合矫治安氏Ⅱ类1分类错 形的效果。方法 选择11名10-13岁以下颌后缩为主的安氏Ⅱ类错畸形患者应用Twin block及直丝弓固定正畸联合矫治。男5名，女6名。每位患者治疗前拍摄头颅侧位片、曲面断层X线片。对Twin block及直丝弓固定正畸联合矫治前后头颅侧位X线片进行测量。结果 SNA、ANB、OJ、UI/SN减小，SNB、LI/MP、Sn-A'-UL、LL-B'-Pos增大，下颌升支、下颌体长及下颌综合长度均有增长，差异均有显著性。结论 Twin block矫治器治疗恒牙早期安氏Ⅱ类1分类错畸形，能明显减小前牙覆合、覆盖，增加上颌弓宽度，促进下颌生长，有效的改善患者下颌后缩的面型。联合固定正畸可达到良好的治疗效果。
[关键词] 安氏Ⅱ类1分类错； Twin block； 正畸治疗
[中图分类号] R783.5[文献标识码] B[文章编号] 1005-0515(2011)-07-012-01
Clinical Effects of Twin Block and Straight Wire Appliances in the Treatment of Angel's Class Ⅱ Malocclusion
[Abstract] Objective To investigate the treatment combined with twin block and straight wire appliances in angel's class Ⅱdivision 1patients. Methods Eleven angle's class Ⅱ patients aged 10-13.There were 5 boys and 6 girls. Lateral cephalograph, panoramic and left hand radiographs were taken for each patient before treatment. Measurement of cephalometrics before and after the treatment of twin block and straight wire appliances were carried out. Results The SNA,ANB ,OJ ,UI/SN decreased ,the SNB ,LI/MP,Sn-A'-UL,LL-B'-Pos increased , the mandibular ramus height, body length and mandibular length increased after the treatment. And the changes were significant. Conclusion After the treatment with twin block and straight wire appliances in angel's class Ⅱ division 1,the overjet, overbite improved，the maxillary arch breadth increased, the mandibular archwas stimulated to growth and profile of patients improved significantly. The effect of treatment combined with twin block and straight wire appliance was efficient.
[Keywords] Angle's classⅡdivision 1 malocclusion; Twin block; Orthodntics treatment
安氏Ⅱ类错是常见的错颌畸形，主要表现为磨牙远中关系、深覆盖、深覆合、下颌后缩等，它不仅发生率高，而且对患者的形态外貌和功能影响最为严重，其形成机制复杂，也是正畸治疗的难点之一。由于下颌后缩是安氏Ⅱ类错的主要特征，因此，纠正骨骼矢状不调，使面型外貌大大改善，是Ⅱ类错矫治的主要目标。我院门诊资料显示Ⅱ类错(48.6%)人数较多，Ⅰ类错(29.9%)，Ⅲ类错(21.5%)。形象的改善是寻求正畸的主要原因，正畸治疗可提高一个人的自信。
Twin block矫治器自20世纪80年代由Clark发明以来，已被广泛的应用[1]。患者戴用矫治器能较舒适地进食。Twin block功能矫治器巧妙地将咀嚼力变为有利于下颌向前生长的力量，用于生长期的安氏Ⅱ类患者，首先纠正上下颌骨关系不调，再在骨骼关系正常的基础上进行第二期的固定矫治，精细调整牙位，从而达到美观、功能最佳、面型协调的完美效果 。作为功能矫治器，Twin block的作用原理是利用生长发育潜力，加上咀嚼肌的力量产生颌骨生长改良的效果。笔者对11例处于恒牙早期的安氏Ⅱ类1分类错畸形患者应用Twin block及直丝弓固定正畸联合矫治，取得了一些临床体会，现介绍如下：
1 材料与方法
1.1 病例选择 年龄10-13岁 ......
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