唇挡在改良摆型矫治器治疗牙列拥挤中应用(1)
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[摘要]目的：研究改良摆型矫治器与上唇挡联合治疗牙列拥挤的临床疗效。方法：选取应用上唇挡联合与不联合改良摆型矫治器治疗替牙晚期或恒牙初期重度牙列拥挤的患者24例，测量矫治前后的X线头颅侧位定位片并进行配对t检验以评估疗效。结果：唇挡结合改良矫治器主要是通过牙齿的移动和牙槽骨的改建，A点的前移，ss-OLP增加2.7mm。上磨牙远中移动3.3mm。结论：改良摆型矫治器可以有效推动磨牙远移，而联合应用唇挡可以促进上颌前部发育、改善患者侧貌外形。
[关键词]上唇挡；摆型矫治器；牙列拥挤；磨牙远移
[中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455(2012)01-0105-03
Research of treatment effects of upper lip bumper on improved reformed pendulum therapy crowed malocclusion in permanent dentition
MU Ming-kui,HOU Lu,YUAN Feng,CHEN Hai-lin,WANG Chuan-jun,LIU Xiao-xiao,ZHANG Yu
(Department of Othodontics,The Second Hospital Affiliate to Harbin Medical University,Harbin 150086,Heilongjiang,China)
Abstract: Objective To evaluate the treatment effects of upper lip bumper improved reformed pendulum therapy on crowed malocclusion in the beginning of permanent dentition. Methods 24 patients with crowed malocclusion in the beginning of permanent dentition were treated with reformed pendulum with or not with upper lip bumper,Cephalometric analysis was performed with pre-treatment and post-treatment cephalograms. Paired t-test conducted to assess the treatment effects. Results Teech moving and alveolar rebuilding is the main change after the treatment by upper lip bumper and reformed pendulum comparison of only use reformed pendulum.The improvement of overjet is achieved with foreward of A point,ss-OLP increase 2.7mm,and the upper molar was distalized by 3.3mm. Conclusion Upper molar was distalized in the beginning of permanent dentition can be obtained effectively by reformed pendulum.And joint upper lip bumper can improved maxillary anterior development,modify the patient side appearance.
Key words:upper lip bumper;pendulum appliance;crowed malocclusion;molar distalization
随着正畸矫治技术的逐步提高，人们对不拔牙矫治的方法逐步深入，在临床上对不拔牙矫治的要求逐渐增多。而摆式矫治器是目前临床上推磨牙向后常用而有效的矫治方法[1-2]。笔者设计了一种改良摆式矫治器治疗牙列拥挤伴，并通过结合应用唇挡来治疗上颌前部发育不足的患者，并研究颌面部硬组织的变化，现报道如下。
1 材料和方法
1.1 病例选择：选取近几年在我院正畸科治疗的替牙晚期及恒牙初期，上颌拥挤的错牙合畸形患者24例(男10例，女14例)为研究对象，年龄8～11岁，平均9.5岁。腕骨X线显示为生长发育高峰期或高峰前期。患者选择标准：①磨牙为远中关系；②软组织侧貌为直面型或凹面型；③上牙列拥挤度>6mm；④下颌角为低角或均角；⑤上颌第二恒磨牙未萌；⑥疗程控制在9个月。
1.2临床设计
1.2.1对照组：上腭为改良的摆型矫治器：在两上颌第一双尖牙上制带环，前腭部铺Nance托，Nance托里埋入两个管槽，将摆形弹簧曲一端插入管槽内，另一端插入两侧上颌第一恒磨牙腭内，每4周把摆式加力臂的弹簧延长0.5～1.0mm。待磨牙远移至中性偏近中关系时去除摆型矫治器 ......
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