本文關鍵詞：骨性Ⅱ類上頜前突下頜后縮手術邊緣病例的審美評價　出處：《重慶醫(yī)科大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 骨性II類 軟組織側貌 審美評價 代償性治療 頦成型 正畸正頜治療

【摘要】：目的:對成人骨性II類上頜前突下頜后縮手術邊緣病例進行審美評價,包括以下兩個方面:一、探索該類患者正畸代償治療中有利于側貌美學的切牙定位方式;二、分析該類患者不同治療方式(正畸代償治療、正畸結合頦成型、正畸正頜治療)的側貌美學。方法:選取一例成年女性骨性II類上頜前突下頜后縮手術邊緣病例作為研究對象,拍攝頭顱側位片和側貌照片。1.分別以Tweed、Andrews理論為指導對切牙位置進行不同方式定位,采用Photoshop軟件進行處理,得到12張側貌圖。選取專業(yè)和非專業(yè)人員對其評分,以探索骨性II類上頜前突下頜后縮患者正畸代償治療中有利于側貌美學的切牙定位方式。2.通過Photoshop軟件處理得到正畸結合頦成型、正畸正頜治療的效果側貌圖,同時選取實驗第一部分得分最高的圖片作為正畸代償治療的效果代表,總共得到6張側貌圖。選取專業(yè)和非專業(yè)人員對其評分,研究骨性II類上頜前突下頜后縮手術邊緣病例不同治療方式(正畸代償治療、正畸結合頦成型、正畸正頜治療)的側貌美學。結果1.正畸代償治療中,專業(yè)組非專業(yè)兩組均認為比較美觀的側貌為下切牙直立的3號圖片(90°)和輕度唇傾代償?shù)?號圖片(92.5°),以及上前牙FA點落于GALL線后方-2mm的4號圖片和-1mm的6號圖片,這4張圖片之間差異無統(tǒng)計學意義,與其余圖片比較差異有統(tǒng)計學意義(p0.05)。而下切牙過度唇傾代償?shù)?1號圖片(100°),以及上前牙fa點落于gall線前方+1mm的10號圖片和+2mm的12號圖片均被認為是不美觀的,與其余圖片比較差異有統(tǒng)計學意義(p0.05)。2.骨性ii類患者正畸代償治療結合頦成型術合適的頦凸度,專業(yè)組非專業(yè)兩組均認為比較美觀的頦部前移量為+4mm(圖片c),與其余圖片比較差異有統(tǒng)計學意義(p0.05)。而頦部前移接近下唇前緣過程中(圖片d、e)逐漸變得不美觀,與其余圖片比較差異有統(tǒng)計學意義(p0.05)。3.比較正畸代償治療和正畸正頜治療美學效果發(fā)現(xiàn),專業(yè)和非專業(yè)兩組均認為正畸正頜治療后側貌(圖片f)較正畸代償治療后側貌(圖片a)更為美觀,差異有統(tǒng)計學意義(p0.05)。4.正畸結合頦成型治療的美學評價結果顯示,正畸結合頦成型治療后側貌(圖片c)較單純正畸治療后側貌(圖片a)更為美觀(p0.05)。但與正畸正頜治療后側貌(圖片f)比較仍有差距(p0.05)。且專業(yè)組和非專業(yè)組都有相同的認識。結論:1.成人上頜前突下頜后縮的骨性ii患者正畸代償治療中,需要上下切牙相互代償,即上切牙需要在andrews理論認為的標準值基礎上進行內收舌傾代償,fa點落于gall線后方-1mm或-2mm。下切牙在tweed理論認為的標準值基礎上進行唇傾代償,但是下切牙只是輕度的唇傾代償處于于90°到95°之間,下切牙的過度唇傾代償有損側貌的美觀。2.“骨性II類患者頦成型應控制頦部前移不超過下唇緣”這一原則對于中國成年女性患者同樣適用,對骨性II類上頜前突下頜后縮患者行正畸結合頦成型治療術時,適當保留頦部相對靠后的狀態(tài),更有利于面部整體的協(xié)調。3.骨性II類手術邊緣患者,正畸正頜治療較正畸代償治療術后效果美觀,且專業(yè)組和非專業(yè)人員有共同的認識。4.正畸掩飾治療結合頦成型較單純正畸代償治療美觀方面有了顯著地提高,表明對于骨性II類患者,通過頦成型術可以達到改善面下1/3比例,視覺上削弱下頜后縮不調。但正畸結合頦成型效果跟正畸正頜治療效果比較仍有差距,頦成型只是一種掩飾手段,能夠在正畸代償治療的基礎上提高面部協(xié)調性,但美學效果不能與正畸正頜治療相媲美。
[Abstract]:Objective: to adult skeletal class II maxillary protrusion mandibular surgical margins were aesthetic evaluation, including the following two aspects: first, to explore a way to locate incisor profile aesthetic of the orthodontic treatment in two, compensation; analysis of different treatment methods of the patients (orthodontic treatment combined with orthodontic compensation, genioplasty orthodontic treatment), the profile of aesthetics. Methods: a case of female adult skeletal class II maxillary protrusion mandibular surgical margins were as the research object, cephalometric film and profile photo.1. respectively with Tweed, Andrews theory for different ways of positioning the position of the incisors were adopted to guide Photoshop software, a 12 profile map. Selection of professional and non professional personnel to score, to explore the skeletal class II maxillary protrusion patients with mandibular retrusion treated with orthodontic tooth cutting compensation positioning method for profile aesthetic.2. Get the orthodontic treatment with genioplasty by Photoshop software, the effect of profile diagram of orthodontic treatment, and selecting the first part of the experiment, the highest score of the picture as a representative of the orthodontic compensation treatment effect, a total of 6 pieces of profile map. Selection of professional and non professional personnel to score, study on skeletal class II mandibular maxillary protrusion after shrinking surgical margins of different treatment cases (orthodontic treatment combined with orthodontic compensation, genioplasty, orthodontic treatment) of the profile esthetics. Results 1. orthodontic treatment of compensatory non professional, professional group of two groups were considered more beautiful profile for lower incisors upright 3 pictures (90 degrees) and mild proclined the compensation of No. 5 pictures (92.5 degrees), and anterior teeth FA falls on GALL -2mm behind the line No. 4 No. 6 pictures and -1mm pictures, there was no significant difference between the 4 pictures, compared with the rest of the picture was significant (P0.05). The lower incisors proclined over compensatory 11 pictures (100 degrees), and anterior teeth FA falls on gall front +1mm 10 pictures and +2mm No. 12 pictures are considered unsightly, compared with the rest of the picture was statistically significant (P0.05).2. class II malocclusion orthodontic compensation treatment combined angioplasty right chin chin convexity, the professional group of two non professional groups that chin antedisplacement of the beauty of +4mm (photo C), compared with the rest of the picture was significant (P0.05). While the chin moved forward close to the front of the lower lip (D, e) gradually become unsightly, compared with the rest of the picture was significant (P0.05) found.3. orthodontic treatment and orthodontic treatment of compensatory aesthetic effect, professional and non professional two groups that orthodontic treatment of posterior appearance (Figure f) compared with the orthodontic treatment of posterior compensatory appearance (figure a) is more beautiful, the difference was statistically The significance of.4. (P0.05) combined with orthodontic treatment genioplasty aesthetic evaluation results show that the combined orthodontic treatment of posterior chin forming appearance (Figure C) than the pure orthodontic treatment of lateral Outlook (figure a) is more beautiful (P0.05). But the appearance and orthodontic treatment of posterior (image f) is still relatively poor distance (P0.05) and professional and non professional groups have the same understanding. Conclusion: orthodontic treatment of skeletal II compensatory 1. adult patients with maxillary protrusion mandibular retrusion in the upper and lower incisors to compensate for each other, namely the upper incisor needed in the Andrews theory that the standard value on the basis of the adduction of lingual inclination compensation, FA falls on gall behind the line of -1mm or -2mm. in the lower incisor tweed theory suggests that the standard value on the basis of the labial inclination of lower incisors compensation, but only slightly proclined in compensatory 90 degrees to 95 degrees between the excessive lip incisor inclination compensatory loss profile.2. skeletal class II patients should be genioplasty Control does not exceed the lower lip of the chin moved forward "this principle is also suitable for Chinese adult female patients of skeletal class II maxillary protrusion mandibular retrusion patients with orthodontic therapy combined with genioplasty, appropriate to retain the chin by the relative state, more conducive to the overall coordination of the.3. facial skeletal class II patients with surgical margins. Orthodontic treatment of orthodontic treatment of postoperative appearance of a compensatory effect, and professional and non professional personnel have a common understanding of orthodontic treatment combined with.4. mask genioplasty than simple orthodontic compensatory treatment appearance has been significantly increased, that for skeletal class II patients, through the mental molding operation can improve the proportion of under 1/3, vision on the weakening of mandibular retrusion. But not orthodontic treatment with genioplasty effect with orthodontic treatment effect is still a gap, genioplasty is just a disguise means can based on the treatment of orthodontic compensation It can improve facial coordination, but the aesthetic effect can not be compared with orthodontic orthodontic treatment.

【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R783.5

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