本文選題：牙列擁擠　切入點：拔牙矯治　出處：《大連醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：探討應用拔牙矯治對安性I類伴牙列擁擠患者的臨床矯治效果和思考。 方法：選取大連博士口腔門診2010年收治的青少年患者一例，女性，11歲，生長發(fā)育期，骨性I類，均角，安氏I類，牙列擁擠，上頜擁擠度4.3mm，屬于中度擁擠。下頜擁擠度（包括整平Spee曲線以及下切牙唇傾）為8.0mm，屬于中度擁擠，前牙覆蓋為3.7mm，屬于I度深覆蓋，覆牙合為下前牙切緣咬在上切牙舌面超過切1/2,不足2/3，屬于Ⅱ度深覆牙合。上頜第二磨牙未萌出。下切牙牙軸舌傾，IMPA為80度。雙側尖牙，磨牙關系均為中性關系。上下頜中線對正，下頜Spee曲線左右兩側均為1.5mm。本病例根據(jù)檢查結果，采用拔除上頜第一前磨牙和下頜第二前磨牙的拔牙模式進行矯治，應用陶瓷托槽排齊整平上下頜牙列，控制上下磨牙在關閉間隙階段的牙齒移動一致性，上下頜磨牙應用弱支抗，滑動法關閉拔牙間隙，頭帽Ｊ鉤結合Ⅱ類牽引矯治深覆牙合和控制頜骨生長方向。治療結束后，結合矯治前后ｘ線頭顱側位片重疊圖和測量結果進行分析對比。 結果：矯治療程為31個月，上下頜牙列排齊整平，解除牙列擁擠，牙列無間隙存在，上頜中線對正，前牙覆蓋減小為2.9mm，屬于正常覆蓋，覆牙合為下前牙切緣咬在上切牙舌面切1/3處，屬于正常覆牙合，全口牙列咬合關系穩(wěn)定，尖牙，磨牙關系保持中性關系，上頜第二磨牙萌出，上下第二磨牙建立咬合關系，顳下頜關節(jié)活動正常，無壓痛，無關節(jié)彈響，對比治療前后曲面斷層片分析，牙根發(fā)育正常，全口牙根無明顯吸收，ｘ線頭顱側位片前后對比結果顯示，（1）上下頜骨正常生長發(fā)育，ANB由治療前的4度減小為3度。（2）上切牙輕微唇傾，U1-SN增加2度，下切牙牙冠唇傾，L1-NB增加5度，IMPA則增加了4度，U1-L1減少至127度，上下切牙牙軸交角改善更加自然。（3）頜骨面高均有所增長，ANS-Me由58mm增加至60mm，下頜升支高度增加3mm，面高指數(shù)（FHI）由65%增加至70%,頜骨垂直向比例更加協(xié)調。（4）上下頜骨均有所增長，上頜骨長度ANS-PNS增加1mm，下頜骨長度Co-Po增加5mm，頜骨長度增長使得矢狀向變化更加協(xié)調。（5）軟組織側貌更為協(xié)調自然，Z角由治療前的64度增大至71度，ULP和LLP均各自減小到4mm，頦部和上下唇突度更加自然。 結論：對于生長發(fā)育期牙列擁擠的安氏I類患者，，綜合其他測量結果以及仔細分析考量，選擇合理的拔牙模式進行拔牙矯治，往往可以收到非常良好的矯治效果。
[Abstract]:Objective: to investigate the clinical effect and thinking of dental extraction in patients with class I and dentition crowding. Methods: in 2010, a young patient, female, aged 11 years, was selected from the Department of Stomatology in Dalian. The age of female was 11 years old, the growth and development period, bone type I, average angle, class I of Ann's, and dentition crowded. The mandibular crowding (including leveling Spee curve and lower incisor labial tilting) was 8.0mm, which was moderately crowded, and the anterior tooth overlay was 3.7mm, which belonged to I-degree deep overlay, and the mandibular crowding (including leveling Spee curve and lower incisor labial inclination) was 8.0mm. The overbite is the incisal edge of the lower incisor and more than 1 / 2 / 2, less than 2 / 3 of the upper incisor tongue. It belongs to the second degree of deep overbite. The maxillary second molar does not erupt. The IMPA of the lower incisor axis is 80 degrees. The molar relationship was neutral. The central line of the upper and lower mandible was positive, and the left and right sides of the mandibular Spee curve were 1.5 mm. According to the results of the examination, the extraction model of the first premolar and the second premolar of the maxilla was used to correct the molar. The ceramic brackets were used to level the upper and lower dentition, to control the consistency of tooth movement between the upper and lower molars in the closing space, to apply weak Anchorage to the upper and lower molars, and to close the extraction space by sliding. The head cap J hook combined with class 鈪

本文編號：1618484