本文選題：PASS技術(shù) + 鄈平面�。� 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討應(yīng)用PASS技術(shù)矯治兩例牙列重度擁擠患者的臨床效果病例與方法:選取2015年1月至2016年1月,于大連醫(yī)科大學(xué)附屬第一醫(yī)院就診患者兩例,一例為女性,一例為男性。患者一,18歲女性,恒牙列,雙側(cè)磨牙關(guān)系為近中關(guān)系,且第一磨牙近中傾斜較嚴重,即生理支抗喪失明顯。ANB=8.5,II類骨面型,下頜角示高角,牙列重度擁擠,前牙開(?),口腔衛(wèi)生一般,上頜前、后牙(?)平面較平坦。患者二,16歲男性,恒牙列,雙側(cè)磨牙關(guān)系為近中關(guān)系,ANB=5,II類骨面型,下頜角示高角,牙列重度擁擠,前牙覆蓋較大。上頜前牙(?)平面較平坦,因上頜第二磨牙萌出高度明顯不足故可發(fā)現(xiàn)后牙(?)平面較陡峭。經(jīng)過對該兩例患者資料的系統(tǒng)分析和討論得出治療方案。兩例患者治療方案大致相同:一、首選正畸正頜聯(lián)合治療,二、正畸掩飾治療。因兩位患者及家屬均拒絕手術(shù)治療,故兩位患者均選擇正畸掩飾治療。兩位患者均拔除四顆第二前磨牙并且采用PASS矯治技術(shù)。通過對治療中與治療前頭影測量數(shù)值分析、穩(wěn)定結(jié)果重疊和草耙分析,對治療效果進行討論。結(jié)果分析:患者一自接診至今,療程共22個月,雖ANB未發(fā)生變化,即骨性問題并沒有得到解決,但是效果依舊顯著,U1-NA(mm)由4變?yōu)?,U1-NA(°)由28變?yōu)?3,U1-SN(°)由110變?yōu)?4說明上頜唇傾切牙回收效果明顯,L1-NB(mm)由10變?yōu)?,L1-NB(°)由32變?yōu)?9,說明下頜切牙略有輕微直立,Y軸角由72變?yōu)?3,說明下頜骨略有輕微順時針旋轉(zhuǎn)。EL-UL值由3變?yōu)?,EL-LL值由6.5變?yōu)?,Z角(°)測量值由52變?yōu)?5,說明患者面型改善。治療前,前牙(?)平面為4°,較正常值10±3.58(°)偏小,治療后變?yōu)?9°,通過頭影測量可發(fā)現(xiàn)切牙較正常值有一定舌傾,治療前后牙(?)平面角度為13°,雖然在正常值范圍14.9±3.85(°)之內(nèi),但發(fā)現(xiàn)該患者上下頜第一第二磨牙均有不同程度的生理支抗喪失,治療后,后牙(?)平面角度為16°,在正常值范圍之內(nèi),發(fā)現(xiàn)在矯治后牙(?)平面的同時,第一磨牙、第二磨牙發(fā)生后傾,有效改善磨牙軸傾度,從而減少生理支抗的丟失�；颊叨越釉\至今,療程共9個月,同患者一,ANB并未發(fā)生變化,U1-NA(mm)測量值由8變?yōu)?,U1-NA(°)測量值由33變?yōu)?0,U1-SN(°)測量值由114變?yōu)?00說明上頜唇傾切牙得到回收且效果明顯,L1-NB(mm)測量值由9變?yōu)?,L1-NB(°)測量值由38變?yōu)?3,說明下頜切牙略有輕微直立,Y軸角由72變?yōu)?0,說明下頜骨略有輕微逆時針旋轉(zhuǎn)。雖然EL-UL值和EL-LL值均未發(fā)生改變,但Z角(°)測量值由55變?yōu)?8,仍說明患者面型改善,由凸面型變成直面型。治療前,前牙(?)平面為11°,于正常值范圍之內(nèi),現(xiàn)階段前牙(?)平面為12°,未發(fā)生明顯改變,患者治療前后牙(?)平面為24°,較為陡峭,治療后后牙(?)平面角度為17°,較之前大為改善,上頜第二前磨牙、第一磨牙、第二磨牙均發(fā)生向前向下生長,第二磨牙較之前近中傾斜且生長量較大,有效改善之前較為陡峭的后牙(?)平面。通過重疊可見,在陡峭的后牙(?)平面發(fā)生改善的過程中,下頜骨也發(fā)生了較大幅度的向前向下的生長,由于后牙(?)平面較之前變得平坦,故下頜骨發(fā)生了逆時針旋轉(zhuǎn),患者治療效果明顯。結(jié)論:1.患者一:針對此成年女性患者,PASS技術(shù)解除開(?)、牙列擁擠擁擠迅速,改善凸面型,維持后牙(?)平面于正常范圍2.患者二:針對此處于生長發(fā)育期男性患者,PASS技術(shù)解除擁擠迅速,改善后牙陡峭的(?)平面的同時使下頜骨發(fā)生逆時針旋轉(zhuǎn)。
[Abstract]:Objective: To investigate the clinical effects and methods of two cases of severe crowding in dentition by using PASS technique: two cases were selected from January 2015 to January 2016 in the First Affiliated Hospital of Dalian Medical University, one was female, one was male. The one, 18 year old female, permanent tooth column, bilateral molar relationship were closely related, and the first molar was the first molar. The near middle tilt is more serious, that is, the loss of.ANB=8.5, II type of bone face, high angle of the mandibular angle, high angle of mandibular angle, severe crowding of the teeth, the anterior teeth open (?), the oral hygiene general, the maxillary front, and the posterior teeth (?) flat plane. The two, 16 year old male, the permanent dentition, and the bilateral teeth are closely related, the ANB=5, II type, the angle of the mandible, the high angle of the mandibular angle, and the severe crowding of the teeth. The front teeth were more flat. The maxillary front tooth (?) plane was flat. The posterior teeth (?) was more steep because of the obvious deficiency of the second molar eruption. After the systematic analysis and discussion of the data of the two cases, the treatment scheme was obtained. Two patients were treated roughly the same as the orthodontic orthodontic combined treatment, two, orthodontic mask. Treatment. Two patients and their families refused surgical treatment, so two patients all chose orthodontic mask treatment. Two patients all removed four second premolars and adopted the PASS correction technique. Through the numerical analysis of the treatment and treatment before the treatment, the stability results overlap and the hay rake analysis, the results were discussed. The course of treatment was 22 months. Although ANB did not change, the bone problem was not solved, but the effect was still significant, U1-NA (mm) changed from 4 to 0, U1-NA (degree) changed from 28 to 13, U1-SN (degree) changed from 110 to 94, and L1-NB (mm) changed from 10 to 9, L1-NB (degree) changed from 32 to 29, indicating mandibular cutting. The teeth were slightly erect, and the Y axis angle changed from 72 to 73, indicating that the.EL-UL value of the mandible slightly clockwise rotation was changed from 3 to 0, EL-LL value changed from 6.5 to 4, Z angle (degree) changed from 52 to 55, indicating that the patient's face shape was improved. Before treatment, the front tooth (?) plane was 4 degrees, compared with the normal value 10 + 3.58 (degree), after treatment, it became 19 degree, through cephalometric measurement can be found tangent. The tooth (?) tooth (?) plane angle was 13 degrees before and after treatment. Although it was within the normal range of 14.9 + 3.85 (degree), it was found that the first second molar of the patient had different degree of physiological support loss. After treatment, the plane angle of the posterior teeth (?) was 16 degrees, within the normal range, it was found in the same plane of the posterior teeth. At the time of the first molar and the second molar, the inclination of the molar was effectively improved and the loss of the physiological support was reduced. The course of treatment was 9 months for the patient for a total of 9 months. The U1-NA (mm) measurement value changed from 8 to 3, the measurement value of U1-NA (degree) changed from 33 to 20, and the measurement value of U1-SN (degree) changed from 114 to 100 to explain the upper lip tilting. The L1-NB (mm) measured value changed from 9 to 8, and the measurement value of L1-NB (degree) changed from 38 to 33, indicating that the mandibular incisors were slightly erect and the Y axis angle changed from 72 to 70, indicating that the mandible was slightly reverse clockwise rotation. Although the EL-UL value and EL-LL value were not changed, the measurement value of Z angle (degree) changed from 55 to 58, which still indicated the improvement of the patient's face shape. Before treatment, the front tooth (?) plane was 11 degrees before the treatment. The front tooth (?) plane was 12 degrees at the present stage. The front tooth (?) plane was 24 degree, the angle of the posterior teeth (?) was 17 degrees before and after treatment, and the maxillary second premolar, the first molar and second molar. The second molars are inclined and grow larger than before, and the more steep posterior teeth (?) planes are effectively improved. In the process of improvement of the steep posterior teeth (?), the mandible also grows larger and downward, as the posterior (?) plane becomes flat. Therefore, the mandible was reversed clockwise rotation, and the treatment effect of the patients was obvious. Conclusion: 1. patients one: for this adult female patient, PASS technology is lifted (?), the teeth are crowded and crowded quickly, the convex surface is improved, the posterior teeth (?) in the normal range of 2. patients is two: the needle is in the growth stage male patients, the PASS technique is relieved quickly, To improve the posterior plane of the posterior teeth, the mandible is rotated counterclockwise.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R783.5

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