本文選題：骨性III類錯合畸形 + 下頜不對稱畸形　； 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討骨性III類錯合伴下頜不對稱畸形正畸掩飾性治療的臨床效果。 材料和方法：選取2013年6月在大連醫(yī)科大學(xué)附屬第一醫(yī)院就診的骨性III類錯合伴下頜不對稱畸形的19歲女性患者一例�；颊邽榘济嫘�，下頜前突，下頜向右側(cè)偏斜，下頜骨相對上頜骨發(fā)育過度；前牙12與42、43反合伴開合，13與44對刃，11與41、31對刃；磨牙關(guān)系近中尖對尖；Spee曲線較平直。下頜中線相對于面中線右偏2.5mm;上下牙弓輕度擁擠；患者否認(rèn)面部腫瘤，外傷等疾病史，家族史中，其母親也為凹面型，前牙反合。經(jīng)過對患者模型、頭顱側(cè)位片，曲面斷層片，頭顱正位片以及軟組織相片的分析，確定診斷方案。正畸治療采用多曲方絲弓聯(lián)合直絲弓的正畸代償治療，直絲弓排齊整平后，更換已經(jīng)加力的多曲方絲弓，配合不同階段的垂直牽引、中線牽引以及短III類牽引，調(diào)整咬合關(guān)系。 結(jié)果：患者歷時21個月矯治完成，前牙建立了正常的覆合覆蓋，磨牙以及尖牙關(guān)系到達(dá)中性，下中線較矯治前回正2mm,建立了良好的咬合關(guān)系；對治療前后的硬組織進(jìn)行分析：上頜骨以及上頜牙長軸在三維方向上基本沒有變化；下頜骨有很顯著的變化，，SNB減小2.5o，wits值減小8.5mm,B點到FHV的垂直距離減小3mm;L1－NB由23o減小到19o，L1-MP由86o減小到83o，說明下頜切牙代償性的更加舌傾。治療前后的軟組織分析：下頜前凸的軟組織側(cè)貌得到改善，面型由原來的凹面型變?yōu)榻咏泵嫘��；颊哒嬗^下頜偏斜程度有一定的改善�；颊呒捌浼议L對矯治結(jié)果滿意。 結(jié)論：通過多曲方絲弓技術(shù)對骨性III類錯合伴下頜不對稱畸形患者進(jìn)行正畸掩飾性治療，患者咬合恢復(fù)正常，前牙覆合、覆蓋正常，磨牙、尖牙達(dá)到中性關(guān)系；患者的軟組織面型有了一定的改善，尤其是側(cè)貌改善顯著。但是,還是存在一定程度的偏斜。說明，利用多曲方絲弓技術(shù)對骨性下頜不對稱畸形進(jìn)行正畸掩飾性治療，對改變其牙齒和牙槽骨的作用很大，對骨的改變很輕微。
[Abstract]:Objective: to investigate the clinical effect of orthodontic concealment treatment of skeletal class III malocclusion with mandibular asymmetry. Materials and methods: a 19-year-old female patient with mandibular asymmetry was selected from the first affiliated Hospital of Dalian Medical University in June 2013. The patients were concave, mandibular protruding, mandibular oblique to the right, the mandible overdeveloped relative to the maxilla, the anterior teeth were 12 and 42O43 opposite with the open and closing 13 and 44 pairs of edges, 11 and 41 of the edges, and the relationship between the molar and the proximal cusp of the teeth was straight. The middle line of the mandible is 2.5 mm right relative to the middle line of the face; the upper and lower dental arch is slightly overcrowded; the patient denies the history of facial neoplasms, trauma and other diseases. In the family history, her mother is concave, and the anterior teeth are concave. The diagnostic scheme was determined by analyzing the patient model, lateral cephalograms, curved tomography, head positives and soft tissue photographs. The orthodontic treatment was performed with multiple square wire arch combined with straight wire arch. After the straight wire arch was leveled out, the multiple curved wire arch was replaced with different stages of vertical traction, midline traction and short type III traction to adjust the occlusal relationship. Results: after 21 months of orthodontic treatment, the anterior teeth were covered with normal cladding, the relationship between molars and canines was neutral, and the inferior midline was 2 mm higher than that of the anterior gyrus, and a good occlusion relationship was established. The hard tissue before and after treatment was analyzed: the maxillary and maxillary long axis had no change in three dimensional direction; There were significant changes in the mandible. SNB decreased 2.5owits, the vertical distance from point B to FHV decreased by 3mmL1-NB from 23o to 19oL1-MP from 86o to 83o. it indicated that the mandibular incisor was more tongue-tilting. Soft tissue analysis before and after treatment: the soft tissue profile of mandibular protruding was improved and the facial shape changed from concave to straight. The degree of mandibular deflection was improved. The patients and their parents were satisfied with the results of the treatment. Conclusion: orthodontic concealment was performed in patients with bone class III malocclusion and mandibular asymmetry by multi-curved wire arch technique. The occlusal of the patients returned to normal, the anterior teeth overlaid, covered normally, the molars and canines reached a neutral relationship. The soft tissue features of the patients improved, especially the side features. However, there is still a certain degree of skew. The results showed that the orthodontic treatment of osteomorphic mandibular asymmetry with multi-curved wire arch technique had a great effect on the change of teeth and alveolar bone, and a slight change on bone.
【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】：2014
【分類號】：R783.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 晉長偉;林久祥;;多曲方絲弓技術(shù)矯治恒牙期偏鉭矯治的鉭頜變化的研究[J];現(xiàn)代口腔醫(yī)學(xué)雜志;2007年01期

2 盛瀟;顧愛春;朱敏;馬玉波;;589例面部不對稱畸形髁突生長活性核素顯像分析[J];中國口腔頜面外科雜志;2012年01期

3 賈綺林，黃金芳;顏面不對稱畸形的顱面骨骼結(jié)構(gòu)及其生長發(fā)育的研究[J];中華口腔醫(yī)學(xué)雜志;1994年01期

4 董研,郭天文,林麗紅;下頜偏斜對顏面形態(tài)和身體姿勢的影響[J];中華醫(yī)學(xué)美容雜志;2000年02期

5 朱吉坤;張桂榮;李濟(jì)強(qiáng);劉繼輝;;多曲方絲弓及擴(kuò)弓技術(shù)矯治輕中度骨性偏鉭畸形的臨床研究[J];中國實用口腔科雜志;2009年03期

6 丁寅;;骨性偏頜畸形診斷與治療[J];中國實用口腔科雜志;2010年05期

本文編號：2014812