應(yīng)用MEAW技術(shù)治療成人低角雙頜前突病例
發(fā)布時(shí)間：2018-08-07 08:40
【摘要】：目的:采用MEAW(Multiloop Edgewise Arch Wire,多曲方絲弓)技術(shù)調(diào)整陡峭的后牙(?)平面,使傾斜的磨牙直立獲得微小的間隙,來(lái)矯治成人低角雙(?)前突錯(cuò)(?)畸形患者。材料及方法:選擇大連醫(yī)科大學(xué)附屬第二醫(yī)院口腔門(mén)診正畸科矯治的一例成人低角雙頜前突患者為病例,患者為27歲成年女性,曾于2015年有過(guò)短暫的非拔牙正畸治療史,但矯治一年后上下頜前牙更為前突。2016年1月經(jīng)過(guò)再次診斷分析,重新制定矯治方案,開(kāi)始正畸治療。患者的口腔衛(wèi)生狀態(tài)良好,牙周組織無(wú)明顯異常,但患者自述易發(fā)生口腔潰瘍,患者無(wú)口呼吸及咬下唇等不良習(xí)慣�；颊咦笥覂蓚�(cè)尖牙關(guān)系為II類(lèi)關(guān)系,右側(cè)磨牙關(guān)系為安氏II類(lèi)關(guān)系(磨牙尖對(duì)尖,遠(yuǎn)中錯(cuò)(?)),左側(cè)磨牙關(guān)系為安氏I類(lèi)關(guān)系。下頜右側(cè)尖牙與第一前磨牙之間有約1mm的間隙,上下頜牙列均無(wú)擁擠、具有陡峭的后牙(?)平面、有淺度Spee曲線(xiàn)。前牙覆蓋程度較深為3.2mm、覆(?)程度為I度深覆(?),約為4.47mm。上下頜中線(xiàn)正,位于正中,上下頜前牙均唇傾,有輕微的開(kāi)唇露齒,軟組織側(cè)貌為凸面型。該病例經(jīng)過(guò)模型分析和X線(xiàn)頭影測(cè)量分析后設(shè)計(jì)的治療計(jì)劃為:拔除上頜雙側(cè)第二前磨牙及下頜第三磨牙,粘接上頜4個(gè)前牙直絲托槽,其余牙齒使用方絲弓托槽,在上下頜牙列整平排齊后,使用MEAW弓絲加力使下頜磨牙直立,同時(shí)利用有效牽引使下頜前牙后移為上頜的拔牙間隙關(guān)閉打下基礎(chǔ)。完成階段上下頜均使用多曲方絲弓來(lái)調(diào)整咬合關(guān)系,改善覆(?)覆蓋程度,以求得到良好的矯治結(jié)果。最后使用保持器保持牙齒穩(wěn)定、美觀的正畸治療效果。同時(shí)進(jìn)行治療前后的模型及頭顱側(cè)位片對(duì)比分析。結(jié)果:預(yù)想設(shè)計(jì)的總治療過(guò)程為20個(gè)月。治療結(jié)束的時(shí)候期望的矯治效果如下:(一)唇傾的前牙回收接近直立,突出的側(cè)貌改善為直面型,雙唇凸度減小,鼻唇角增大,改善開(kāi)唇露齒,可以自然閉唇,增加美觀程度。磨牙直立后獲得平坦的后牙(?)平面以及穩(wěn)定咬合關(guān)系。上下頜牙列排齊整平,前牙覆蓋和覆(?)在正常范圍內(nèi),雙側(cè)磨牙關(guān)系為完全遠(yuǎn)中關(guān)系,尖牙達(dá)到中性關(guān)系,上頜拔牙間隙完全關(guān)閉,上下頜中線(xiàn)對(duì)正,位于正中。(二)治療前后X線(xiàn)對(duì)比分析:1.對(duì)比治療前后的曲面斷層片可見(jiàn),下頜前傾的磨牙直立,淺度的spee曲線(xiàn)改善,牙齒牙根基本平行,牙根未見(jiàn)明顯吸收,牙槽骨、牙周、牙體組織健康。2.對(duì)比治療前后的X線(xiàn)頭影測(cè)量數(shù)據(jù)分析結(jié)果:1)ODI,APDI,CF數(shù)據(jù)對(duì)比基本沒(méi)有變化。2)IIA角由102.51度增加到122.26度,U1-FH角由129.86度減小到120.22度,L1-MP角唇傾度105.45度減小到98.12度。3)POP為9.57度,數(shù)據(jù)明顯變小。以上結(jié)果表明上下頜過(guò)度唇傾的前牙被回收,開(kāi)唇露齒情況得到改善,軟組織側(cè)貌變?yōu)橹泵嫘汀６骂M應(yīng)用MEAW多曲弓絲調(diào)整后牙(?)平面使磨牙直立,同時(shí)壓低下前牙,整平Spee曲線(xiàn),取得了良好的下頜不拔牙矯治效果。結(jié)論:(1)對(duì)于成人低角雙(?)前突錯(cuò)(?)畸形患者的矯正治療,采用MEAW技術(shù)使傾斜的磨牙直立獲得微小的間隙,有利于獲得下頜前牙后移所需的間隙,回收前突的牙齒。進(jìn)而使患者下頜采用非拔牙矯治的可能性提高。(2)用MEAW多曲方絲弓技術(shù)可以使陡峭的后牙(?)平面變成平坦的后(?)平面。可以更好的調(diào)整咬合關(guān)系達(dá)到更好的效果。
[Abstract]:Objective: to adjust the steep posterior teeth (?) plane by using MEAW (Multiloop Edgewise Arch Wire, multiple curved square arch) technique to make the tilted molar straight to a small gap to correct the deformity of adult low angle double (?) protrusion (?) malformation. Materials and methods: a case of orthodontic orthodontists in the Second Affiliated Hospital of Dalian Medical University, orthodontic orthodontists The patient with low angle dimaxillary protrusion was a case of 27 year old female, who had a history of transient non extraction orthodontic treatment in 2015, but after a year, the anterior and lower mandibular anterior teeth were rediagnosed and analyzed again in January.2016 years, and the orthodontic treatment began to be reformulated. The patient's oral hygiene was good and the periodontium had no obvious difference. Often, the patient is prone to oral ulcers, the patients have no mouth breathing and bad habit of biting the lower lip. The relationship between the left and right sides of the canine is II relationship, the right molar relationship is the II relationship of the ANS (apex to apex, far middle and wrong), the left molar is the I class relationship. There is a gap of about 1mm between the right canine and the first premolar. There is no crowding in the upper and lower jaw teeth, with a steep posterior teeth (?) plane with a shallow Spee curve. The front teeth are covered with a deeper level of 3.2mm, the overlying (?) degree is I degree overlying (?), about the middle and lower jaw line of the 4.47mm., in the middle of the upper and lower mandibular teeth, a slight open lip, and the soft tissue on the convex surface. The case is analyzed by model analysis and X-ray. The treatment plan after cephalometric analysis was designed to remove the maxillary bilateral second premolars and mandibular third molars, adhere to the maxillary 4 anterior teeth straight wire brackets, and the rest of the teeth using a square arch bracket. After the leveling of the upper and lower jaw teeth, the mandibular molar was upright with the MEAW bow force, and the mandibular anterior teeth were moved up with effective traction. The gap between the teeth of the jaw is closed. The multiple curved arch is used to adjust the occlusion relationship and improve the coverage of the overlay. In order to get good correction results. Finally, the retention device is used to keep the tooth stable and the orthodontic treatment effect. At the same time, the model and the lateral head of the head before and after the treatment are compared. Results: the total treatment process of the preconceived design is 20 months. The desired effect of treatment at the end of the treatment is as follows: (1) the reclaim of the lip of the anterior teeth is close to the upright, the prominent side looks to the straight face, the lips are reduced, the nose and lip are increased, the lip is improved, the lip is improved, the lip is naturally closed, and the beauty is increased. After the molar is upright, a flat posterior tooth (?) is obtained upright after the molar is erect. Plane and stable occlusal relationship. The upper and lower jaw teeth are leveled, the front teeth cover and overlay (?) in the normal range, the bilateral molar relationship is completely far and middle relation, the canine reaches the neutral relation, the maxillary extraction gap is completely closed, the upper and lower middle line is right in the middle. (two) the X-ray contrast analysis and analysis before and after treatment: 1. contrast the curved surface fault before and after treatment It was seen that the mandibular premolars were upright, the shallow spee curves improved, the root of the teeth were basically parallel, the root of the teeth were not obviously absorbed, the alveolar bone, the periodontium and the tissue health of the teeth were compared with the X-ray cephalometric data before and after the treatment of.2.: 1) ODI, APDI, and CF data were basically unchanged.2) IIA angle increased from 102.51 degrees to 122.26 degrees, U1-FH angle. From 129.86 degrees to 120.22 degrees, the L1-MP angle lip dropped from 105.45 degrees to 98.12.3), POP was 9.57 degrees, and the data was significantly smaller. The above results showed that the anterior teeth of the overlip overlips were recovered, the open lip teeth were improved and the soft tissue profile changed into a straight face. The mandible applied the MEAW multiple arch wire to adjust the posterior teeth to make the molar stand upright, At the same time, the lower anterior teeth were lowered and the Spee curve was leveled out. Conclusion: (1) for the correction treatment of the adult with low angle double (?) protrusion (?) malformation (?) malformation, the MEAW technique was used to make the tilted molars get vertical clearance, which was favorable for the clearance of the posterior mandibular teeth, and the recovery of the teeth of the protrusion. The possibility of the patient's mandible is improved by non extraction. (2) the MEAW multi curved wire technique can make the steep posterior teeth (?) plane into a flat back (?) plane. It can better adjust the occlusion relationship to achieve better results.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R783.5
，
本文編號(hào)：2169493
[Abstract]:Objective: to adjust the steep posterior teeth (?) plane by using MEAW (Multiloop Edgewise Arch Wire, multiple curved square arch) technique to make the tilted molar straight to a small gap to correct the deformity of adult low angle double (?) protrusion (?) malformation. Materials and methods: a case of orthodontic orthodontists in the Second Affiliated Hospital of Dalian Medical University, orthodontic orthodontists The patient with low angle dimaxillary protrusion was a case of 27 year old female, who had a history of transient non extraction orthodontic treatment in 2015, but after a year, the anterior and lower mandibular anterior teeth were rediagnosed and analyzed again in January.2016 years, and the orthodontic treatment began to be reformulated. The patient's oral hygiene was good and the periodontium had no obvious difference. Often, the patient is prone to oral ulcers, the patients have no mouth breathing and bad habit of biting the lower lip. The relationship between the left and right sides of the canine is II relationship, the right molar relationship is the II relationship of the ANS (apex to apex, far middle and wrong), the left molar is the I class relationship. There is a gap of about 1mm between the right canine and the first premolar. There is no crowding in the upper and lower jaw teeth, with a steep posterior teeth (?) plane with a shallow Spee curve. The front teeth are covered with a deeper level of 3.2mm, the overlying (?) degree is I degree overlying (?), about the middle and lower jaw line of the 4.47mm., in the middle of the upper and lower mandibular teeth, a slight open lip, and the soft tissue on the convex surface. The case is analyzed by model analysis and X-ray. The treatment plan after cephalometric analysis was designed to remove the maxillary bilateral second premolars and mandibular third molars, adhere to the maxillary 4 anterior teeth straight wire brackets, and the rest of the teeth using a square arch bracket. After the leveling of the upper and lower jaw teeth, the mandibular molar was upright with the MEAW bow force, and the mandibular anterior teeth were moved up with effective traction. The gap between the teeth of the jaw is closed. The multiple curved arch is used to adjust the occlusion relationship and improve the coverage of the overlay. In order to get good correction results. Finally, the retention device is used to keep the tooth stable and the orthodontic treatment effect. At the same time, the model and the lateral head of the head before and after the treatment are compared. Results: the total treatment process of the preconceived design is 20 months. The desired effect of treatment at the end of the treatment is as follows: (1) the reclaim of the lip of the anterior teeth is close to the upright, the prominent side looks to the straight face, the lips are reduced, the nose and lip are increased, the lip is improved, the lip is improved, the lip is naturally closed, and the beauty is increased. After the molar is upright, a flat posterior tooth (?) is obtained upright after the molar is erect. Plane and stable occlusal relationship. The upper and lower jaw teeth are leveled, the front teeth cover and overlay (?) in the normal range, the bilateral molar relationship is completely far and middle relation, the canine reaches the neutral relation, the maxillary extraction gap is completely closed, the upper and lower middle line is right in the middle. (two) the X-ray contrast analysis and analysis before and after treatment: 1. contrast the curved surface fault before and after treatment It was seen that the mandibular premolars were upright, the shallow spee curves improved, the root of the teeth were basically parallel, the root of the teeth were not obviously absorbed, the alveolar bone, the periodontium and the tissue health of the teeth were compared with the X-ray cephalometric data before and after the treatment of.2.: 1) ODI, APDI, and CF data were basically unchanged.2) IIA angle increased from 102.51 degrees to 122.26 degrees, U1-FH angle. From 129.86 degrees to 120.22 degrees, the L1-MP angle lip dropped from 105.45 degrees to 98.12.3), POP was 9.57 degrees, and the data was significantly smaller. The above results showed that the anterior teeth of the overlip overlips were recovered, the open lip teeth were improved and the soft tissue profile changed into a straight face. The mandible applied the MEAW multiple arch wire to adjust the posterior teeth to make the molar stand upright, At the same time, the lower anterior teeth were lowered and the Spee curve was leveled out. Conclusion: (1) for the correction treatment of the adult with low angle double (?) protrusion (?) malformation (?) malformation, the MEAW technique was used to make the tilted molars get vertical clearance, which was favorable for the clearance of the posterior mandibular teeth, and the recovery of the teeth of the protrusion. The possibility of the patient's mandible is improved by non extraction. (2) the MEAW multi curved wire technique can make the steep posterior teeth (?) plane into a flat back (?) plane. It can better adjust the occlusion relationship to achieve better results.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R783.5
，
本文編號(hào)：2169493
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