運用種植釘輔助治療骨性Ⅲ類開合錯合畸形一例
發(fā)布時間:2018-11-11 22:14
【摘要】:研究背景:安氏Ⅲ類前牙(牙合)對于正畸醫(yī)生來說一直都是一種挑戰(zhàn)。為了得到好的矯治效果,醫(yī)生需要徹底了解錯(牙合)畸形的病因、嚴重程度、患者的訴求和期望值,從而選擇恰當?shù)某C治方法。對于生長發(fā)育停止的成人來說,輕度的病人可以通過牙齒的代償來治療,而對于比較嚴重的病人來說,常常需要正頜手術(shù)。正畸正頜聯(lián)合治療相對于單純正畸代償治療而言,具有更好的穩(wěn)定性。正畸代償治療Ⅲ類開(牙合)有很多種方法,具體方法的選擇取決于支抗的設(shè)計,患者的訴求,以及醫(yī)生的技術(shù)和喜好。常用的治療Ⅲ類開(牙合)的技術(shù)有多曲方絲弓(MEAW)技術(shù),Tweed-Merrifield技術(shù)和直絲弓固定矯治技術(shù)。它們都能取得讓人滿意的矯治效果,但這些方法都存在一些不足。MEAW技術(shù)需要醫(yī)生有很好的弓絲彎制技巧,Tweed技術(shù)需要患者的良好配合。現(xiàn)在有一些更好的骨支抗也對Ⅲ類開(牙合)有較好的效果。研究目的:本病歷試圖采用自鎖托槽加種植釘輔助進行Ⅲ類牽引的方法來探究其對Ⅲ類開(牙合)病歷的矯治效果。方法:選取大連奧索口腔門診一名16歲健康男性為研究對象,該患者主訴是前牙咬不上,診斷結(jié)果是骨性Ⅲ類開(牙合),下唇突,上牙唇傾,前牙以及右側(cè)后牙反(牙合),下中線左偏1mm,上下前牙散隙。病因分析為遺傳因素(父親有類似面型)以及不良舌習(xí)慣。拔除上合第三磨牙,矯治方法采用Damon Clear自鎖托槽以及上后牙區(qū)種植釘輔助Ⅲ類牽引。上頜進行適當弓形調(diào)整以及后牙進行交互牽引用于糾正后牙的反(牙合)。矯治期間督促患者進行舌肌訓(xùn)練以及口腔衛(wèi)生宣教。主動治療結(jié)束后采用哈雷式保持器進行保持。結(jié)果:患者側(cè)貌有了明顯改善,Z角達到73°。下唇突度得到一定內(nèi)收,覆(牙合)覆蓋恢復(fù)到正常。上切牙唇傾度稍有減小,1-NA從40°減小到38°,下前牙稍有內(nèi)收,IMPA從92.5°減小到83°。上下前牙伸長以輔助糾正開(牙合),垂直向沒有明顯的改變,上下磨牙有輕微伸長。結(jié)論:自鎖托槽加上后牙種植釘輔助Ⅲ類牽引治療該骨性Ⅲ類開(牙合)病例,取得了較為滿意的效果。
[Abstract]:Background: class III anterior teeth (occlusal) have been a challenge for orthodontists. In order to get good treatment effect, doctors need to thoroughly understand the causes, severity, patients' demands and expectations of malocclusion, and choose the appropriate treatment methods. For adults with stunting, mild patients can be treated by tooth compensation, while for more severe patients, orthognathic surgery is often required. Orthodontic orthognathic combined therapy has better stability than simple orthodontic compensatory therapy. There are many methods of orthodontic compensatory treatment for class 鈪,
本文編號:2326291
[Abstract]:Background: class III anterior teeth (occlusal) have been a challenge for orthodontists. In order to get good treatment effect, doctors need to thoroughly understand the causes, severity, patients' demands and expectations of malocclusion, and choose the appropriate treatment methods. For adults with stunting, mild patients can be treated by tooth compensation, while for more severe patients, orthognathic surgery is often required. Orthodontic orthognathic combined therapy has better stability than simple orthodontic compensatory therapy. There are many methods of orthodontic compensatory treatment for class 鈪,
本文編號:2326291
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