J鉤配合直絲弓矯治技術(shù)治療成人雙頜前突的病例分析
發(fā)布時間：2019-06-06 16:07
【摘要】：目的：J鉤配合直絲弓矯治技術(shù)矯治成人雙頜前突，通過對比矯治前后牙齒以及軟硬組織的變化情況，探討J鉤對上前牙矢狀向和垂直向的控制以及拔牙矯治后軟組織側(cè)貌的改善。 方法：選取沈陽市口腔醫(yī)院正畸科2011年11月收治的雙頜前突患者1例，，女性，18歲。骨性I類，上下頜骨發(fā)育正常，上下頜單純牙性前突，唇外翻，閉唇時頦肌緊張，頦靨窩明顯，頦唇溝上抬，下唇過度覆蓋上切牙，下唇突出明顯(如圖1)；雙側(cè)磨牙、尖牙中性關(guān)系，覆牙合覆蓋正常，中線齊，不擁擠。根據(jù)初診模型測量和頭影測量數(shù)據(jù)分析，結(jié)合患者主訴后決定采用直絲弓矯治技術(shù)，拔除4顆第一前磨牙進行矯治，并在關(guān)閉拔牙間隙階段配合使用頭帽J鉤進行牽引，牽3向遠中保護后牙支抗，同時整體壓低和回收上頜前牙來使上下唇后移，改善軟組織側(cè)貌。本病例采用美國3M公司生產(chǎn)的3-3陶瓷托槽(0.022*0.025in)進行矯治，使用J鉤牽3向遠中時牽引力量大小為200g左右，方向與牙合平面平行；壓低和回收上頜前牙時牽引力每側(cè)100~150g，牽引方向與牙合平面呈30°向上，佩戴時間每天12小時以上。對矯治前后模型以及頭顱側(cè)位片進行測量分析，對比矯治前后患者軟硬組織以及牙齒的變化。另外附加一例成人雙突應(yīng)用種植釘增強支抗的病例(見17頁)與之作對比。 結(jié)果：J鉤病例矯治療程共24個月。矯治結(jié)束后患者上下牙排列整齊；雙側(cè)磨牙、尖牙中性關(guān)系；前牙覆牙合覆蓋正常；上下中線正；牙齒尖窩鎖結(jié)關(guān)系良好。凸面型變?yōu)橹泵嫘�，軟組織側(cè)貌得到較大程度的改善，患者對矯治結(jié)果非常滿意。對患者治療前后頭顱側(cè)位片進行測量比較：(1)矢狀向改變，SNA減小0.5°，說明上頜骨隨著前牙的回收也有少量改建；U1-SN減小12.5°，U1-NA減小11°，L1-MP減小8°，L1-NB減小8°，U1-L1增加21°，說明上下前牙唇傾度、突度均減小；U6-RL增加2.2mm，U1E-RL減小4.8mm說明J鉤增強了上后牙支抗，后牙前移少，前牙回收多，患者矢狀向得到了很好的控制。(2)垂直向改變，U6-PP未變化說明上后牙在矯治過程中并未伸長；U1E-PP減小2.5mm，U1A-PP減小1.5mm，說明J鉤對上前牙有明顯的壓低；OP-FH減小1°，MP-FH減小1.5°說明下頜骨以及牙合平面得到少量逆時針旋轉(zhuǎn)，說明垂直向得到控制。(3)軟組織改變，鼻唇角NLA增加5°，Z角減小8°，UL-EP減小1.4mm，LL-EP減小4.9mm，ULP減小0.7mm，LLP減小4.9mm，上下唇隨著切牙的回收后移；NLA增加5°，說明鼻唇溝變淺；上唇厚度增加1.4mm，下唇厚度基本不變，上唇長度無變化，下唇長度代償性減小2.0mm說明隨著牙齒的回收，上下唇形態(tài)也得到代償性改建。 種植釘增強支抗病例：(1)矢狀向:U6-RL增加0.7mm，U1E-RL減小5.7mm，垂直向U6-PP不變，說明種植體矢狀向可以明顯增強支抗；(2)垂直向:U1A-PP減小-0.5mm，說明種植體垂直向?qū)ι锨把烙休p微的壓低作用；U1E-PP增加1.5mm，OP-FH減小1°，大量內(nèi)收前牙時伴隨的鐘擺效應(yīng)使牙合平面順時針旋轉(zhuǎn)。 結(jié)論：(1)頭帽J鉤牽引在矢狀向可內(nèi)收前牙，保護后牙支抗，明顯改善患者側(cè)貌。(2)頭帽J鉤在垂直向可整體壓低上前牙，抵抗回收前牙過程中的鐘擺效應(yīng)；同時控制高角患者的下面高，防止下頜骨順時針旋轉(zhuǎn)。(3)正畸拔牙矯治后，軟組織也得到代償性改建，上下唇隨著切牙內(nèi)收的量與多種因素相關(guān)。(4)J鉤與種植體在增強支抗時，在矢狀向均可得到很好的控制，但在垂直向控制上J鉤優(yōu)于種植體支抗。
[Abstract]:Objective: To study the effect of J-hook on the sagittal and vertical control of the anterior teeth and the improvement of the profile of soft tissue after tooth extraction. Methods:1 case, female,18 cases of double-jaw process were selected from the orthodontic department of Shenyang Stomatological Hospital in November,2011. The bone type I, the upper and lower mandible are normal, the upper and lower jaw is simple, the upper and lower jaws are simple, the lips are turned out, the upper and lower lips of the upper and lower jaws are tense, the upper and lower lips of the upper and lower lips are obvious (as shown in FIG.1), and the bilateral molars and the sharp teeth have sexual relations, and the overbite cover is positive. It's often, the middle line, it's not. Extruding. According to the data analysis of the initial diagnosis model and the cephalometric measurement data, combined with the patient's complaint, it was decided to use the direct-wire-arch correction technique, to remove the four first premolars for correction, and to cooperate with the head cap J-hook for traction during the closing of the tooth extraction clearance phase, and pull 3 to protect the posterior teeth in the distal direction. The upper and lower lips are removed and the soft tissue side is improved when the upper and lower lips are lowered and recovered at the same time. In this case, the 3-3 ceramic bracket (0.022 * 0.025 in) produced by 3M Company of the United States was used for the treatment. When the J-hook was used for three-way, the traction force was about 200 g, the direction was parallel to the occlusal plane, and the traction force was 100-150g per side when the maxillary anterior teeth were depressed and recovered, and the traction direction was 30 擄 to the occlusal plane. on top, the wearing time is 12 hours a day, To measure and analyze the anterior and posterior model of the correction and the side of the skull, and compare the soft and soft tissue of the patient and the change of the teeth before and after the correction. In addition, an additional case of an adult double-process application (see page 17) was added to the treatment. Bi. Results: A total of 2 cases of J-hook case treatment course 4 months. After the end of the treatment, the upper and lower teeth of the patient are arranged orderly; the bilateral molar and the sharp tooth have sexual relations; the covering of the front teeth is normal; the upper and lower midline is positive; and the tooth tip and the tooth lock are closed The shape of the convex surface becomes the face of the face, the side appearance of the soft tissue is improved to a great extent, and the patient has no effect on the correction result. It is generally satisfactory. The measurement of the head-side panel before and after the treatment of the patient is as follows: (1) the sagittal changes and the reduction of the SNA by 0.5 擄, indicating that the maxilla has little alteration with the recovery of the anterior teeth; the U1-SN is reduced by 12.5 擄, the U1-NA is reduced by 11 擄, the L1-MP is reduced by 8 擄, the L1-NB is reduced by 8 擄, and the U1-L1 increases 21 擄, indicating the inclination of the upper and lower anterior teeth, the degree of penetration decreased, the U6-RL increased by 2.2 mm, and the U1E-RL was reduced by 4.8 mm. The J-hook enhanced the upper posterior teeth support, the posterior teeth advanced less, the anterior teeth were recovered, and the sagittal alignment of the patient was very good Control. (2) Vertical change, U6-PP did not change, the teeth did not extend during the treatment; U1E-PP was reduced by 2.5 mm, and U1A-PP was reduced by 1.5 mm, indicating that the J-hook had a significant depression on the upper anterior teeth; the reduction of OP-FH by 1 擄, and the reduction of MP-FH by 1.5 擄 indicated that the mandible and the occlusal plane were reduced in a small amount The needle is rotated to indicate the vertical orientation To control. (3) Soft tissue change, nasal lip angle NLA increased by 5 擄, Z angle reduced by 8 擄, UL-EP reduced by 1.4 mm, LL-EP reduced by 4.9 mm, ULP was reduced by 0.7 mm, LLP was reduced by 4.9 mm, and upper lower lip was removed with the recovery of the incisor; NLA was increased by 5 擄, indicating that the nasolabial groove was shallow; the upper lip thickness increased by 1.4 mm, the lower lip thickness group The length of the upper lip is not changed, the compensatory reduction of the length of the lower lip is reduced by 2.0 mm. With the recovery of the tooth, the upper and lower lip form is also compensated. (1) Sagittal: U6-RL increased by 0.7 mm, U1E-RL decreased by 5.7 mm, and vertical to U6-PP, indicating that the sagittal alignment of the implant was significantly enhanced; (2) the vertical orientation: U1A-PP was reduced to 0.5 mm, indicating that the implant was vertical to the anterior teeth slightly The pressure of U1E-PP increased by 1.5 mm, OP-FH was reduced by 1 擄, and the pendulum effect associated with the large number of internal anterior teeth was used to make the occlusal plane Clockwise rotation. Conclusion: (1) The head cap J hook is pulled in the sagittal direction to receive the anterior teeth, and the posterior teeth are anti-and bright. improve that lateral appearance of the patient. (2) the head cap J hook can lower the upper front tooth in the vertical direction to resist the pendulum effect in the process of recovering the front teeth; and meanwhile, the lower level of the high-angle patient is controlled, The jaw is rotated clockwise. (3) After the orthodontic tooth extraction, the soft tissue is also compensated, and the upper and lower lips follow the amount of the tooth in the incisor. (4) The J-hook and the implant can be well controlled in the sagittal direction when the reinforcing brace is enhanced, but the J-hook is in the vertical direction
【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
本文編號：2494432
[Abstract]:Objective: To study the effect of J-hook on the sagittal and vertical control of the anterior teeth and the improvement of the profile of soft tissue after tooth extraction. Methods:1 case, female,18 cases of double-jaw process were selected from the orthodontic department of Shenyang Stomatological Hospital in November,2011. The bone type I, the upper and lower mandible are normal, the upper and lower jaw is simple, the upper and lower jaws are simple, the lips are turned out, the upper and lower lips of the upper and lower jaws are tense, the upper and lower lips of the upper and lower lips are obvious (as shown in FIG.1), and the bilateral molars and the sharp teeth have sexual relations, and the overbite cover is positive. It's often, the middle line, it's not. Extruding. According to the data analysis of the initial diagnosis model and the cephalometric measurement data, combined with the patient's complaint, it was decided to use the direct-wire-arch correction technique, to remove the four first premolars for correction, and to cooperate with the head cap J-hook for traction during the closing of the tooth extraction clearance phase, and pull 3 to protect the posterior teeth in the distal direction. The upper and lower lips are removed and the soft tissue side is improved when the upper and lower lips are lowered and recovered at the same time. In this case, the 3-3 ceramic bracket (0.022 * 0.025 in) produced by 3M Company of the United States was used for the treatment. When the J-hook was used for three-way, the traction force was about 200 g, the direction was parallel to the occlusal plane, and the traction force was 100-150g per side when the maxillary anterior teeth were depressed and recovered, and the traction direction was 30 擄 to the occlusal plane. on top, the wearing time is 12 hours a day, To measure and analyze the anterior and posterior model of the correction and the side of the skull, and compare the soft and soft tissue of the patient and the change of the teeth before and after the correction. In addition, an additional case of an adult double-process application (see page 17) was added to the treatment. Bi. Results: A total of 2 cases of J-hook case treatment course 4 months. After the end of the treatment, the upper and lower teeth of the patient are arranged orderly; the bilateral molar and the sharp tooth have sexual relations; the covering of the front teeth is normal; the upper and lower midline is positive; and the tooth tip and the tooth lock are closed The shape of the convex surface becomes the face of the face, the side appearance of the soft tissue is improved to a great extent, and the patient has no effect on the correction result. It is generally satisfactory. The measurement of the head-side panel before and after the treatment of the patient is as follows: (1) the sagittal changes and the reduction of the SNA by 0.5 擄, indicating that the maxilla has little alteration with the recovery of the anterior teeth; the U1-SN is reduced by 12.5 擄, the U1-NA is reduced by 11 擄, the L1-MP is reduced by 8 擄, the L1-NB is reduced by 8 擄, and the U1-L1 increases 21 擄, indicating the inclination of the upper and lower anterior teeth, the degree of penetration decreased, the U6-RL increased by 2.2 mm, and the U1E-RL was reduced by 4.8 mm. The J-hook enhanced the upper posterior teeth support, the posterior teeth advanced less, the anterior teeth were recovered, and the sagittal alignment of the patient was very good Control. (2) Vertical change, U6-PP did not change, the teeth did not extend during the treatment; U1E-PP was reduced by 2.5 mm, and U1A-PP was reduced by 1.5 mm, indicating that the J-hook had a significant depression on the upper anterior teeth; the reduction of OP-FH by 1 擄, and the reduction of MP-FH by 1.5 擄 indicated that the mandible and the occlusal plane were reduced in a small amount The needle is rotated to indicate the vertical orientation To control. (3) Soft tissue change, nasal lip angle NLA increased by 5 擄, Z angle reduced by 8 擄, UL-EP reduced by 1.4 mm, LL-EP reduced by 4.9 mm, ULP was reduced by 0.7 mm, LLP was reduced by 4.9 mm, and upper lower lip was removed with the recovery of the incisor; NLA was increased by 5 擄, indicating that the nasolabial groove was shallow; the upper lip thickness increased by 1.4 mm, the lower lip thickness group The length of the upper lip is not changed, the compensatory reduction of the length of the lower lip is reduced by 2.0 mm. With the recovery of the tooth, the upper and lower lip form is also compensated. (1) Sagittal: U6-RL increased by 0.7 mm, U1E-RL decreased by 5.7 mm, and vertical to U6-PP, indicating that the sagittal alignment of the implant was significantly enhanced; (2) the vertical orientation: U1A-PP was reduced to 0.5 mm, indicating that the implant was vertical to the anterior teeth slightly The pressure of U1E-PP increased by 1.5 mm, OP-FH was reduced by 1 擄, and the pendulum effect associated with the large number of internal anterior teeth was used to make the occlusal plane Clockwise rotation. Conclusion: (1) The head cap J hook is pulled in the sagittal direction to receive the anterior teeth, and the posterior teeth are anti-and bright. improve that lateral appearance of the patient. (2) the head cap J hook can lower the upper front tooth in the vertical direction to resist the pendulum effect in the process of recovering the front teeth; and meanwhile, the lower level of the high-angle patient is controlled, The jaw is rotated clockwise. (3) After the orthodontic tooth extraction, the soft tissue is also compensated, and the upper and lower lips follow the amount of the tooth in the incisor. (4) The J-hook and the implant can be well controlled in the sagittal direction when the reinforcing brace is enhanced, but the J-hook is in the vertical direction
【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】
相關(guān)期刊論文 前10條
1 謝永建,王大為,林界偉,盧新華,何旭順;雙頜前突畸形正畸治療后顱面硬組織變化的研究[J];華西口腔醫(yī)學(xué)雜志;2004年05期
2 付昌平;馬平生;;J鉤配合方絲弓技術(shù)矯治安氏Ⅱ類1分類錯鉭[J];中外醫(yī)療;2008年24期
3 田存美;J形鉤在固定正畸中的應(yīng)用[J];交通醫(yī)學(xué);2003年05期
4 伍妍;吳中興;;露齦微笑病因的研究進展[J];口腔頜面外科雜志;2009年04期
5 王云，許天民;軟組織側(cè)貌的美學(xué)指標(biāo)[J];口腔正畸學(xué)雜志;1994年03期
6 伍軍,吳建勇;安氏Ⅱ~1類錯鉭上頜尖牙遠中移位后切牙及磨牙位置變化的研究[J];口腔正畸學(xué);2001年02期
7 曹偉清;陳文靜;郭玉杰;;J鉤牽引方向?qū)ι项M切牙牙周膜初始應(yīng)力影響的三維有限元分析[J];口腔醫(yī)學(xué);2011年11期
8 陳斯軍;浦路明;李青奕;陳文靜;;J鉤配合直絲弓技術(shù)矯治安氏Ⅱ~1錯鉭[J];口腔醫(yī)學(xué);2011年12期
9 李琥,李強,牟永斌;J鉤配合滑動直絲弓技術(shù)矯治安氏Ⅱ~1錯鉭[J];東南大學(xué)學(xué)報(醫(yī)學(xué)版);2003年06期
10 胡小坤;穆錦全;彭輝;王晴竹;陳文靜;;下頜J鉤高位牽引配合改良MEAW技術(shù)矯治骨性Ⅲ類錯鉭的臨床研究[J];南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版);2010年10期
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