改良式Activator矫治器矫治儿童前牙反

乳牙期及替牙期前牙反是儿童常见错畸形,前牙反的早期矫治具有重要意义。作者在临床中采用改良式Activator矫治器治疗23例乳牙期前牙反,它制作简单,戴用舒适,患儿易配合,矫治效果良好,疗程短。现介绍如下:材料与方法1、临床资料23例乳牙期、替牙期前牙反患者,男性11例,女性12例,年龄3-10岁;乳牙期患者18例,替牙期患者5例;其中有家族遗传史的5例。临床检查:上下前牙均排列整齐,乳牙期患者前牙————　反,替牙期患者6　66　6　为近中关系,21　1221　12　　反,下颌可退至前牙对刃。2、矫治器的制作改良式Activator由诱导丝,腭…     

正畸2×4 技术配合Ⅲ类牵引(牙合)

前牙反(牙合)是一种儿童常见的错牙合畸形,并且随患者的生长发育,症状逐渐加重,易发展成为骨性前牙反牙合,早期矫治尤为重要,以便阻断错牙合畸形的继续发展.本文应用"2×4"技术("2"代表两个磨牙带环,"4"代表4 个切牙粘结托槽)配合Ⅲ类颌间牵引矫治替牙期前牙反牙合取得满意的疗效.     

乳替牙期前牙反牙合的早期矫治原则

前牙反牙合是乳替牙期常见的错牙合畸形,是安氏Ⅲ类错牙合畸形的主要症状之一,也是儿童口腔医生常常需要面对的临床问题。安氏Ⅲ类错牙合前牙反牙合有骨性和非骨性之分,其鉴别诊断对前牙反牙合的治疗及预后判断具有重要意义。乳牙期常用的前牙反牙合治疗技术包括乳尖牙调牙合、咬翘法、下颌联冠斜面导板、上颌牙合垫舌簧矫治器及不良习惯去除。上颌前方牵引治疗是替牙期最为常用的前牙反牙合矫治技术。随着上下颌骨生长发育的不断进行,前牙反牙合可能会出现加重或复发。     

正畸2×4技术配合Ⅲ类牵引矫治替牙期前牙反

前牙反牙合是一种儿童常见的错牙合畸形 ,并且随患者的生长发育 ,症状逐渐加重 ,易发展成为骨性前牙反牙合 ,早期矫治尤为重要 ,以便阻断错牙合畸形的继续发展。本文应用“2× 4”技术(“2”代表两个磨牙带环 ,“4”代表 4个切牙粘结托槽 )配合Ⅲ类颌间牵引矫治替牙期前牙反牙合取得满意的疗效。1　材料和方法1.1　一般资料替牙期前牙反牙合 2 6例 ,男 11例 ,女 15例 ,年龄 7～ 11岁。前牙反覆盖 2～ 3 .5mm ,反覆牙合 2～ 5mm ,磨牙近中关系或偏近中关系。1 2　矫治方法在第一磨牙上粘带环 ,切牙粘方丝弓托槽。可先用0 3 6mm ( 0 .0 14英…     

儿童替牙期常见错畸形的防治进展

儿童替牙期错畸形发病率高,错发生的形式多样,对患儿颌面发育影响大,最佳矫治时机不易确定。该文对近年来临床上儿童替牙期错畸形的矫治时机及防治作一综述。     

上海市浦东新区青少年错牙合畸形调查分析

目的了解上海市浦东新区生长发育期青少年错牙合畸形的患病情况，重点了解牙列拥挤、前牙深覆合覆盖和前牙反牙合的患病率。方法按Ａｎｇｌｅ分类法进行分类，以个别正常牙合和错牙合分类为标准。结果错牙合畸形的患病率替牙期为４４．０２％，恒牙期为４８．７８％。牙列拥挤、前牙深覆合覆盖和前牙反牙合的患病率替牙期分别为２２．７４％、１７．１８％和４．４４％；恒牙期分别为３２．３６％、１１．０６％和４．０７％。结论上海市浦东新区生长发育期青少年错牙合畸形的患病率替牙期与恒牙期无明显差异。提示前牙深覆合覆盖和前牙反牙合的患者并伴有上下颌骨异常需尽早矫治，以改善牙合颌关系。     

头帽－颏兜矫洽乳前牙反合

本文介绍了笔者运用头帽－颏兜矫治乳牙期和替牙早期的前牙反病例的体会。分析了乳前牙反矫治后复发的因素;探讨了头帽－颏兜牵引矫治下颌前移型乳前牙反　的机理;提出了乳牙期前牙反　可分牙型和下颌前移型。强调尽可能在乳牙期矫治前牙反　,以阻断颌骨畸形的发展,诱导儿童颅、颌、面的正常发育。介绍了运用布替代自凝塑料制作颏兜的具体方法。     

口腔正畸学

方丝弓矫治技术中人宇型唇弓的临床效果评价,交互牵引在矫治替牙期前牙浅覆[牙合]反[牙合]中的临床应用，十堰地区错黯畸形患者Bolton指数的测量，远中错黯畸形的Moyers分粪，改良型Twin-block矫治安氏Ⅱ类Ⅰ分类错[牙合][编者按]     

替牙期儿童反伴牙列拥挤的早期矫治

本文通过对替牙期儿童前牙反且拥挤病例的临床矫治,总结了固定及活动矫治器应用于替牙期反伴拥挤畸形的矫治效果,并对矫治预后做了5个月到24个月的临床观察,结果说明利用生长发育潜力,早期矫治替牙期反,纠正已发生的能导致颌骨发育异常的畸形因素,利于上下颌骨正常的生长发育和良好面形的形成.     

口腔正畸2×4矫治技术及临床应用

目的 :探讨 2× 4矫治技术对替牙期的各类错的矫治。方法 :运用 2× 4矫治技术通过在弓丝上弯制V形曲产生的不同力学系统 ,治疗安氏Ⅱ类 1分类错、前牙反。结果 :V形曲位置的改变可导致前后牙受力方向的改变 ,正确应用V形曲产生的力系统对替牙期安氏Ⅱ类 1分类错、前牙反可取得良好疗效。结论 :2× 4矫治技术是矫治替牙期错的有效方法     

Effects of nonnutritive sucking habits on occlusal characteristics in the mixed dentition

PURPOSE: Little is known about the extent to which nonnutritive sucking habits contribute to malocclusion in the mixed dentition. The purpose of this study was to report on the relationship between certain occlusal traits in the mixed dentition and longitudinal sucking behaviors. METHODS: Dental examinations were conducted on 630 children in the mixed dentition who participated in a large, ongoing longitudinal study. Five hundred eighty consented to impressions, and 524 adequate study models were obtained. Of these, 444 also had adequate longitudinal nonnutritive sucking data obtained via mailed questionnaires to parents at 3- to 6-month intervals from birth to 8 years. Sucking behaviors were grouped by predominant type and duration. Study models were hand articulated using wax bites to evaluate the occlusion for the presence of open bite, crossbite, molar relationship, and excessive overjet. Bivariate statistical analyses related presence of these malocclusions to sucking duration and type. RESULTS: Fifty-five percent of the children had malocclusions (anterior open bite, posterior crossbite, bilateral Class II molar relationship, or overjet >4 mm). Class II molar relationship was most common (30%). Overall, anterior open bite and posterior crossbite was associated with habits of 36 months or more. Sustained pacifier habits, including those of 24 to 47 months, were associated with anterior open bite and Class II molar relationships, while digit habits were associated with anterior open bite when sustained for 60 months or longer. CONCLUSIONS: Malocclusions are quite prevalent in the mixed dentition, and anterior open bite and posterior crossbite may be preventable by modifying nonnutritive sucking behaviors.     

Interrelation between Occlusal Findings and Orofacial Myofunctional Status in Primary and Mixed Dentition

AIM: It was the purpose of this study to analyze the relationship between selected types of malocclusion and specific types of static and dynamic orofacial dysfunction and to compare the results with subjects presenting regular occlusion. We aimed to identify which orthodontic and functional symptoms in early dentition would lead to malocclusion later on. SUBJECTS AND METHODS: Occlusal relations and myofunctional status were evaluated in 3,041 children. We diagnosed dynamic and static myofunctional disorders as well as oral habits by means of functional examinations. RESULTS: No orofacial dysfunctions were found in 11.2% of the children with primary dentition and in 10.2% of the children with early mixed dentition. We observed no correlation between the existence of distoclusion and functional disorders. Lateral crossbite in mixed dentition, as well as increased overjet and frontal open bite in primary and early mixed dentitions appeared significantly more frequently in children with orofacial dysfunctions. Individuals with frontal open bite, lateral crossbite, reduced and increased overjet presented static dysfunctions significantly more frequently than those in dentitions with normal occlusion. Dynamic dysfunctions were significantly more prevalent in subjects with frontal open bite and lateral crossbite than in those with normal occlusion. CONCLUSIONS: Our results enable us to prognosticate which children risk future orthodontic problems. Any child presenting one of the four occlusal disorders plus one static or two dynamic dysfunctions is a child more likely to develop orthodontic problems later on. Orthodontic prevention and early treatment must include functional rehabilitation so as to eliminate or at least diminish those factors causing undesirable developments.     

Indication for and Frequency of Early Orthodontic Therapy or Interceptive Measures

The early treatment of nonskeletal and skeletal orthodontic anomalies in the deciduous and early mixed dentition is intended to prevent the development of pronounced anomalies in the late mixed and permanent dentition with the ultimate aim of reducing or even eliminating the need for later orthodontic treatment. There is a general consensus in the international literature that early therapy is indicated in cases of anterior and lateral crossbite and Class III malocclusion, and possibly for extreme forms of mandibular retrognathism (overjet > or =10 mm) and of open bite. However, evidence of the efficiency of early orthodontic measures is just as rare as studies providing serviceable information on the incidence of tooth malalignments and malocclusions in the deciduous and early mixed dentition, some of whose findings are in any case highly divergent. This makes it substantially more difficult to draw conclusions on the extent to which early orthodontic therapy may be indicated. In order to obtain information on the incidence of nonskeletal and skeletal orthodontic problems constituting a treatment need, 2326 first-year schoolchildren aged between 6 and 7 years were examined in Frankfurt am Main and in the Rural District of Offenbach. In only 14.7% of the children were no relevant orthodontic findings recorded. 77.2% displayed mild to severe dysgnathic symptoms, though without early orthodontic therapy being considered indicated. Treatment with orthodontic appliances was considered urgent for 187 of the children (8.04%). With 8.3% and 7.9% respectively, lateral and anterior crossbite were top of the list of anomalies with an urgent treatment need. Among the patients with lateral crossbite, the prognostically less favorable unilateral form was recorded approximately four times more often than the bilateral form. Markedly increased sagittal overjet > or =10 mm) was registered in only 1.4% of the children, and negative overjet (Class III) (with the exception of edge-to-edge bite) in 1.9%. Extreme anterior open bite > or =6 mm) was recorded in only two children (0.09%). In 19.6% of the children, a supporting zone was reduced in at least one quadrant, necessitating interceptive measures such as the insertion of a space maintainer or later orthodontic treatment (space opening or extraction therapy).     

Masticatory muscle thickness, bite force, and occlusal contacts in young children with unilateral posterior crossbite

Few investigations have evaluated the characteristics of functional and structural malocclusion in young children. Thus, the aim of this study was to assess the ultrasonographic thickness of the masseter and anterior portion of the temporalis muscles, the maximum bite force, and the number of occlusal contacts in children with normal occlusion and unilateral crossbite, in the primary and early mixed dentition. Forty-nine children (26 males and 23 females) was divided into four groups: primary-normal occlusion (PNO), mean (PNO) age 58.67 months; primary-crossbite (PCB), mean age 60.50 months; mixed-normal occlusion (MNO), mean age 72.85 months; and mixed-crossbite (MCB), mean age 71.91 months. Thickness was evaluated with the muscles at rest and during maximal clenching, and comparison was made between the right and left side (normal occlusion), and between the normal and crossbite side (crossbite). The results were analysed using Pearson's correlation, paired and unpaired t-test, and Mann-Whitney ranked sum test. The anterior temporalis thickness at rest was statistically thicker for the crossbite side than the normal side in the MCB group (P = 0.0106). A statistical difference in bite force and the number of occlusal contacts was observed between the MNO and MCB groups, with greater values for the MNO subjects (P < 0.05). Masseter muscle thickness showed a positive correlation with bite force, but the anterior temporalis thickness in the PCB and MCB groups was not related to bite force. Masticatory muscle thickness and bite force did not present a significant correlation with occlusal contacts, weight, or height. It was concluded that functional and anatomical variables differ in the early mixed dentition in the presence of a malocclusion and early diagnosis and treatment planning should be considered.     

Influence of orthodontic treatment in the primary dentition upon development of the dentition and craniofacial growth

Thirty patients who underwent orthodontic treatment of the primary dentition were examined in this retrospective follow-up study. The mean age at the beginning of treatment was 4.4 (±1.1) years, and at follow-up 15.4 (±1.7) years. Different kinds of malocclusion were present.—Results: The early treatment lasted on average 12.3 (±7.2) months. Treatment time of Class III malocclusion and lateral crossbite was significantly shorter than that of Class II,1 malocclusion, functional Class II,2 malocclusion or anterior open bite (p<0.05). A Class I occlusion was achieved in 90% of the patients during treatment of the primary dentition. No patient treated successfully in the primary dentition showed any relapse to initial malocclusion.—Conclusion: These results suggest that changes in occlusion and mandibular position during treatment in the primary dentition are maintained in the mixed and permanent dentition. It can be concluded that a Class I occlusion following orthodontic treatment in the primary dentition serves as a basis for physiological development of the dentition and craniofacial growth.     

昆明市乳牙列错畸形发病率的调查研究

目的 了解云南省昆明市市区乳牙列错情况,为乳牙期错畸形的预防性和阻断性矫治提供依据.方法 对昆明市市区3所幼儿园的乳牙全萌出且达到接触的2 116名乳牙列儿童进行调查,计算其错畸形发病率.结果 在2116名乳牙列儿童中,错1 516名,错率72％.排列在错前6位的依次是:深覆、牙列拥挤、前牙反、切、乳牙早失、开.结论 昆明市市区乳牙列错率的数据报告显示其发病率较高,需加强乳牙列错畸形的防治.     

Temporomandibular joint dysfunction and occlusion in the mixed and permanent dentition

The aim of this study was to investigate the relation between occlusal factors: Angle classification, overbite, overjet, openbite, anterior and posterior crossbite, scissors bite or buccal crossbite and lateral openbite--and the presence of mandibular dysfunction in a sample of 359 Turkish children with mixed and permanent dentition. Z Test was used to compare the results. It was found that, Class III malocclusion in the permanent dentition and openbite, overbite = 0, overjet = 0, anterior-posterior crossbite in the mixed dentition were related with TMD.     

Prevalence of malocclusions in the early mixed dentition and orthodontic treatment need

Early interceptive treatment for the elimination of factors inhibiting dental arch development and mandibular and maxillary growth is applied varyingly by orthodontists, possibly because there is little scientific evidence that such interventions are of actual benefit. The aim of this study was to determine specific factors for treatment need in the early mixed dentition period in order to obtain basic data to support early intervention. The study was part of a larger survey of 8768 children aged between 6 and 17 years. From this sample, 1975 children aged between 6 and 8 years were used to estimate the prevalence of malocclusions using the Index of Orthodontic Treatment Need (IOTN) during the early mixed dentition period. The results showed that deep overbite and overjet, both more than 3.5 mm, were the most frequent discrepancies, affecting 46.2 and 37.5 per cent of patients, respectively. An anterior open bite was registered in 17.7 per cent, crossbite in 8.2 per cent, and a reverse overjet in 3.2 per cent. A tooth width to arch length discrepancy was recorded in 12 per cent of teeth in the upper arch and in 14.3 per cent in the lower arch. The proportion of children estimated using the Dental Health Component of the IOTN to have a great or very great treatment need (grades 4 and 5) was 26.2 per cent. The higher values of treatment need during the mixed dentition period may account for temporary changes in the dentition and for the discrepancy in overjet and overbite. These discrepancies will be compensated in part during mandibular growth and development of the dental arch. Nevertheless, the findings indicate the early development of progressive malocclusion symptoms which are evidenced in the IOTN and concur with the acronym 'MOCDO' hierarchy (missing, overjet, crossbite, displacement, overbite). This early formation of progressive symptoms inhibiting or disturbing mandibular or maxillary growth or the development of the normal dental arch, i.e. crossbite, reverse overjet and increased overjet with myofunctional disorders, should be treated at an early stage.     

成都市城郊地区乳牙列错及其分布的横断面调查

目的　了解成都市城郊地区乳牙列错情况,为乳牙列期错的预防性及阻断性矫治提供依据。方法　 对成都市双流县华阳镇幼儿园的乳牙全萌且达到接触的1 279名乳牙列儿童进行调查,计算其错率。结果　 1 279名乳牙列儿童中,错491名,错率38·38%,排列在错前5位的依次是:深覆、前牙反、切、乳牙早 失、融合牙。结论　成都市城郊地区乳牙列错率较高,需进一步作好乳牙列错的预防性及阻断性矫治工作。