微螺钉种植体支抗推磨牙向后的临床研究

目的研究临床上微螺钉种植体作为强支抗在推磨牙向远中的治疗效果。方法选取10例AngleⅡ类重度拥挤的患者作为研究对象,采用双侧颊侧植入微螺钉种植体作为强支抗远移上颌磨牙,施力为2.45～2.94N。在治疗前后拍摄头颅侧位片,测量上颌第一磨牙在矢状向的位置变化。取研究模型,通过三维扫描仪及测量软件测量上颌磨牙的三维方向的变化,进行统计学分析。结果所有病例都达到了预期的矫治效果,磨牙中性关系、面型得到了较好的改善。上颌第一磨牙平均向远中移动3.58±0.87mm;上颌磨牙的压低、颊倾、远中倾斜治疗前后均无显著性差异。结论微螺钉种植体作为强支抗,能成功远移上颌磨牙,没有出现支抗丧失,是非常有效的非依从性远移磨牙的方法。     

种植体支抗及口外弓推磨牙向后的临床效果比较

目的观察种植体支抗推磨牙向后的临床效果并与口外弓推磨牙进行比较。方法选择恒牙初期牙列轻中度拥挤患儿16例,男5例,女11例,年龄8~11岁,随机分成A、B2组,A组采用种植体支抗,植入位置在两前磨牙间或第二前磨牙与磨牙之间根方,4周后加力;B组用头帽口外弓,4周后力值恒定为2.94~3.92N。结果B组有1例患儿因不合作,治疗7个月后停止口外弓改为拔牙矫治,其余均在治疗10个月后基本达预期效果;A组患者在治疗后3~6个月均达预期效果,且下牙轴较治疗前直立,ANB角改变,面型更和谐。结论2组均有不同程度的矫形变化;采用种植体支抗推磨牙组临床疗效、各项指标均好于口外弓组,头影测量分析差别无显著性,但种植体支抗组不依赖于患者配合,疗效迅速。     

Clinical study of correction of ClassⅡdivision 1 malocclusion with improved mandibular lip bumper in mixed dentition

Objective To evaluate the early treatment effects of improved mandibular lip bumper on patients with Angle Class Ⅱ,Division 1 malocclusion in mixed dentition.Methods According to inclusion criteria of the study,six patients with Angle Class Ⅱ,Division 1 malocclusion in mixed dentition were selected and treated with improved mandibular lip bumper and maxillary removable appliance.Cephalometric analysis was performed before and after treatment.Resuits The improved appliance could stimulate the growth of mandible.After treatment,overjet and molar relationship improved.Conclusions The improved mandibular lip bumper can interrupt lip-biting and is helpful to achieve growth modification in treating Class Ⅱ,Division 1 malocclusion.     

颧牙槽嵴处植入微螺钉种植体在支抗推上磨牙向远中移位中的效果

目的:探讨颧牙槽嵴处植入微螺钉种植体在支抗推上磨牙向远中移位中的效果。方法:52例轻中度安氏Ⅱ类畸形患者随机分为颧牙槽嵴处植入组(A组)和上颌第一磨牙颊侧根部与第二前磨牙之间植入组(B组)。记录两组患者种植成功率情况,分析两组患者治疗前和矫正后头颅定位侧位片。结果:两组患者治疗前后头颅定位侧位片测量指标差值SNA、SNB、ANB、U6-Y、U1-Y和SN-OP差异均无统计学意义(P>0.05),两组患者治疗前后U6-X、U1-X和SN-MP差异均具有统计学意义(P<0.05);A组患者初次种植成功率100.0%,高于B组的88.9%,但差异无统计学意义(P>0.05),A组推磨牙所需时间短于B组,A组磨牙移动速度和磨牙移动距离均大于B组,差异均具有统计学意义(P>0.05)。结论:颧牙槽嵴处植入微螺钉种植体效果更佳,更有利于垂直向压入磨牙及对抗切牙唇倾,可加快支抗推上磨牙向远中移位速度,缩短恢复时间。     

种植体支抗对高角拔牙病例垂直向控制的颌（牙合）面改变

目的探索以微螺钉种植体支抗压低磨牙对高角拔牙病例进行后牙垂直向控制的临床应用。方法20例矢状骨面型Ⅰ类或Ⅱ类的高角拔牙病例,采用MBT直丝弓矫治技术,于第一、第二磨牙间颊侧植入MAS微螺钉种植体作为垂直向支抗对磨牙实施持续轻力压低,同时微螺钉也作为矢状向支抗结合滑动法回收前牙。结果治疗后X线头影测量分析结果显示：上颌磨牙平均压低2．27mm; MP／SN角平均减小2．8°,SNPo角平均增加1．34°;面角（NsPos／FH）角平均增加3．18°;差异均有统计学意义（P〈0．001）。结论微螺钉种植体支抗压低磨牙能够为高角拔牙病例提供有效的后牙垂直向控制,患者软组织侧貌显著改善。     

微螺钉种植体支抗对高角非开拔牙病例后牙垂直向控制的临床初步研究

目的初步探索采用微螺钉种植体支抗压低磨牙对高角非开[牙合]拔牙病例进行后牙垂直向控制。方法7例矢状骨面型Ⅰ类或Ⅱ类的高角非开[牙合]病例，减数双尖牙矫治，MBT直丝弓矫治技术，上下颌第一、二磨牙间植入MAS微螺钉种植体作为垂直向支抗对磨牙实施持续轻力压低，结合摇椅弓控制前牙覆[牙合]，种植体同时也作为矢状向支抗用于滑动法回收前牙。结果所有患者拔牙间隙全部关闭后的治疗结果显示：上颌磨牙平均压低2．43mm，MP／SN角平均减小3．35°，差异具有极显著性（P〈0．001）；下颌磨牙平均压低1．79mm，前牙覆[牙合]平均减小2．63mm，差异均具有显著性（P〈0．01）。结论微螺钉种植体支抗压低磨牙可以作为一种新的垂直向控制手段为高角非开[牙合]拔牙病例提供有效的后牙垂直向控制。     

微螺钉种植体支抗在牙性殆平面倾斜矫治中的临床应用

目的：探索微螺钉种植体支抗在牙性殆平面倾斜矫治中的临床疗效。方法：13例牙性殆平面倾斜病例,在牙齿伸长最严重部位的牙根间膜龈联合处颊侧植入微螺钉种植体,以橡皮圈作为力源,利用持续轻力（80g／牙）对牙齿进行垂直向调整,纠正倾斜的胎平面。结果：13例患者均表现出良好且稳定矫正效果,较好地矫治了倾斜的胎平面。结论：微螺钉种植体支抗能够有效矫正牙性耠平面倾斜,明显改善患者的面型。     

Changes of occlusal function in patients with Class Ⅱ division 1 malocclusion after orthodontic therapy

Objective To investigate the change of occlusal function of patients with Class Ⅱ division 1 malocclusion after orthodontic therapy. Methods T-scan Ⅱ was used in 26 orthodontic patients with class Ⅱ division 1 malocclusion. Bite force, occlusal contacts were measured before,during and after orthodontic therapy. The data of total occlusal force (TOF), asyrmmetry index of occlusal force (AOF), number of occlusal contacts (NOC), asymmetry index of occlusal area (AOA),center of force (COF), maximal movement of COF(MMCOF) and occlusal interference index (OII)were recorded. Results Compared with pre-orthodontics, the TOF and NOC during treatment were smaller, while the TOF and NOC were higher after treatment(P＜0. 05). AOF, AOA, COF,MMCOF and OII were significantly decreased (P＜0. 01 )after orthodontic treatment. Conclusions Total occlusal force and occlusal contacts were improved in Class Ⅱ patients after orthodontic treatment.     

微种植体支抗推磨牙向远中移动的临床应用

目的 评价2种推磨牙向远中移动支抗装置的临床疗效。方法 选择30例因上颌磨牙前移所致的安氏Ⅱ类错牙合畸形患者,随机分为2组：微种植体支抗结合磨牙推进器组（A组）和Nance腭托支抗结合磨牙推进器组（B组）。对矫治开始之前与磨牙远移到位后的头颅定位侧位片以及磨牙远移速率进行比较,评价磨牙远移后颅面硬组织变化的结果。结果 A组与B组治疗前后SNA、SNB、ANB值变化量均无明显差异;B组U1-NA、U1-SN值在治疗前后变化量均较A组大;2组在磨牙移动距离上无明显差异(P>0.05);但A组月平均移动速率明显大于B组。结论 初步临床观察表明应用微种植体支抗推磨牙向远中移动能更好地控制支抗,移动速率快,异物感小,易清洁,治疗效果更佳。     

Skeletal and dental features of extraction cases in the second phase of two-phase treated Class Ⅱ malocclusion

Objective To investigate the skeletal and dental features of extraction cases in the second phase of two-phase treated Class Ⅱ malocclusion. Methods Twenty-one two-phase treated Class Ⅱ cases with satisfied treatment results were chosen (11 extraction cases and 10 non-extraction cases). The sagittal skeletal pattern, vertical skeletal pattern, incisors' position and overjet were examined from cephalograms before treatment (T0), at the end of phase Ⅰ treatment (T1) and at the end of phase 2 treatment (T2). Results (1) There was no difference in skeletal and dental factors between extraction and non-extraction groups before treatment (T0) (P ＞ 0. 05). (2) In nonextraction group, improvement of Wits in the first phase was significant than that in extraction group (P＜0. 05). SNB increased and wits decreased significantly in the second phase of treatment in nonextraction group (P＜0. 05), which indicated favorable growth pattern. (3) MP-SN was reduced approaching statistical significance (P=0. 052) in extraction group in the second phase of treatment.(4) In the first-phase treatment, reduction of U1-NA was significant in non-extraction group (P＜0. 05). (5) In the first-phase treatment, LI-NB was significantly increased (P＜0. 001) in extraction group. (6) The overjet at the end of treatment (T2) was less in extraction group than that in non-extraction group, which indicated over-correction. Conclusions (1) Decision can not be made only according to the skeletal and dental factors before treatment. (2) Extraction and over-correction in the second phase may be considered for those cases which show limited improvement of sagittal skeletal pattern after the first phase of treatment. (3) Extraction may be considered if upper incisors are not much retracted while lower incisors are much proclined during the first-phase treatment. (4)Extraction in the second phase may be considered for cases with vertical growth pattern, which could benefit vertical control and achievement of balanced Tweed triangle by lower incisors' retraction.     

Analysis of second mesiobuccal root canal instrumentation in maxillary first molars with three nickel–titanium rotary instruments: a micro-computed tomographic study

Odontology - The aim of this study was to evaluate the shaping characteristics of Protaper Universal (PTU; Dentsply Tulsa Dental Specialties, Johnson City, TN), Hero Shaper (HS; MicroMega, Besacon,...     

Clinical study of restoration of bone defect in cleft alveolus with β-tricalcium phosphate

目的 采用颗粒状β-磷酸三钙(β-TCP)修复牙槽嵴裂,观察其临床效果,探寻一种理想的可代替自体骨修复牙槽嵴裂的人工材料.方法 将24例先天性牙槽嵴裂患者分成A、B两组,A组 (10例)用自体骼骨松质骨修复牙槽嵴裂骨缺损,B组 (14例)用颗粒状β-TCP修复牙槽嵴裂隙.术后7天观察两组患者伤口愈合情况,并于术前、术后4~6个月,采用锥形束CT(CBCT)及三维重建的方法观察牙槽嵴裂骨缺损新骨形成的情况,比较两种植骨材料的植骨效果.结果 术后1周,A组1例患者出现感染症状,其余患者伤口均一期愈合,无感染、裂开及排异反应.术后4~6个月CBCT扫描及三维重建显示两种材料植入后均可形成新骨,与原裂隙两侧骨组织部分或完全连续.两种材料修复牙槽嵴裂骨缺损的临床成功率无显著差异.结论 颗粒状人工材料β-TCP的成骨效果与自体骼骨骨松质无显著差异,可以代替自体骨修复牙槽嵴裂.     

Clinical effects of Angle's Ⅱ1 cases in Alignment with Incognito System

Objective The aim is to reveal the dentofacial changes of Angle Ⅱ1 cases during alignment phase using Incognito lingual orthodontic appliance. Methods Nineteen patients (8 Male and 11 female, aging from 12y to 23y) with Angle Ⅱ1 malocclusion were selected for lingual orthodontic treatment with four premolars extraction. Customized lingual orthodontic appliance (IncognitoTM) was used. Cephalometric radiographs and alginate impressions were taken before treatment and at the end of alignment. The comparison between pre-treatment and post-alignment were analyzed by Paired-Sample Wilcoxon Signed Rank Test through SPSS Statistical Package.Results From the Cephalometric analysis, the following changes were found significantly different (P＜0.05). U1/SN decreased 7.70°. U1/NA decreased 7.94°with 2.85 mr. L1/NB decreased 4.60°with 1.8mm. MP/SN increased 1.52°. L6-MP increased 0.51 mm. L1-MP decreased 1.29mm. OB decreased 1.18mm. From the model analysis, the following changes with significant differences were demonstrated. Upper and lower intercanine widths and lower intermolar widths increased 2.39mm,2.60mm and 1.26mm respectively. Upper arch depth from molar to incisor decreased 2.42mm. The curve of spee became shallow by 1.11mm. Conclusion During alignment phase, the upper and lower incisors tipped lingually with profile improved. The overbite decreased with lower incisors intruded, and the lower molars extruded with mandibular plane angle increased. It implied that lingual appliance would be helpful for lower angle cases with deep overbite, and cautions should be taken from the initial phase during lingual orthodontic treatment in high angle cases.     

Clinical effects of Angle's Ⅱ1 cases in Alignment with Incognito System

Objective The aim is to reveal the dentofacial changes of Angle Ⅱ1 cases during alignment phase using Incognito lingual orthodontic appliance. Methods Nineteen patients (8 Male and 11 female, aging from 12y to 23y) with Angle Ⅱ1 malocclusion were selected for lingual orthodontic treatment with four premolars extraction. Customized lingual orthodontic appliance (IncognitoTM) was used. Cephalometric radiographs and alginate impressions were taken before treatment and at the end of alignment. The comparison between pre-treatment and post-alignment were analyzed by Paired-Sample Wilcoxon Signed Rank Test through SPSS Statistical Package.Results From the Cephalometric analysis, the following changes were found significantly different (P＜0.05). U1/SN decreased 7.70°. U1/NA decreased 7.94°with 2.85 mr. L1/NB decreased 4.60°with 1.8mm. MP/SN increased 1.52°. L6-MP increased 0.51 mm. L1-MP decreased 1.29mm. OB decreased 1.18mm. From the model analysis, the following changes with significant differences were demonstrated. Upper and lower intercanine widths and lower intermolar widths increased 2.39mm,2.60mm and 1.26mm respectively. Upper arch depth from molar to incisor decreased 2.42mm. The curve of spee became shallow by 1.11mm. Conclusion During alignment phase, the upper and lower incisors tipped lingually with profile improved. The overbite decreased with lower incisors intruded, and the lower molars extruded with mandibular plane angle increased. It implied that lingual appliance would be helpful for lower angle cases with deep overbite, and cautions should be taken from the initial phase during lingual orthodontic treatment in high angle cases.     

口腔正畸学

舌侧矫治上颌第-磨牙垂直向移动的有限元研究,安氏Ⅱ类错殆的牙冠宽度与Bolton指数的测量分析,正畸治疗中磨牙的拔除和保留（二十九）——拔除第一磨牙的矫治设计,微钛钉种植体支抗单侧推磨牙向后的临床应用,     

Immediate function dental implants inserted with less than 30 N·cm of torque in full-arch maxillary rehabilitations using the All-on-4 concept: retrospective study

The aim of this retrospective clinical study was to evaluate the short-term implant success rate and marginal bone loss in full-arch fixed prosthetic maxillary rehabilitations supported by implants in immediate function with the All-on-4 treatment concept placed with insertion torque of <30 N·cm or ≥30 N·cm. This study included 83 patients (69 female, 14 male) with 332 implants placed (120 inserted with <30 N·cm and 212 inserted with ≥30 N·cm) who were treated between January 2010 and March 2013. Outcome measures were implant success and marginal bone loss at 1 year of follow-up. Ten patients (12.0%; 13 implants inserted with <30 N·cm and 27 implants with ≥30 N·cm) were lost to follow-up. The cumulative implant success rate was 97.5% at the patient level, and 98.3% for implants inserted with <30 N·cm and 97.5% for implants inserted with ≥30 N·cm. The mean ± standard deviation marginal bone loss at 1 year was 1.14 ± 0.38 mm for implants inserted with <30 N·cm and 1.39 ± 0.49 mm for implants inserted with ≥30 N·cm (significant difference; P < 0.001, Wilcoxon signed rank test). These results indicate that implants with insertion torques of <30 N·cm may render comparable success rates and marginal bone loss at 1 year compared to implants inserted with insertion torques of ≥30 N·cm.     

The use of mineralized bone allograft as a single grafting material in maxillary sinus lifting with severely atrophied alveolar ridge (1–3 mm) and immediately inserted dental implants. A 3- up to 8-year retrospective study

Objective

The primary aim of our study was to evaluate the efficacy of mineralized bone allograft alone in sinus floor augmentation with simultaneous implant placement in cases with severe atrophy of the residual maxillary bone (bone height <?4 mm).

Methods

Thirty-five dental implants were placed in 29 patients who underwent sinus augmentation via traditional lateral window technique from 2008 to 2013. Patients with residual alveolar height between 1 and 3 mm at the site of implantation were included in the study. The height of residual bone was initially estimated by plain panoramic X-ray and reevaluated intraoperatively by precise micrometric measurement at the site of implantation. Implants of 13 mm height and 3.5 or 4.3 mm in diameter were inserted simultaneously. Mineralized bone allograft was used alone to augment the sinus floor.

Results

No wound dehiscence was recorded. In one case there was a postoperative site infection which subsided with antibiotics without implant failure. One implant migrated during the postoperative period to the maxillary sinus and was removed. One implant failed. The remaining 33 implants were successfully loaded. Follow-up ranged from 3 to 8 years.

Conclusions

Maxillary sinus lift in severely absorbed alveolar ridges with simultaneous implant placement could be safely performed using mineralized allograft alone, rendering the procedure less invasive and less time-consuming.