Spee曲线深度与牙颌面形态之间关系的研究

目的：探讨Spee曲线深度与牙齿以及颌面形态之间的关系。方法：对106例15~21岁患者的头颅侧位片及牙齿模型进行测量分析。按照Spee曲线深度不同分为3组,分析组间差异以及Spee曲线深度与其他变量之间的相关性。结果：3组间覆牙合,覆盖,下切牙、下颌第二磨牙的倾斜情况,前下面高以及前下面高与前面高之比的差异具有统计学意义。且Spee曲线越深,则覆牙合越深,覆盖越大,前下面高越小,下切牙越直立,下颌第二磨牙越前倾、高度越低,以及前下面高占前面高的比值越小。结论：Spee曲线深度与牙齿以及颌面形态之间均密切相关,在正畸诊断以及矫治设计时需要综合考虑。     

儿童和成人深覆牙合牙合颅颌形态的横断面研究

目的对儿童和成人深覆牙合患者的颅颌面形态进行横断面研究,分析其生长发育中颅颌形态变化的趋势,探讨成人深覆牙合患者的颅颌面形态特征。方法随机抽取Ⅲ度儿童深覆牙合患者159例（平均年龄12.47岁）,成人深覆牙合患者81例（平均年龄21.76岁）,个别正常对照组51例（平均年龄18.41岁）。采用Winceph 7.0软件对3组X线头影测量项目进行测量,采用SPSS 12.0软件进行统计学分析。结果儿童深覆牙合患者在上前面高、下前面高、上颌第一磨牙相对于上颌前部的位置、上颌骨长度、上下颌骨-平面距、上颌磨牙-腭平面距、下颌切牙-下颌平面距、上下齿槽座点平面-下颌平面角、下颌角、下颌切牙距、覆盖、下颌平面-前颅底平面角、下颌磨牙-下颌平面距、后面高、上颌切牙距、下颌体长度、下颌升支高度、平面-前颅底平面角、上颌中切牙-前颅底平面角与成人深覆牙合患者间差异有统计学意义。成人深覆牙合患者在下颌-前颅底平面角、上下颌骨-前颅底平面角、颌凸角、上下颌骨矢状向不调指数、上下颌骨垂直向不调指数、上下颌骨-平面距、上下齿槽座点平面-下颌平面角、下颌角、覆盖、下颌平面-前颅底平面角、上颌后部位置、下颌磨牙-下颌平面距、上颌中切牙-前颅底平面角、下颌体长度、下颌升支高度、后颅底长度、平面-前颅底平面角、后面高与正常个体间差异有统计学意义。结论深覆牙合患者随着年龄的增长,颅、颌、、面部仍表现有一定的生长潜力,但是患者颌骨矢状关系并无改善。成人深覆牙合患者颌面部特征表现为垂直向、矢状向关系显著不调。     

高角Ⅱ类开(牙合)患者上下颌前牙根长及中切牙冠根形态的锥形束CT研究

目的 探讨高角Ⅱ类前牙开(牙合)患者的上下颌前牙牙根长度及中切牙冠根形态,为临床正畸治疗提供参考。方法 本研究已通过单位伦理委员会审查批准,并获得患者知情同意。对81例高角Ⅱ类患者（前牙开(牙合)40例、正常覆(牙合)41例）正畸治疗前的锥形束CT(cone-beam computed tomography,CBCT)图像进行分析,运用Dolphin软件对上下颌前牙的牙根长度以及中切牙冠根形态进行研究,并行统计学分析。结果 高角Ⅱ类开患者（开(牙合)组）与高角Ⅱ类正常覆患者（正常覆(牙合)组）的上颌尖牙和侧切牙牙根长度差异无统计学意义,但开(牙合)组上颌中切牙（11.12±1.37）mm、下颌中切牙（10.15±1.09）mm、下颌侧切牙（11.27±1.15）mm和下颌尖牙（12.81±1.48）mm的牙根长度均较正常覆(牙合)组短且差异均具有统计学意义（P<0.05）;另一方面,开(牙合)组的上颌中切牙冠根成角（1.10°±3.62°）显著小于正常覆(牙合)组（4.53°±2.30°）（P<0.01）,而开(牙合)组的下颌中切牙冠根成角与正常覆(牙合)组的差异无统计学意...     

基于锥形束计算机成像技术的骨性Ⅲ类错牙合下颌中切牙冠根形态特征分析

目的:通过锥形束计算机成像技术(Cone-beam computed tomography,CBCT)对骨性Ⅲ类错牙合下颌中切牙冠根形态进行分析,并探讨其与牙槽骨形态之间的关系.方法:从拍摄CBCT的患者中随机选取40例骨性Ⅲ类错牙合患者为实验组,个别正常牙合15例为对照组,并且将实验组根据下中切牙唇倾度不同分为舌倾组和直立组2个亚组,测量下颌中切牙冠根角、冠长、根长、冠根比和实验组牙槽骨形态,并对数据进行统计学分析.结果:(1)实验组冠根角小于对照组(P<0.01);(2)骨性Ⅲ类错牙合患者直立组冠根角小于舌倾组(P<0.01),直立组根长大于舌倾组(P<0.05);(3)骨性Ⅲ类错牙合患者冠根形态与牙槽骨形态有不同程度相关性(P<0.05).结论:骨性Ⅲ类错牙合患者下颌中切牙冠根成角明显,并且直立组和舌倾组中的下颌中切牙冠根形态存在显著差异;骨性Ⅲ类错牙合患者下颌中切牙冠根形态与牙槽骨形态有显著相关性.     

广东籍安氏Ⅱ类1分类错(牙合)青少年患者后牙牙槽骨高度与生长型的相关关系

目的 探讨安氏Ⅱ类1分类错(牙和)青少年患者后牙牙槽骨高度与生长型的相关关系.方法 选择广东籍安氏Ⅱ类1分类错(牙合)青少年患者50例,男女各25例,拍摄头颅定位侧位片,测量下颌平面角、前面高、后面高、前下面高、上颌后牙牙槽骨高度、下颌后牙牙槽骨高度、前后面高比等11项指标,与广东籍正常(牙合)人群进行比较,并进行多元相关回归分析.结果 11项指标在广东籍安氏Ⅱ类1分类错(牙合)青少年患者的男女差异没有统计学意义(P＞0.05);上、下颌平面角及垂直向异常指数(overbite depth indicator,ODI)大于广东籍正常(牙合)人群,上、下颌后牙牙槽骨高度及前后面高、前下面高、前后向异常指数(anteroposterior dysplasia indicator,APDI)比广东籍正常(牙合)人群小,差异有统计学意义(P＜0.05);后牙牙槽骨的高度与前下面高、后面高、前面高及前后面高比呈正相关(P＜0.05),与ODI、下颌平面角呈负相关(P＜0.05).结论 广东籍安氏Ⅱ类1分类错(牙合)青少年患者的后牙牙槽骨高度与下颌平面角、ODI、前面高、后面高、前下面高、前后面高比之间存在相关性,适当增加上下颌后牙牙槽骨的高度对矫治十分重要.     

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错牙合畸形伴深覆牙合病例中经常伴随Spee曲线异常。深Spee曲线会造成咀嚼肌失衡,严重可导致咬合功能障碍。正确理解Spee曲线概念以及整平Spee曲线的方法对于每位正畸医生均相当重要,且临床治疗中存在一定难度。本文对Spee曲线的发生发展、整平Spee曲线的方法以及影响因素做一系统性梳理,以助于正畸临床的诊断与治疗。     

Spee曲线口腔正畸学应用研究进展

错牙合畸形伴深覆牙合病例中经常伴随Spee曲线异常。深Spee曲线会造成咀嚼肌失衡,严重可导致咬合功能障碍。正确理解Spee曲线概念以及整平Spee曲线的方法对于每位正畸医生均相当重要,且临床治疗中存在一定难度。本文对Spee曲线的发生发展、整平Spee曲线的方法以及影响因素做一系统性梳理,以助于正畸临床的诊断与治疗。     

恒牙期前牙Ⅲ度深覆盖深覆牙合的拔牙疗效评价

目的 观察伴有上颌骨前突或牙列拥挤的恒牙期前牙Ⅲ度深覆盖深覆牙合方丝弓拔牙矫治的疗效.方法 对12例伴有上颌骨前突或牙列拥挤的恒牙期前牙Ⅲ度深覆盖深覆牙合患者,采用方丝弓技术进行矫治,均拔除4个第一前磨牙,部分患者加戴平面导板以解除深覆牙合,治疗前后对所有患者进行头影测量及模型分析.结果 12例患者治疗后覆盖覆牙合均达到正常,SNA减小1.6°,NP-FH增加1.5°,差异有显著性,NA-PA平均减少4.4°,ANB减小1.8°,差异有高度显著性.下颌Spee曲线与上颌补偿曲线明显整平.结论 本法矫治效果良好,深覆牙合的矫治是获得良好支抗控制的前提.     

下切牙先天缺失与牙颌畸形关系的分析研究

目的：探讨下恒切牙先天缺失情况及其与牙颌畸形的关系以及下尖牙近远中径的变化。方法：从962名门诊正畸病人中选取下颌恒切牙缺失的病例27名，并测量下前牙牙冠的近远中径。结果：下颌恒切牙先天缺失96％是中切牙，92％伴有前牙深覆He，下尖牙无显著性增大。结论：下颌中切牙先天缺失与前牙深覆He的形成有密切关系，下尖牙无代偿性增大。     

正常[牙合]青年前、后牙槽高度与垂直生长型的相关性分析

目的:研究正常殆青年前、后牙槽高度与垂直生长型的相关关系.方法:选取哈尔滨地区110例正常恒牙<牙合>样本,男女各55名,拍摄头X线颅侧位定位片,测量上颌平面角、下颌平面角、上下颌平面角、前面高、前上面高、前下面高后面高、后下面高、升支高度、ODI、ANB角、APDI、上下颌前后牙牙槽高度等17项指标,并进行多元相关分析.结果:上下后牙牙槽高度与TAFH、LPFH、TPFH、UAFH、RH、R成正相关,下后牙牙槽高度与PP-MP成负相关;前部牙槽高度与TAFH、LAFH等高度正相关.结论:前后牙牙槽高度与垂直生长型之间存在显著性相关,为正畸医生诊断和治疗设计提供依据.     

Components of adult Class II open-bite malocclusion

In an effort to identify the frequency and distribution of the dental and skeletal components of adult Class II malocclusion with and without open-bite, 124 adults, half of whom had an anterior open-bite, were evaluated. Significant differences (P less than 0.05) between the open-bite and non-open-bite groups were found for the following measurements: the posterior maxilla exhibited vertical excess in the open-bite group; the maxillary occlusal plane was less steep in the open-bite group; the mandibular occlusal plane was more steep in the open-bite group; the gonial angle was higher in the open-bite group; the mandibular plane angle was higher in the open-bite group; the mandibular ramus was positioned in a more downward and backward (clockwise) location in the open-bite group; the total and lower anterior facial height were increased in the open-bite group; and the mandible was less protrusive in the open-bite group. No significant intergroup differences were noted in the cranial base, the anteroposterior position of the maxilla or of the upper and lower incisors, the palatal plane, posterior facial height, mandibular ramus height, or mandibular body length. The results of this analysis indicate that the average Class II open-bite malocclusion is characterized by aberrations in both the maxilla and the mandible. Therapy, therefore, may frequently require surgical intervention in both jaws to successfully correct this deformity.     

Dentoalveolar compensation in Iranian adult skeletal open bite subjects

PurposeThe aim of present study was to compare skeletal and dentoalveolar features of compensated and noncompensated adult open bite subjects with each other and also with those of control group.Materials and methodsA total of 100 lateral cephalograms were included in the study and were divided according to skeletal vertical characteristics into two groups: control group (CG) and open bite group (OBG). The OBG further divided into two subgroups based on amount of overbite: dentally compensated open bite group (COBG) and non compensated open bite group (NCOBG). Twenty skeletal and dentoalveolar variables were evaluated and compared between OBG and CG and also between open bite subgroups by means of Student t-test. Association between different variables and overbite was assessed using Pearson's correlation coefficient.ResultsIncreased molar and incisor height in both jaws were observed in OBG compared to CG. In NCOBG lower anterior facial height and lower posterior dentoalveolar height were significantly higher than COBG.ConclusionDentoalveolar compensatory mechanisms in skeletal open bite patients consist of increased anterior and posterior dentoalveolar heights in upper and lower jaws compared to CG, while decreased mandibular molar height and shorter anterior face height are the most important determinants of adequate compensation in skeletal open bite subjects in our sample.     

Nonsurgical treatment of a hyperdivergent skeletal Class III patient with mini-screw–assisted mandibular dentition distalization and flattening of the occlusal plane

Treatment of hyperdivergent skeletal Class III malocclusion is challenging for orthodontists, and orthognathic-orthodontic treatment is usually required. This report presents the successful nonsurgical treatment of a 20-year-old man who had a skeletal Class III malocclusion with anterior open bite, anterior and posterior crossbite, hyperdivergent growth pattern, steep occlusal plane, early loss of three first molars, and an uncommon convex profile with a retruded chin. An orthodontic camouflage treatment plan was chosen based on the etiology and the patient''s complaints. Tooth #37 was extracted. Miniscrews were used for uprighting and intruding of the lower molars, distalization of the lower dentition, and flattening of the occlusal plane. After 34 months of active treatment, Class I relationships, proper anterior overjet and overbite, flat occlusal plane, and an esthetic facial profile were achieved. The results demonstrated that the biomechanics involved in the nonsurgical treatment assisted with miniscrews to distalize the mandibular dentition and flatten the occlusal plane while keeping the mandibular plane stable was effective for treating this hyperdivergent skeletal Class III patient with a convex profile and anterior open bite.     

Bite-bumper配合固定矫治器矫治内倾型深覆的临床研究

目的探讨Bite-bumper配合固定矫治器矫治内倾型深覆打开咬合的机制及临床使用要点。方法对14名生长发育期的内倾型深覆患者,采用Bite-bumper配合固定矫正技术打开咬合,观察其临床疗效,并通过X线头影测量比较治疗前和咬合打开后有关硬组织的变化。结果1）14例患者打开咬合的时间平均为28 d;2）咬合打开后,颌骨矢状向（SNA、SNB、ANB）的变化无统计学差异,前后面高（S-Go、ANS-Me）增加,前后面高比值（S-Go/N-Me）、下颌平面角（SN-MP）、Y轴（Y axis）的变化无统计学差异,上下前牙唇倾（U1-SN、L1-MP）、切牙间角（U1-L1）减小,后牙（U6-PP,L6-MP）伸高,上切牙（U1-PP）压低,覆（overbite）减小。结论Bite-bumper配合固定矫正技术矫治内倾型深覆可快速打开咬合,并可改善内倾型深覆患者的短面型。     

The bite force and craniofacial morphology in patients with acromegaly: A pilot study

Objectives: Acromegaly is a metabolic disorder caused by increased growth hormone secretion. As a consequence of acromegaly some typical craniofacial morphology changes appear. This pilot study was conducted to compare the bite force and the characteristic size and shape of the craniofacial components of acromegalic patients with the healthy Turkish individuals. In additon, the correlations between bite force and craniofacial morphology of patients with acromegaly and control individuals were evaluated. Study Design: The maximum bite force of the participants was recorded with strain-gage transducer. Lateral x-ray scans were made under standard conditions, in centric occlusion. On cephalograms, the linear and angular measurements was performed. Results: Patients with acromegaly showed increased anterior and posterior total face height, ramus length, width of frontal sinuse, gonial angle and a negative difference between maxillary and mandibular protrusions. In addition, females with acromegaly showed larger lower anterior face height and sella turcica, decreased facial angle, increased mandibular plane angle. The cephalometric measurements, except one did not showed correlation with the bite force in acromegalic patients. In control group, significant correlations were observed between anterior total face height and anterior lower face height, mandibular plane angle and gonial angle. Conclusions: The greater changes were observed in the mandible. The maximum bite force of patients with acromegaly showed no difference from healthy individuals. The non-significant difference of bite force between healthy participants and acromegalic patients provide important information for dental treatment and prosthetic rehabilitation of acromegalic patients. Key words:Acromegaly, bite force, cephalometric analysis, mandibular prognathism.     

Anterior open-bite malocclusion: a longitudinal 10-year postretention evaluation of orthodontically treated patients

Long-term response of the anterior open-bite malocclusion was evaluated in forty-one white subjects who had undergone orthodontic treatment and were out of retention a minimum of 9 years 6 months. The purpose of the study was threefold: (1) to make cephalometric comparisons between a sample of open-bite patients and a sample with normal cephalometric standards, (2) to evaluate treatment and posttreatment changes that occurred in treated open-bite patients, and (3) to search for predictors and associations of value. Changes occurring across time in the open-bite patients were analyzed by computer means using pretreatment, posttreatment, and long-term cephalometric radiographs and dental casts. An analysis of subgroups was reviewed to compare dentoalveolar and skeletal relationships of both stable and relapse groups. More than 35% of the treated open-bite patients demonstrated a postretention open bite of 3 mm or more, with the relapse subgroup demonstrating across-time, less mandibular anterior dental height, less upper anterior facial height, greater lower anterior facial height, and less posterior facial height. Neither the magnitude of pretreatment open bite, mandibular plane angle, nor any other single parameter of dentofacial form proved to be a reliable predictor of posttreatment stability.     

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目的了解排除了自然生长因素后,Twin—block矫治器治疗青少年安氏Ⅱ^1错（牙合）引起的硬组织改变,从而更为真实、准确地评价该矫治器的矫治效能。方法于2008年9月至2010年9月在河北医科大学附属口腔医院正畸科门诊选择30例手腕骨片为FG—G期的安氏Ⅱ^1下颌后缩患者。治疗组15例,平均年龄11．5岁,采用Twin—block矫正器治疗,平均治疗及保持时间14个月;对照组15例,平均年龄11岁,作为自然生长对照,平均观察时间13个月。对治疗及观察前后头颅X线侧位片的32项硬组织项目进行Pancherz测量分析,评价矫治疗效。结果排除了自然生长因素的影响,治疗组在采用Twin—block矫治器矫治后,下颌全长、升支高度及下颌体长分别净增加了4．95、4．03和1．67mm,SNB角（蝶鞍中心、鼻根点及下齿槽座点所构成的角）增加了2．39°;全面高、下面高及后面高均明显增加,但下颌平面保持稳定;上切牙舌倾、下切牙唇倾。在4．76mm的覆盖减少量和5．22mm的磨牙关系改善中,牙齿效应分别占61％和75％,骨骼效应占39％和25％。结论Twin—block矫治器使发育期安氏Ⅱ^1错（牙合）患者覆（牙合）覆盖、磨牙关系均得到改善,有效促进了下颌骨矢状方向上的生长发育,Ⅱ类骨面型趋于好转。     

Comparative cephalometric study of Class III malocclusion in Saudi and Japanese adult females

The cephalometric features of class III malocclusion in Saudi adult females were investigated and compared with reference data for Japanese females. The sample consisted of 30 standardized pre-treatment cephalometric radiographs of adult Saudi females diagnosed as having skeletal class III malocclusion. The radiographs were traced and digitized. Linear and angular variables were obtained for comparison of cranial base, maxilla, mandible, intermaxillary and dentoalveolar measurements. The method error in identifying and locating the anatomical landmarks was small and acceptable. Student's t-test was used for comparing the measurements. The results showed that Saudi females had a larger anterior cranial base, a smaller posterior cranial base, a smaller cranial base angle, smaller anterior and posterior facial heights, downward tipping of the maxilla, a retruded chin, a less steep mandibular plane, an increased joint angle, a smaller ramus, body and total mandibular length, and less retroclined mandibular incisors. The null hypothesis of no difference between the two groups was rejected. These results appear to suggest real differences in skeletal features between Saudi and Japanese adult females.     

Limitations in the surgical treatment of skeletal Class II deep bite malocclusions

The present article illustrates a treatment option for managing the skeletal Class II malocclusion complicated by a deep bite and short face in an adult and emphasizes the limitations of such an approach and its potential complications. The patient had an inadequate tooth display upon smiling and a deep lower curve of Spee. Treatment consisted of a double jaw surgery with a maxillary three-piece LeFort to expand, downgraft, and advance the maxilla and a bilateral sagittal split osteotomy to advance the mandible. Treatment was staged so that the leveling of the mandibular arch was completed postsurgically by extrusion of the mandibular buccal segments. During surgery, the mandible was rotated clockwise at the osteotomy site to bring the chin down. This treatment approach resulted in a dramatic increase in the lower facial height, as well as an improvement in skeletal and occlusal relationships, with a much improved tooth display upon smiling, despite the few complications that occurred.     

成人Ⅱ~1类错垂直骨面型特征的头影测量分析

目的:利用头影测量分析成人安氏Ⅱ1类错颅面结构的垂直向特征。方法:选取福建籍安氏Ⅱ1类错成人患者100例,男46例(高角12例,均角14例,低角20例),女54例(高角16例,均角24例,低角14例)。拍摄头颅定位侧位片,导入Winceph软件进行测量。结果:①高角组后颅底长较均角、低角组缩短。低角组颅底相对逆时针旋转,高角组相对顺时针旋转。②随下颌平面角的增大,下颌垂直向发育大于水平向发育。低角组腭平面呈逆时针旋转。③上面高占前面高比例三组间无差异。④随着下颌平面角减小,上下前牙牙槽高度逐渐减低。上下颌磨牙段牙槽骨高度三组间无差异。三组间平面倾斜度不同,高角组顺时针旋转,低角组逆时针旋转。结论:安氏Ⅱ1类错机制复杂,表现出复杂的形态学差异。不同下颌平面角组之间有不同的垂直向特征表现。