成人AngleⅢ前牙反牙合非手术治疗新方法.doc

成人AngleⅢ前牙反牙合非手术治疗新方法[摘要]目的：应用改良固定反式双阻板矫治器（Twin-block appliance，TBA）联合方丝弓技术矫治成人AngleⅢ前牙反牙合，为成人前牙反牙合提供新的治疗方法。方法：矫治成人患者15例，进行临床表现及相关硬组织测量。结果：固定反式TBA戴用4个月后下颌明显后退。所有患者在未拔牙的情况下前牙反牙合均得到有效治疗，磨牙及尖牙均达到I类关系。但上颌仅为牙及牙槽的代偿性变化。结论：下颌前突的成人患者应用改良固定反式TBA后，下颌明显后退，下颌的变化较上颌大。同时联合方丝弓技术较其它掩饰性治疗的疗程明显缩短，对成人的治疗快速高效。 [关键词]改良固定反式TBA；方丝弓固定矫治； AngleⅢ类错牙合；前牙反牙合；成人正畸治疗 [中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455（2008）03-04 New method of non-surgery in treatment of adult Angle Ⅲ anterior crossbite LIU Hong1,ZHANG Xiao-hui2,LIU Yan-jun3，LI Xuan1,LI Jian-xue1,ZHANG Hai-jun1 (1.Department of Stomatology, Lanzhou General hospital, Lanzhou Command, Lanzhou,730050, Gansu,China;2.Department of Stomatology,the First Hospital of PLA;3.Dental Dispensery of Xigu,Lanzhou,Gansu) Abstract:ObjectiveThe aim of this study was to evaluate the curative effects of the modified fixed reverse Twin-block appliance combine Edgewise on treatment of adult Angle Ⅲ anterior crossbite.MethodsThe appliance was used on 15 adult subjects with Angle Ⅲ malocclusion and then compared clinical character and X-ray cephalometry before and after treatment.ResultsAfter 4 months treatment the appearance and profile were improve evidently, mandible retrusion was to lead molar and canine were Angle I，overjet and overbite were normal. ConclusionAll findings indicated that adult Angle III anterior crossbite can be corrected with reverse TBA combined Edgewise，and the speed was very quickly. Key words:modified fixed reverse Twin-block appliance;edgewise;Angle III malocclusion;anterior crossbite;adult orthodontic treatment 我国前牙反牙合高发、危害大。成人由于种种原因错过正畸治疗最佳时机，现多行正颌手术或牙齿掩饰性治疗。手术前后均需进行相应正畸治疗，拖延时间长。此手术难度大、风险高，很多地区尚未开展。掩饰性治疗在不拔牙的情况下，仅靠上下颌牙齿的变化来解决反牙合问题往往显得力不从心，若能适当后退下颌骨代偿上颌的不足，那么治疗就将简单化。此研究在改良固定反式Twin-block应用儿童前牙反牙合的基础上将其应用于成人患者15例，疗程明显缩短，使成人患者避免手术之苦。可为临床提供有效、简便、快捷非手术治疗新方法。目前尚未见此类报道。矫治反牙合同时治疗反牙合引起的耳屏前疼痛、弹响、张口受限、头痛等TMJD症状。 1材料和方法 1.1临床资料：选择2003年8月～2006年10月就诊于兰州军区总医院口腔科安氏Ⅲ类成人前牙反牙合患者15例（男性6例，女性9例），其中11例存在关节弹响、疼痛或头痛症状，4例无关节紊乱症状。 选