医学论文-应用微钛钉矫治上颌前突或双牙弓前突.docVIP

医学论文-应用微钛钉矫治上颌前突或双牙弓前突 【摘要】? 目的 研究应用微螺钉型种植体支抗治疗上前牙前突或双牙弓前突。 方法 15例正畸患者的上牙列前牙区牙齿覆盖在Ⅱ°以上，平均覆盖为9.9mm。内收前牙阶段应用自攻型微钛钉支抗种植体，植入上颌第一恒磨牙和上颌第二恒磨牙，或上颌第一恒磨牙和第二前磨牙颊侧根尖之间的牙槽间隔，以每侧100～150g力滑动内收前牙。比较内收前后头颅X线侧位片，测量前牙内收情况和磨牙支抗的变化。结果 15例牙弓突度均得到明显改善，切牙切缘平均内收6.9mm，支抗磨牙平均前移0.4mm，磨牙在前后向和垂直向均未发生显著性移动，种植体保持了稳定。结论 微钛钉支抗能够有效治疗上颌前牙前突或双牙弓前突患者，起到磨牙强支抗的效能。 【关键词】? 正畸支抗 微钛钉支抗 牙列前突或双牙弓前突 　　【Abstract】? Objective? To evaluate the treatment results of maxillary protrusion or bimaxillary protrusion cases by the application of microcrew anchorage. Methods? The study comprised 15 patients，whose ages ranged from 14.5 to 40.5 years，average (26.3±6.2)years. All the patients presented maxillary protrusion，a mean of 9.9 mm in maxillary anterior teeth.Self-drilling microscrews were implanted in the bilateral buccal alveolar bone between maxillary the first and the second molars or between the first molar and second premolar before bonding straight wire appliance.When the main arch was stable enough，the canine and lateral incisor were retracted? respectively with the microscrew anchorage.100g force each side was applied to miniscrew and retraced teeth.The cephalometric films before and after the relieving of upper anerior teeth croweing were measured and compared. Result? Maxillary protrusion in 15 patients were corrected effectively. Incisors were retracted siginificantly .Molars were moved slightly forward.Central incisor and first molar had no significant changes in anteroposterior and vertical directions. Conclusion? Maxillary protrusion could be relieved effectively by microsrew anchorage，with no loss of molar anchorage. 　　【Key word】? orthodontic anchorage? miniscrew anchorage? maxillary protrusion or bimaxillary protrusion??? 　　由于牙量骨量不调导致的前牙前突或双牙弓前突，矫治这类问题的错颌畸形时，需要设计拔除第一前磨牙，并且拔牙间隙需要全部或大部分来内收前牙，因此磨牙支抗要求强支抗控制［１］。对于前突严重患者，在治疗的初期即要求很好的控制磨牙支抗，尽量避免前牙的往复移动和支抗丧失，尽早设计微钛钉支抗，分批移动前牙至拔牙间隙内收前牙。 　　1? 资料与方法 　　1.1? 一般资料? 　　2006年1月至2007年11月本院门诊15例正畸患者，男7例，女8例；年龄14.5～40.5岁，平均(26.3±6.2)岁。15例患者的上牙列前牙区牙齿覆盖在Ⅱ°以上，平均覆盖为9.9mm。 　　1