固定矫正技术矫治开牙合的临床观察分析-口腔临床医学专业论文.docxVIP

PAGE PAGE 10 The clinical observation and analysis of the open bite treatment with fixed appliance Abstract Objective: To observe the clinical effect and treatment characteristics of the open bite treatment using fixed appliance. Materials and Methods: A male ,17 years old patient who suffered the Angle’s Class Ⅰopen bite malocclusion was selected from orthodontic department, stomaology hospital, FuJian Medical University in 2010.She presented with a convex profile. Intraorally, the upper and lower incisors were retroclined. ClassⅠbilateral molar relationship, accompanied with congenital missing lower incisors and there were spaces in the Upper jaw and lower jaw. The cephalometric analysis showed a Class Ⅱskeletal pattern with increased ANB, normal Wits. The increased FH-MP angle, PP-MP angle, decreased face height ratio and ODI .This case was treated by non-extraction ,Straight Wire Appliances in conjunction with fIxed appliance. Result: After 2 years and 2 months orthodontic treatment, significant achivements including a good alignment of teeth in both arches, a normal relationship between incisors and a good intercuspation were obtained，Class Ⅰocclusion with ideal overjet and overbite was achieved. The profile was improved. Conclusion: The treatment outcome indicates that fixed appliance is one of the effective methods in the treatment of anterior open bite． Key words: open bite, fIxed appliance, orthodontic treatment 前 言 上下前牙切端间无覆牙合关系，垂直向呈现间隙者为前牙开牙合。开牙合畸形的临 床表现是上下颌部分牙在正中牙合位以及下颌功能运动时在垂直方向上无牙合接触， 严重者只有个别牙接触。这种畸形在错牙合畸形中很常见，对患者的咀嚼、切割、 发音、吞咽等功能造成严重影响，而且对患者美观、心理健康也有很大影响，其 病因、机制复杂多样，诊断、治疗困难，复发率高，所以成为口腔正畸领域的重 点难点 1。 美籍韩国正畸学家 Kim 等 2 于 1987 年首先运用多曲方丝弓（MEAW）技术 矫治开牙合畸形，并取得良好的矫治效果，同时国内外也有学者利用三维有限元等 分析方法对 MEAW 进行了力学分析，证实了其对开牙合畸形矫治的有效性 3。但 该技术存在弓丝弯制复杂、临床椅旁操作时间长、初学者不容易掌握、患者口腔 卫生难清洁等不利因素，所以临床应用推广难度较大。Enacar 等 4 首次利用“摇 椅形”弓丝配合前牙区垂直牵引矫治开牙合畸形，并取得很好的矫治效果。 本临床研究通过运用固定矫治技术，观察分析一开牙合病例矫治前后颌面部 软、硬组织变化，探讨开牙合的治疗方法。 1、 病例基本情况 临床病例 治 疗 前 姓名：林某某 性别：女 年龄：17 周岁