口腔疾病医学.docxVIP

ORTHODONTICS Fang Bojun Normal occlusion versusmalocclusion ? Fundamental to orthodontic diagnosis is understanding the concept of ideal occlusion”. Traditionally, any deviation from ideal occlusion” lias represented what Guilford termed mabocclusion. Of course ? ideal occlusion rarely exists in nature and so perhaps it is better to call this concept the imaginary ideal”. Unfortunately there is no clearcut or acceptable definition of normal occlusion”; thus much of our diagnosis in orthodontics is based on this highly arbitraiy concept of the ideal. ? What we today call ideal occlusion was described as early as the eighteenth centuiy buy Hunter. Carabelli in the mid nineteenth century firstly described the abnonnal relationships of the upper and lower dental arches in a systematic way—edge to edge bite and overbite. Incidence of malocclusion ? The incidence of malocclusion varies widely in different countries of the world. In primitive and isolated societies there is less variation in occlusal patterns than is observed in more heterogeneous populations. The variation between primitive and modern groups has been attributed to the effect of natural selection, inbreeding versus out breeding, and environmental factors. ? The reported rate of malocclusion is higher in developed than in primitive countries. For example, the rate of malocclusion in the USA is more than 75%，while that of the African is less than 30%? In China the number is about 33% to 50%. ? A major difficulty in assessing need for orthodontic treatment is that malocclusion can be either a condition that，although detectable，causes no functional or esthetic difficulty and does not warrant treatment or a problem that does need treatment. ? Malocclusion creates problems in three major circumstances: (1) it causes or predisposes disease, (2) it leads to disturbances in jaw function (TMJ syndrome and related conditions) or affects other oral functions (e.g., speech), and (3) its effect on facial esthetics c