本文選題：牙列擁擠　切入點(diǎn)：拔牙矯治　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討應(yīng)用拔牙矯治對(duì)安性I類伴牙列擁擠患者的臨床矯治效果和思考。 方法：選取大連博士口腔門診2010年收治的青少年患者一例，女性，11歲，生長(zhǎng)發(fā)育期，骨性I類，均角，安氏I類，牙列擁擠，上頜擁擠度4.3mm，屬于中度擁擠。下頜擁擠度（包括整平Spee曲線以及下切牙唇傾）為8.0mm，屬于中度擁擠，前牙覆蓋為3.7mm，屬于I度深覆蓋，覆牙合為下前牙切緣咬在上切牙舌面超過切1/2,不足2/3，屬于Ⅱ度深覆牙合。上頜第二磨牙未萌出。下切牙牙軸舌傾，IMPA為80度。雙側(cè)尖牙，磨牙關(guān)系均為中性關(guān)系。上下頜中線對(duì)正，下頜Spee曲線左右兩側(cè)均為1.5mm。本病例根據(jù)檢查結(jié)果，采用拔除上頜第一前磨牙和下頜第二前磨牙的拔牙模式進(jìn)行矯治，應(yīng)用陶瓷托槽排齊整平上下頜牙列，控制上下磨牙在關(guān)閉間隙階段的牙齒移動(dòng)一致性，上下頜磨牙應(yīng)用弱支抗，滑動(dòng)法關(guān)閉拔牙間隙，頭帽Ｊ鉤結(jié)合Ⅱ類牽引矯治深覆牙合和控制頜骨生長(zhǎng)方向。治療結(jié)束后，結(jié)合矯治前后ｘ線頭顱側(cè)位片重疊圖和測(cè)量結(jié)果進(jìn)行分析對(duì)比。 結(jié)果：矯治療程為31個(gè)月，上下頜牙列排齊整平，解除牙列擁擠，牙列無間隙存在，上頜中線對(duì)正，前牙覆蓋減小為2.9mm，屬于正常覆蓋，覆牙合為下前牙切緣咬在上切牙舌面切1/3處，屬于正常覆牙合，全口牙列咬合關(guān)系穩(wěn)定，尖牙，磨牙關(guān)系保持中性關(guān)系，上頜第二磨牙萌出，上下第二磨牙建立咬合關(guān)系，顳下頜關(guān)節(jié)活動(dòng)正常，無壓痛，無關(guān)節(jié)彈響，對(duì)比治療前后曲面斷層片分析，牙根發(fā)育正常，全口牙根無明顯吸收，ｘ線頭顱側(cè)位片前后對(duì)比結(jié)果顯示，（1）上下頜骨正常生長(zhǎng)發(fā)育，ANB由治療前的4度減小為3度。（2）上切牙輕微唇傾，U1-SN增加2度，下切牙牙冠唇傾，L1-NB增加5度，IMPA則增加了4度，U1-L1減少至127度，上下切牙牙軸交角改善更加自然。（3）頜骨面高均有所增長(zhǎng)，ANS-Me由58mm增加至60mm，下頜升支高度增加3mm，面高指數(shù)（FHI）由65%增加至70%,頜骨垂直向比例更加協(xié)調(diào)。（4）上下頜骨均有所增長(zhǎng)，上頜骨長(zhǎng)度ANS-PNS增加1mm，下頜骨長(zhǎng)度Co-Po增加5mm，頜骨長(zhǎng)度增長(zhǎng)使得矢狀向變化更加協(xié)調(diào)。（5）軟組織側(cè)貌更為協(xié)調(diào)自然，Z角由治療前的64度增大至71度，ULP和LLP均各自減小到4mm，頦部和上下唇突度更加自然。 結(jié)論：對(duì)于生長(zhǎng)發(fā)育期牙列擁擠的安氏I類患者，，綜合其他測(cè)量結(jié)果以及仔細(xì)分析考量，選擇合理的拔牙模式進(jìn)行拔牙矯治，往往可以收到非常良好的矯治效果。
[Abstract]:Objective: to investigate the clinical effect and thinking of dental extraction in patients with class I and dentition crowding. Methods: in 2010, a young patient, female, aged 11 years, was selected from the Department of Stomatology in Dalian. The age of female was 11 years old, the growth and development period, bone type I, average angle, class I of Ann's, and dentition crowded. The mandibular crowding (including leveling Spee curve and lower incisor labial tilting) was 8.0mm, which was moderately crowded, and the anterior tooth overlay was 3.7mm, which belonged to I-degree deep overlay, and the mandibular crowding (including leveling Spee curve and lower incisor labial inclination) was 8.0mm. The overbite is the incisal edge of the lower incisor and more than 1 / 2 / 2, less than 2 / 3 of the upper incisor tongue. It belongs to the second degree of deep overbite. The maxillary second molar does not erupt. The IMPA of the lower incisor axis is 80 degrees. The molar relationship was neutral. The central line of the upper and lower mandible was positive, and the left and right sides of the mandibular Spee curve were 1.5 mm. According to the results of the examination, the extraction model of the first premolar and the second premolar of the maxilla was used to correct the molar. The ceramic brackets were used to level the upper and lower dentition, to control the consistency of tooth movement between the upper and lower molars in the closing space, to apply weak Anchorage to the upper and lower molars, and to close the extraction space by sliding. The head cap J hook combined with class 鈪

本文編號(hào)：1618484