【摘要】：目的:通過對成人安氏IIIS類錯牙合患者拔牙矯治并內(nèi)收前牙，探討Tweed-Merr-ifield定向力矯治技術(shù)療效以及矯治結(jié)束后唇齒關(guān)系的變化,評價該技術(shù)對于唇部美觀的影響。 材料和方法:選取2012年3月大連奧索口腔來診的成人患者一例，診斷為安氏IIIS類錯牙合，女性，年齡22周歲，凸面型，左側(cè)磨牙關(guān)系為中性,右側(cè)磨牙關(guān)系為近中尖對尖，，前牙對刃，擁擠度分析上、下牙列均為中度擁擠，上頜中線左偏2mm。通過對患者矯治前的口腔檢查、X線頭顱側(cè)位片和曲面斷層片分析、模型分析，最終矯治方案為拔除15、24、34、44、18、28、38、48應(yīng)用Tweed-Merrifield定向力矯治技術(shù)。在矯治前后一周內(nèi)拍攝X線頭顱側(cè)位片，選取Tweed頭影測量分析法中的測量項目以及與唇部相關(guān)的軟組織測量項目，并進(jìn)行矯治前后頭影測量重疊分析，來評價治療前后的變化。 結(jié)果:矯治療程21個月。該患者治療前后分析比較:上、下頜牙齒排齊；上頜中線左偏得到糾正；前牙切對切關(guān)系得到矯正；右側(cè)磨牙近中尖對尖關(guān)系得到矯正；上下頜咬合關(guān)系良好，達(dá)到正常的尖窩交錯咬合關(guān)系。矯治后的全口曲面斷層片顯示該患者根尖未見明顯吸收，牙根排列基本平行；牙周組織及牙槽骨未見異常；髁狀突未見吸收，對稱性良好。頭顱側(cè)位片顯示下頜逆時針旋轉(zhuǎn)，下頜平面角減小(FMA由30°減小為28°)，下切牙豎直(IMPA由95°減小為82°)，側(cè)貌得到改善（Z ANGLE由66°增大為75°；下唇突點(diǎn)-H線的距離由3mm變化為0mm），患者獲得美觀和諧的唇部形態(tài)，患者對矯治結(jié)果比較滿意。 結(jié)論:拔牙矯治成人安氏IIIS類錯牙合患者，應(yīng)用Tweed-Merrifield定向力矯治技術(shù)內(nèi)收前牙，在三維方向控制牙齒的精確移動，可以使唇齒關(guān)系得到改變,使患者唇部獲得美觀的效果。
[Abstract]:Objective: to investigate the effect of IIIS orthodontic technique and the relationship between lip and teeth after Tweed-Merr-ifield directional force correction in adult patients with IIIS malocclusion and to evaluate the effect of this technique on the beauty of lip. Materials and methods: a case of adult Oso oral malocclusion diagnosed as IIIS malocclusion, female, aged 22 years, with convex shape, was selected. The relationship between left molar and right molar was neutral, and the right molar was proximal cusp to cusp. According to the analysis of the edge of the anterior teeth and the degree of crowding, the lower dentition was moderately crowded and the maxillary midline was 2mm left. According to the oral examination before treatment, the analysis of lateral radiographs and curved surface tomograms of the patients, and the model analysis, the final treatment plan was to remove 15244C 34C, 4C4C, 288848, and to apply the Tweed-Merrifield directional force correction technique. The lateral radiographs of the head were taken within one week before and after orthodontic treatment. The measurement items in Tweed cephalometric analysis and the soft tissue measurement items related to the lips were selected, and the overlap analysis of cephalometric measurements before and after correction was carried out to evaluate the changes before and after treatment. Results: the course of treatment was 21 months. Before and after treatment, the patients were analyzed and compared: the upper and lower teeth were aligned; the left deviation of the maxillary midline was corrected; the anterior incisor was corrected; the right molar was corrected near the middle tip to the tip; the maxillary and mandibular occlusion was good. To reach the normal point fossa staggered occlusal relationship. The results showed that there was no apparent absorption at the root tip, the root arrangement was basically parallel, the periodontal tissue and alveolar bone were not abnormal, the condylar process was not absorbed, and the symmetry was good. Lateral cranial radiography showed that the mandible rotated counterclockwise, the mandibular plane angle decreased (FMA decreased from 30 擄to 28 擄), the lower incisor vertical (IMPA decreased from 95 擄to 82 擄), and the lateral appearance was improved from 66 擄to 75 擄. The distance between the point of the lower lip and H line changed from 3mm to 0mm. The patients obtained beautiful and harmonious lip shape. The patients were satisfied with the treatment results. Conclusion: extraction of teeth for adult patients with IIIS malocclusion can change the relationship between lips and teeth and make the lip of the patient obtain beautiful results. The technique of Tweed-Merrifield directional force is used to correct the anterior teeth and to control the accurate movement of the teeth in three dimensional direction.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.5

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