儿童阻塞性睡眠呼吸暂停(obstructive sleep apne-a,OSA)是一种严重的睡眠呼吸障碍疾病,是儿童在睡眠中反复发生上气道狭窄,通气不畅,导致低氧和异常的睡眠结构,引起一系列身体、心理异常变化,若未能及时诊断及有效干预,会引起严重的并发症,如颌面部发育异常、神经认知功能受损、心血管功能异常等,甚至随着年龄的增长发展为成人OSA,严重影响儿童的生长发育、身心健康[1].

目的 探讨行拔牙掩饰性矫治的成人骨性Ⅱ类错殆病例治疗前颌骨不调的极限.方法 选取采用拔除四颗前磨牙进行固定矫治器的掩饰性矫正治疗成功的成人骨性Ⅱ类错患者24例,测量矫治前、后头颅定位侧位 X 片上的 SNA、SNB、ANB、FMA、SN-MP、U1-NA、U1-NA 距、U1-SN、L1-NB、L1-NB 距、L1-MP、U1-L1、Ls-E线距、Li-E线距、Z角等15项头影测量参数,分析治疗前的颌骨不调参数ANB角与其他矫治前后参数之间的相关性,对有临床意义的组对,建立回归方程.结果 治疗前ANB角(Y)与治疗后L1-NB距(X)显著性相关,相关系数为0.62,建立的回归方程为Y=0.432X+3.83.结论 当治疗前患者ANB角≥8.6.时,应积极建议患者选择正畸联合正颌外科手术治疗,否则下前牙有可能过度唇倾或不能达到可接受的治疗效果.

目的 本研究拟探讨下颌前移口腔矫治器(OA)治疗阻塞性睡眠呼吸暂停与失眠共病(COMISA)的疗效.方法 选取2013年4月至2019年8月至广西壮族自治区人民医院就诊的14例COMISA患者作为共病组、17例单纯鼾症患者作为对照组,对共病组OA治疗前、治疗1个月后及对照组治疗前的多导睡眠图(PSG)检查参数进行比较.结果 共病组治疗后,睡眠潜伏期(SL)、觉醒指数(ArI)、暂停指数(AI)、呼吸暂停低通气指数(AHI)减少(P<0.05),总睡眠时间(TST)、睡眠效率(SE)、N3期及最低血氧饱和度(LSpO2)增加(P<0.05).与对照组相比,共病组治疗前SL、ArI、N1期百分比较大,TST、SE、N2期百分比较小,治疗后快速眼球运动睡眠潜伏期、ArI较大,TST、SE较小(P<0.05).结论 OA是治疗COMISA的较好疗法.

目的 分析口腔矫治器治疗不同严重程度阻塞性睡眠呼吸暂停(OSA)的疗效.方法 选择2009 年12 月至2019 年10 月广西壮族自治区人民医院口腔正畸科收治的OSA或单纯鼾症患者74 例.根据多导睡眠图(PSG)检查结果将其分为轻度OSA组(18 例)、中度OSA组(18 例)、重度OSA组(21 例)和单纯鼾症组(17 例),各组均接受下颌前移口腔矫治器治疗.比较四组治疗前后睡眠指标和呼吸指标的变化情况.结果 与治疗前比较,轻度OSA组的N3 期占比升高,中度OSA组的觉醒指数(ArI)降低,重度组N1 期占比降低,差异均有统计学意义(P＜0.05).与治疗前比较,轻度OSA组呼吸暂停指数(AI)、低通气指数(HI)、呼吸暂停低通气指数(AHI)、最长呼吸暂停时间、最长低通气持续时间均减少,睡眠状态下最低血氧饱和度(LSpO2)上升;中度OSA组AI、HI、AHI、最长呼吸暂停时间均减少,睡眠状态下LSpO2 上升;重度OSA组AI、HI、AHI、最长呼吸暂停时间、最长低通气持续时间均减少,睡眠状态下LSpO2、清醒状态下平均血氧饱和度(ASpO2)上升,差异均有统计学意义(P＜0.05).结论 口腔矫治器治疗对轻、中度OSA患者均有改善睡眠的作用.经治疗后,不同严重程度OSA患者的呼吸指标参数均获得改善.

目的 观察成人骨性Ⅱ类错牙合患者行拔牙掩饰性矫治后软硬组织、牙体长轴的变化.方法 选取2002—2019年在广西壮族自治区人民医院采用拔除四颗前磨牙完成掩饰性矫治治疗的成人骨性Ⅱ类错牙合患者24例,比较其治疗前后的SNA角、SNB角、ANB角、FMA角、SN?MP角、U1?NA角、U1?NA距、U1?SN角、L1?NB角、L1?NB距、L1?MP角、U1?L1角、Ls?E线距、Li?E线距和Z角等15项头影测量参数,并与正常牙合的正常参考值进行比较.分析L1?NB距的变化量与其余14项参数的变化量的相关性.结果 与治疗前比较,患者治疗后的SNA角、SNB角、U1?NA角、UI?NA距、U1?SN角、L1?NB距、Ls?E线距和Li?E线距减小,SN?MP角、U1?L1角和Z角增大,差异有统计学意义(P<0.05).治疗前患者的SNB角、U1?L1角和Z角较正常参考值小,ANB角、SN?MP角、L1?NB距、L1?MP角、Ls?E线距和Li?E线距较正常参考值大,差异有统计学意义(P<0.05).治疗后患者的SNB角、U1?NA角、UI?NA距、U1?SN角和Z角较正常参考值小,ANB角、SN?MP角、L1?MP角、U1?L1角和Ls?E线距较正常参考值大,差异有统计学意义(P<0.05).患者治疗前后△L1?NB距与△U1?NA角、△U1?NA距、△U1?SN角、△Ls?E线距、△Li?E线距、△L1?NB角、△L1?MP角呈正相关(P<0.05),与△U1?L1角、△Z角呈负相关(P<0.05).结论 成人骨性Ⅱ类错牙合拔牙矫治后上下唇软组织、下前牙牙体长轴均较治疗前改善,上前牙牙体长轴较正常略舌倾,硬组织改善不明显.下前牙的内收量影响上下颌前牙的唇倾度及后移量、上下唇的突度.

阻塞性睡眠呼吸暂停与失眠是人群中患病率较高的两种常见疾病,当二者共存时会演变成一种新的疾病,具有自身发病特点,整体病情严重程度增加,其治疗比单独出现的任何一种都更加难.本文将在阻塞性睡眠呼吸暂停与失眠共病现象的流行病学、发病机制、临床表现、治疗方法、影响因素等方面进行综述.

目的 观察成人骨性Ⅱ类错■患者行拔牙掩饰性矫治后软硬组织、牙体长轴的变化。方法选取 2002—2019 年在广西壮族自治区人民医院采用拔除四颗前磨牙完成掩饰性矫治治疗的成人骨性Ⅱ类错■患者 24 例，比较其治疗前后的 SNA 角、SNB 角、ANB 角、FMA 角、SN-MP 角、U1-NA 角、U1-NA 距、U1-SN 角、L1-NB 角、L1-NB 距、L1-MP 角、U1-L1 角、Ls-E 线距、Li-E 线距和 Z 角等 15 项头影测量参数，并与正常牙合的正常参考值进行比较。分析 L1-NB 距的变化量与其余 14 项参数的变化量的相关性。结果 与治疗前比较，患者治疗后的 SNA 角、SNB 角、U1-NA 角、UI-NA 距、U1-SN 角、L1-NB 距、Ls-E 线距和 Li-E 线距减小，SN-MP 角、U1-L1 角和 Z 角增大，差异有统计学意义（ P ＜ 0. 05） 。治疗前患者的 SNB 角、U1-L1 角和 Z 角较正常参考值小，ANB 角、SN-MP 角、L1-NB 距、L1-MP 角、Ls-E 线距和 Li-E 线距较正常参考值大，差异有统计学意义（ P ＜0. 05） 。治疗后患者的 SNB 角、U1-NA 角、UI-NA 距、U1-SN 角和 Z 角较正常参考值小，ANB 角、SN-MP 角、L1-MP 角、U1-L1 角和 Ls-E 线距较正常参考值大，差异有统计学意义（ P ＜ 0. 05） 。患者治疗前后△L1-NB 距与△U1-NA 角、△U1-NA 距、△U1-SN 角、△Ls-E 线距、△Li-E 线距、△L1-NB 角、△L1-MP 角呈正相关（ P ＜ 0. 05） ，与△U1-L1 角、△Z 角呈负相关（ P ＜0. 05） 。结论 成人骨性Ⅱ类错■拔牙矫治后上下唇软组织、下前牙牙体长轴均较治疗前改善，上前牙牙体长轴较正常略舌倾，硬组织改善不明显。下前牙的内收量影响上下颌前牙的唇倾度及后移量、上下唇的突度。

目的 探讨恒牙列骨性Ⅱ类错牙合拔牙矫治后牙弓形态、颊廊及侧貌的变化情况及其相关性,为骨性Ⅱ类错牙合拔牙矫治提供参考.方法 选取2013-01～2017-12在广西壮族自治区人民医院口腔正畸科接受拔牙矫治的恒牙列骨性Ⅱ类错牙合患者15例,应用X线头影测量技术分析矫治前后患者牙颌颅面结构变化,游标卡尺测量矫治前后上颌模型牙弓长度、宽度的变化,Adobe Photoshop CS6软件测量分析矫治前后患者正面微笑像变化.分析矫治前后颅颌牙面软硬组织,牙弓宽度、长度以及正面微笑像颊廊相关指标的变化情况及相关性.结果 矫治后,患者SNA角、ANB角、U1-NA角、UL-E和LL-E较治疗前降低,NLA角较治疗前增加,差异有统计学意义(P＜0.05);上颌牙弓中段宽度(UPP)、上颌牙弓后段长度(UPD)、上颌牙弓后段宽度(UMM)和上牙弓全段长度(UAD+UPD)指标均减小,与治疗前比较差异有统计学意义(P＜0.05).与治疗前比较,矫治后正面微笑像口角宽度(Ch to Ch)、正面微笑像颊廊宽度之和(BC)及正面微笑像双侧颊廊比率(BCR)水平增加,正面微笑像上颌可见牙列宽度(Va to Va)水平降低,但治疗前后比较差异均无统计学意义(P＞0.05).Pearson相关分析结果显示,UPP变化与BC和BCR变化呈负相关(P＜0.05);UAD+UPD变化与UL-E变化呈正相关(P＜0.05);Ch to Ch变化与U1-NA和UL-E变化呈负相关(P＜0.05);BC变化与SNB角呈正相关(P＜0.05).结论 骨性Ⅱ类错牙合拔牙矫治后牙弓长度变化与侧貌凸度改善密切相关,牙弓中段宽度减少可能会引起正面微笑时颊廊增加.

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)是一种睡眠呼吸疾病,该病病因复杂,影响患者的睡眠质量和生活质量.本文综述各种治疗方法对OSAHS患者睡眠质量的影响,这将对OSAHS的治疗具有临床意义.

目的 了解恒牙列骨性Ⅲ类错(牙各)患者单纯正畸掩饰性治疗前后(牙各)平面、下颌平面的变化及其相关关系.方法 回顾性分析12例恒牙列骨性Ⅲ类错(牙各)患者的临床资料,其中ANB角平均(-3.33±1.74)°,SN-MP角平均(37.67 ±4.89)°.拔下颌左右第二或第三恒磨牙,配合下颌颊棚区微种植体支抗或多曲方丝弓技术矫治,比较矫治前后X线头影测量指标变化情况,分析矫治前后牙颌颅面变化与(牙各)平面、下颌平面变化的相关关系.结果 矫治后ANB角平均增大(1.79±1.62)°;OPP-FH平均减小(2.83±2.92)°,FH-OP平均减小了(2.25±2.13)°,矫治前后比较差异有统计学意义(P＜0.05);OPA-OPP、FH-MP、SN-MP矫治前后比较差异无统计学意义(P＞0.05).相关分析结果显示,前面高、前下面高变化与下颌平面变化之间存在正相关关系(P＜0.05).结论 恒牙列骨性Ⅲ类错(牙各)患者经过合理的支抗设计,可以得到良好的矫治,患者正侧貌也可一定程度改善,(牙各)平面及下颌平面也可以得到较好控制.

BACKGROUND: Lingual bracket system is the best invisible orthodontic appliance due to its aesthetics and efficiency, but it is difficult to control anterior tooth torque during the distal retraction of the anterior tooth. Thereafter, lots of studies on maxillary anterior teeth have been conducted, but there is less knowledge about the mechanical characteristics of whole mandible dentition distal retaction. OBJECTIVE: To analyze the biomechanical characteristics of the mandibular anterior teeth distal retracted by sliding method in lingual orthodontic treatment. METHODS: A three-dimensional finite element model was constructed using a series of specialized software based on volunteer's CT data and lingual brackets, including the mandible, alveolar bone, periodontal ligament, dentition (removal of the two first premolars), lingual brackets and arch wire with hooks (located between lateral incisor and canine and 11 mm distant from the arch wire plane). Subsequently, 1.5 N lingual forces through the hooks of first molar (2 mm distant from the arch wire plane) and the hooks between the lower lateral incisor and canine were loaded and the biomechanical characteristics of the mandibular anterior teeth movement during the en-masse retraction were analyzed. RESULTS AND CONCLUSION: The finite element model was constructed successfully, and had a higher geometrical similarity and resemblance of clinical situation. The crowns of lower incisors showed the tendency of lingual inclination and extension, and this tendency was more obvious in the lateral incisors. The canines were buccal and mesial inclination and intrusion. The periodontal stress concentration area was corresponded with the tendency of tooth movement. Therefore, the movement tendency of incisors is still lingual inclination when mandibular anterior teeth distal retracted by a longer hook in lingual brackets system, and there is no distal inclination. Overall, lower incisors are easy to exhibit lingual inclination; the long anterior hooks contribute to the movement of canines, but it is not available for the vertical control of incisors during mandibular anterior tooth distal retraction.

BACKGROUND: Mandibular advancement devices are commonly used in patients with mild to moderate obstructive sleep apnea hypopnea syndrome. But wearing with mandibular protraction appliance makes the mandible in an abnormal position, and inevitably affects the temporomandibular joint (TMJ). As one of the important components of the TMJ, can structural changes of the joint disk impair the TMJ? Are there any differences in the TMJ structure between Angle Class I and Class II? What will happen to the TMJ structure in the Angle Class I and Class II during mandibular advancement? Is there a same law of TMJ changes for Angle Class I and Class II? All of these are undetermined systematically. OBJECTIVE: To compare the changes in the structure of TMJ disk and the differences during mandible advancement between Angle Class I and Class II adult males. METHODS: Forty non-apnea adult males were divided into two groups (n=20 per group), including Class I and Class II groups, according to the Angle’s classification and sagittal skeletal facial type. Each volunteer was scanned by MRI in three positions, including central occlusion (F 0 ), 75% of the maximum mandible advancement (F 75 ) and maximum of the mandible advancement (F 100 ). These indexes that were correlated with morphology of the joint disk in different mandible advancement positions were measured and calculated by MRI, and then analyzed statistically. RESULTS AND CONCLUSION: In F 0 , the ratio of disk anterior displacement in the Class II group was higher than that in the Class I group (P < 0.01). The angle A was decreased as the mandible advanced in both groups from F 0 to F 75 (P < 0.01). The rotational angular dimension was increased as the mandible advanced, and the sizes from F 0 to F 100 were bigger than those from F 0 to F 75 (P < 0.05). Some differences existed in the structure of TMJ disk between Angle Class I and II adult males. In summary, appropriate mandibular advancement may play a positive role in patients with anterior displacement of the joint disk, but excessive mandible advancement is likely to impair the TMJ disk. Subject headings: Temporomandibular Joint; Temporomandibular Joint Disk; Orthopedic Fixation Devices; Tissue Engineering Funding: the Guangxi Medical and Health Proper Technology Research and Development Project, No. S201315-02; the Science and Technology Research & Development Program of Guangxi Zhuang Autonomous Region, No. 1140003B-72 0 Introduction (obstructive sleep apnea hypopnea syndrome OSAHS) !"#$%& '()*+,-./01 23456)* 78 9: ;<=>+?@ABCD E FG [1] HIJ@A#<+AKL# MNOPQRST UHVW XOSAHS YZ[\6]^$_]^`aY ZbcH_]^YZU IJdY.YZe=20> fgh ij YZkl UmnoWpqIJdY.rst< uv wbcx6yz{|}$~€s‚G Xƒ{U „OSAHS Z… †HnoWpqIJdY. #s‡ ˆ[\e ‰ Š‹sIJdY. ŒnoŽW n‘ ’“”•–—˜“[™š ›™œWmžŸ I¡ ¢ £¤¥¦ ¢ § ̈©Ž V a« ¬ ­® ̄°±¤23 [2-4] H́ ‹sIJdY.YZ OSAHSŠ noμ ¶Š· ̧Wp 1o»Io,‡6 1⁄41⁄2 ¥» 3⁄4¿ÀÁÂà ̈ÄnoÅƁ Ç È (1)* ÂÃ2ɚ Ê1ËÌ«ÍÎYZ [5] H ÏÐ <noÑ Wp ҌXÄnoÅÆÓ%M?_Ô !%ˆ —ÕrÖ XÄnoÅÆ Ô!×Ø$%ˆ01 Ù(1Ú; [6] H Û IJÜÝÔÞ@ßà¬sIJd Y.YZOSAHSŠμXnoWpá⎐ £¤ã16… äÕ¦ ¢ åŠæÊXoçNÀÁÂÃÚ;23HVW6 ÅIJdY.YZOSAHSèÅ ÄnoÅÆ×Ø DEé ê 6ë DEPìíXî°ï ‘ Êð ̈TÄno ÅÆ01ñ<òó ôïÅ,H ́õöÑç÷øù 3úøGàûü¦ýàñ<Ÿ ¦ ¢ þA <ÛöÑç÷6ñ à OSAHS (1 ' OSAHS m + [7] Hå Š àX; õö DEU ÄnoÅÆ ô  %  ö [8] H « õö ÄnoÅÆ(1ýàMŽ ˆ×Ø M ˆ× Ø > ¶« ï [9] H noœW  Än oÅÆôï×، % e X ÄnoÅÆÚ;23 ;<ÄnoÅÆ à* X(1 ýàÄnoÅÆ ˆ×Ø ; õö Tang Q, Fang ZX, Zhou Y, Bai B, Huang MF. A magnetic resonance imaging study to compare structural changes of the temporomandibular joint disk during mandibular advancement between Angle Class I and Class II in adult males.. Zhongguo Zuzhi Gongcheng Yanjiu. 2018;22(12):1811-1816. DOI:10.3969/j.issn.2095-4344.0197 P.O. Box 10002, Shenyang 110180 www.CRTER.org 1813 20 90 Ruf MRI !

目的:分析舌侧矫治技术不同长度牵引钩条件下,滑动法整体内收上前牙时牙移动的生物力学特征.方法:利用所建立的舌侧矫治技术内收上前牙三维有限元模型,分别于上前牙区牵引钩(长度2～10 mm)和腭侧的微种植钉间加力1.5 N,内收上颌前牙并分析其牙列位移趋势.结果:牵引钩长度在4 mm以内时,均表现为上颌切牙牙冠的腭侧移动趋势,从6 mm开始,中切牙和尖牙牙冠出现唇侧移动趋势,并随牵引钩加长唇倾越明显.结论:随着牵引钩的加长,前牙牙冠的腭侧倾斜移动趋势减小,长牵引钩可能更有利于上前牙的整体内收移动.

BACKGROUND: Mandibular advancement devices are commonly used in patients with mild to moderate obstructive sleep apnea hypopnea syndrome. But wearing with mandibular protraction appliance makes the mandible in an abnormal position, and inevitably affects the temporomandibular joint (TMJ). As one of the important components of the TMJ, can structural changes of the joint disk impair the TMJ? Are there any differences in the TMJ structure between Angle Class Ⅰ and Class Ⅱ? What will happen to the TMJ structure in the Angle Class Ⅰ and Class Ⅱ during mandibular advancement? Is there a same law of TMJ changes for Angle Class Ⅰ and Class Ⅱ? All of these are undetermined systematically. OBJECTIVE: To compare the changes in the structure of TMJ disk and the differences during mandible advancement between Angle Class Ⅰ and Class Ⅱ adult males. METHODS: Forty non-apnea adult males were divided into two groups (n=20 per group), including Class Ⅰ and Class Ⅱ groups, according to the Angle's classification and sagittal skeletal facial type. Each volunteer was scanned by MRI in three positions, including central occlusion (F0), 75% of the maximum mandible advancement (F75) and maximum of the mandible advancement (F100). These indexes that were correlated with morphology of the joint disk in different mandible advancement positions were measured and calculated by MRI, and then analyzed statistically. RESULTS AND CONCLUSION: In F0, the ratio of disk anterior displacement in the Class Ⅱ group was higher than that in the Class Ⅰ group (P< 0.01). The angle A was decreased as the mandible advanced in both groups from F0to F75(P < 0.01). The rotational angular dimension was increased as the mandible advanced, and the sizes from F0to F100were bigger than those from F0to F75(P < 0.05). Some differences existed in the structure of TMJ disk between Angle Class Ⅰ and Ⅱ adult males. In summary, appropriate mandibular advancement may play a positive role in patients with anterior displacement of the joint disk, but excessive mandible advancement is likely to impair the TMJ disk.

目的 了解戴用下颌前移口腔矫治器后阻塞性睡眠呼吸暂停疾病(OSAD)患者的睡眠结构变化.方法 选取行下颌前移口腔矫治器治疗的OSAD患者61例,接受口腔矫治器治疗前后均行多导睡眠图检查.将患者分为治疗后成功组52例及不成功组9例,对两组治疗前后的睡眠分期比率及疗效进行比较.结果 成功组治疗前后S3、AI、HI、AHI、LSpO2、最长呼吸暂停时间比较差异有统计学意义(P＜0.05).不成功组治疗前后AHI、最长呼吸暂停时间比较差异有统计学意义(P＜0.05).两组治疗后呼吸参数AI、AHI、LSpO2比较差异有统计学意义(P＜0.05).结论 戴用下颌前移口腔矫治器治疗成功的OSAD患者深睡眠百分比略有增加.

目的 了解拔牙矫治及相关肌功能训练在改善恒牙列Ⅱ类骨面型患者正畸后微笑美中的作用.方法 20例恒牙期Ⅱ类骨面型患者,在拔牙设计,直丝弓矫治技术应用技术同时,配合相关微笑美肌功能训练.应用Adobe Photoshop CS7软件对矫治前后微笑相进行定点和测量(包括上前牙曲度、下唇曲度、颊廊、微笑宽度、微笑高度、上下前牙暴露量、微笑弧及上唇曲度形态等),应用SPSS17.0软件对矫治前后颅颌面结构及微笑相测量数据进行统计分析.结果 矫治后上前牙曲度增大,颊间隙比率和上切牙比率有所增加,下切牙暴露量减少,与矫治前比较差异有统计学意义(P＜0.05);矫治后理想笑弧和上唇曲度向上的例数明显增加,平坦笑弧和向下的上唇曲度例数明显减少,差异有统计学意义(P＜0.05);矫治后U1-SN角变化与上牙曲率变化呈负相关,SN-MP角变化与颊旁间隙比率变化呈负相关(P＜0.05).结论 恒牙列Ⅱ类骨面型患者拔牙矫治并配合微笑美肌功能训练各项微笑美指标矫治后均有所改善,其中颊廊与面下1/3高度相关,笑弧与上前牙唇倾度高度相关.

Objective The aim of this article is to study the changes of dental and base bone arch after non-extraction orthodontic treatment in subjects with skeletal ClassⅢ malocclusion.MethodsThe sample consisted of pre- and post-treatment models from 23 skeletal ClassⅢ malocclusion subjects who accepted non-extraction orthodontic treatment. The length and width of dental arch and basal bone arch in intercanine area, interpremolar area and inter-ifrst-molar area were measured, then analyzed the correlation between pre- and post-treatment group.Results① The dental length of the anterior maxillary arch(UAD) and the width of mandibular inter-first-molar (LMM) increased (P<0.05), while the dental width of maxillary intercanine(UCC),interpremolar (U1PP,U2PP) and mandibular intercanine(LCC) decreased (P<0.05) after treatment.② The length of maxillary basal bone (UBAL) increased(P<0.05), while mandibular basal bone length(LBAL) decreased (P<0.05) after treatment.③ A positive correlation was found between the changes of dental arch and base bone arch width and length, especially in mandibular canine area, ifrst molar area and maxillary ifrst molar area.ConclusionAfter non-extraction orthodontic treament of skeletal ClassⅢ malocclusion in permanent dentition, the compensatory changes of the dental arch can induce the adaptation of the corresponding regional base bone arch,which is beneift to the effect and stability of orthodontic treatment.

目的 了解成人骨性Ⅱ类错(牙合)掩饰性矫治后有好的咬合关系的患者治疗前颌骨不调的极限.方法 选取已完成掩饰性固定正畸治疗的成人骨性Ⅱ类错(牙合)的患者38例,分别对其治疗前、后牙合模型及头颅定位侧位片进行测量分析,获取治疗前后PAR指数、ANB角、U1-SN角等测量项目值并进行比较,分析治疗前ANB角与其它测量项目的相关性.结果 (1)所有患者治疗后均获得了良好的咬合关系;(2)治疗前角ANB与加权PAR总值减少量、治疗后U1-SN存在着线性正或负相关关系(P＜0.05).结论 部分成人骨性Ⅱ类错(牙合)可以通过掩饰性矫治获得满意的咬合效果,但当治疗前ANB角大于9°时,应积极建议患者考虑正颌外科治疗.

目的 建立舌侧矫治技术整体内收上前牙的三维有限元模型,为进一步探讨舌侧矫治技术整体内收上前牙的生物力学特征奠定基础.方法 利用志愿者的CT扫描数据及舌侧托槽等实体数据通过一系列专用软件的运行,建立包含上颌骨、牙槽骨、牙周膜、牙(拔除左右第一双尖牙)、舌侧托槽、有牵引钩(不同长度)的舌侧弓丝及上颌腭侧微种植体在内的整体上颌三维有限元模型.结果 建立了牵引钩长度分别为2 mm、4 mm、6 mm、8mm、10 mm的五个上颌有限元模型,每个模型均包括42个实体模型.结论 所建立的舌侧矫治技术整体内收上前牙阶段具有不同长度牵引钩的整体三维有限元模型,几何相似性强,临床模拟度较高,为后续的模拟加力研究创造了条件.

Objective To investigate the clinical results using the fix appliance combined with myofunctional therapy for improving the smile attractiveness of patients with skeletal malocclusion.Methods 30 patients (11 male and 19 female ,aged from 13 to 34 years old ,average 21.08± 6.67 years old)with skeletal malocclusion were collected. There were 24 cases with classⅡ sagittal skeletal pattern(ANB angle: 5 to 8°)and 6 with classⅢ sagittal skeletal pattern(ANB angle: 0°to -6°). The cases were randomly divided into experimental group and control group, each group had 15 cases, and 26 cases were treated with extraction, 4 cases were treated with noextraction. The cases in experimental group undergone orthodontic treatment combined with myofunctional therapy, the cases in control group with orthodontic treatment alone. The techniques and principles of orthodontic treatments were the same, and the baseline check of two groups was consistent. The frontal smile photographs were taken for each cases before and after the treatment to evaluate the items about the smile attractiveness. All the measurements were analyzed by SPSS 16.0 software.Results There were signiifcant differences in the items of the height of the outermost corner of lip, the smile width and the proportion of buccal corridor in experimental group between before and after the treatment(P<0.05) . The number of patients with ideal smile arc increased and the straight smile arc decreased signiifcantly after the treatment in experimental group(P<0.05). The change of smile index before and after the treatment in control group had no statistical signiifcance (P>0.05 ). After the treatment, there were signiifcant differences in the items of the height of the outermost corner of lip, maxillary gingival display, average mandibular incisal exposure, the proportion of buccal corridor and the shape of smile arc between the two groups(P<0.05).Conclusion Orthodontic treatment combined with smile myofunctional therapy can make the patients with skeletal malocclusion to rebuild the muscular tissues around the mouth with the change of the teeth and jaws synchronously and harmoniously and help the patient achieve attractive smile at the same time.