国际口腔医学杂志

国际口腔医学杂志 ›› 2024, Vol. 51 ›› Issue (2): 241-248.doi: 10.7518/gjkq.2024011

• 综述 • 上一篇    

不同类型的辅弓在正畸前牙压低中的应用与研究进展

斯佳萍(),吕林,王思婕,周宇,陈小燕()   

  1. 浙江大学医学院附属口腔医院正畸科 浙江大学口腔医学院 浙江省口腔疾病医学研究中心浙江省口腔生物医学研究重点实验室 浙江大学癌症研究所 杭州 310006
  • 收稿日期:2023-06-29 修回日期:2023-10-09 出版日期:2024-03-01 发布日期:2024-03-11
  • 通讯作者: 陈小燕
  • 作者简介:斯佳萍，住院医师，硕士，Email：3150103226@zju.edu.cn
  • 基金资助:
    浙江大学基本科研业务费专项资金(2021FZZX005-36);中国牙病防治基金会科研项目(A2021-090)

Application and research progress of various intrusive arches in the orthodontic intrusion of anterior teeth

Jiaping Si(),Lü Lin,Sijie Wang,Yu Zhou,Xiaoyan Chen()   

  1. Dept. of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Pro-vince, Cancer Center of Zhejiang University, Hangzhou 310006, ChinaSFoundation:upported by: Special Fund for Basic Scientific Research of Zhejiang University (2021FZZX005-36); Research Project of the China Dental Disease Prevention and Control Foundation (A2021-090 )
  • Received:2023-06-29 Revised:2023-10-09 Online:2024-03-01 Published:2024-03-11
  • Contact: Xiaoyan Chen
  • Supported by:
    Special Fund for Basic Scientific Research of Zhejiang University(2021FZZX005-36);Research Project of the China Dental Disease Prevention and Control Foundation(A2021-090)

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摘要：

前牙深覆是临床中常见的疑难错畸形，常伴随有不同程度的关节、牙周及美观等问题。压低辅弓是目前临床中治疗前牙深覆的主要方式之一。压低辅弓种类繁多，不同辅弓在适应证、疗效、不良反应、弓丝弯制及生物力学等方面存在差异。在临床实践中，正畸医生应根据目标位及患者牙槽骨情况选择合适的辅弓类型，并适时调整压低力的大小和方向，以达到最佳的效果。本文就不同类型的压低辅弓的应用和研究进展作一综述，以期为临床研究的开展及临床实践提供一定的参考。

关键词: 牙齿压低, 压低辅弓, 正畸弓丝, 牙根吸收

Abstract:

Deep overbite of anterior teeth is a common and difficult malocclusion in clinical practice and is often accompanied by different degrees of joint, periodontal, and aesthetic problems. Intrusive arch is one of the main ways to correct deep overbite of anterior teeth in clinical practice. Various types of intrusion arch exist, and indications, clinical effects, side effects, wire bending, and biomechanics differ among different types of intrusive arches. Therefore, in clinical practice, orthodontists should choose an appropriate intrusion arch that caters to the target position and the patient’s dental bone condition and adjusts the size and direction of the intrusion force to achieve the best effect. This article reviews the application and research progress of different types of intrusive arch to provide reference for its implementation in clinical research and clinical practice.

Key words: tooth intrusion, intrusion arch, orthodontic wire, root resorption

中图分类号: 

  • R783.5

图 1

Burstone压低辅弓"

图 2

Ricketts多用途弓"

图 3

三段式片段弓压低辅弓"

图 4

Connecticut辅弓A：可通过V曲调节压低力的大小；B；CIA/CNA就位于口内，虚线为被动状态，实线为激活后的工作状态。"

图 5

K-SIR压低技术A：双侧尖牙远中各形成一个7 mm×2 mm的U型关闭曲；B：在U型曲的近远中弯制V型曲，使其近远中段弓丝呈90°；C：U型曲远中2 mm处弯制60°的龈向V型曲；D：U型曲远中弯制20°内收弯；E：K-SIR就位于口内。"

表 1

不同压低辅弓特征、疗效及优缺点比较"

辅弓类型力偶类型压低力值/N弓丝材质绝对压低值/mm优点缺点
Burstone压低辅弓单力偶0.6不锈钢丝1.8（每月0.45）

1）压低效率高；

2）压低力持续轻柔

1）磨牙支抗消耗大；

2）前牙易唇倾

Ricketts多用途弓双力偶1.25~1.6不锈钢丝或钴铬合金丝1.6（每月0.44）

1）压低效率高；

2）弯制简单

1）前牙三维控制困难；

2）牙根吸收较显著；

3）磨牙支抗消耗较大

三段式片段弓压低技术双力偶0.6前牙段TMA丝，后牙段不锈钢丝1.66（每月0.42）

1）灵活调整压低力方向；

2）后牙支抗消耗少；

3）牙槽骨损伤较少

1）弯制复杂；

2）舒适度较差

Connecticut辅弓单力偶0.4~0.6超弹镍钛丝和TMA丝1.4 mm（每月0.35）

1）操作方便，椅旁时间少；

2）压低力持续轻柔

1）压低效率较低；

2）非个性化定制

K-SIR弓丝双力偶1.25TMA丝1.25 mm（每月0.33）

1）压低内收同时进行，缩短整体治疗时间；

2）磨牙不良反应小

1）适应证较局限；

2）前牙压低量较少

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