国际口腔医学杂志

国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (1): 82-90.doi: 10.7518/gjkq.2023007

• 方法介绍 • 上一篇    下一篇

实现牙列前移新型推簧装置的改良应用

朱叶玲1(),王茜2,孙天瞳1,王丽娜1,何小明1,李加志1()   

  1. 1.深圳佳至口腔门诊部 深圳 518028
    2.中山大学光华口腔医学院·附属口腔医院正畸科 广东省口腔医学重点实验室 广州 510055
  • 收稿日期:2022-03-10 修回日期:2022-07-10 出版日期:2023-01-01 发布日期:2023-01-09
  • 通讯作者: 李加志
  • 作者简介:朱叶玲，主治医师，学士，Email：1527741078@qq.com
  • 基金资助:
    深圳市福田区卫生公益性科研项目(FTWS2020082)

Improved application of a novel device that could achieve dental arch mesialization

Zhu Yeling1(),Wang Xi2,Sun Tiantong1,Wang Lina1,He Xiaoming1,Li Jiazhi1()   

  1. 1.Jiazhi Dental Clinic, Shenzhen 518028, China
    2.Dept. of Orthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2022-03-10 Revised:2022-07-10 Online:2023-01-01 Published:2023-01-09
  • Contact: Jiazhi Li
  • Supported by:
    Shenzhen Futian District Public Health and Public Welfare Research Project(FTWS-2020082)

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摘要：

临床上能实现单纯磨牙近中移动、单纯前牙近中移动、全牙列前移或者矫正牙列中线的正畸方法不多、操作复杂或者有较多不良反应等，本文结合2例病例介绍一种与种植支抗钉联合应用，能够实现全牙列前移、后牙前移关闭间隙、前牙前移或者矫正中线的新型推簧装置；该推簧装置由控力主杆、加力推簧、传力转换角、传力臂等4个组件组成；并分析探讨了该装置的生物力学结构原理及临床应用效果，为实现临床上类似患者的治疗提供一种新的治疗方法。

关键词: 新型推簧, 正畸前移, 固定正畸矫正器, 种植支抗钉

Abstract:

In clinical practice, few orthodontic methods could be used to achieve simple mesial movement of molars, mesial movement of anterior teeth, anterior movement of whole dentition, or correction of midline of dentition. However, they are complicated or they have many side effects. Combining two cases, this paper introduces a new type of spring pushing device, which could achieve the whole dentition forward, the posterior teeth forward to close the gap, the anterior teeth forward, or the midline correction. The spring pushing device is composed of four components, such as the force control lever, the force pushing spring, the force transfer angle, and the force arm. The biomechanical structure principle and clinical application effect of the device were analyzed and discussed to provide a new treatment method for similar clinical patients.

Key words: novel spring, orthodontic advancement, fixed appliance, skeletal anchorage

中图分类号: 

  • R 783.5

图 1

新型推簧装置结构A：新型推簧装置组装完成的结构图；B：装置的4个组件。"

图 2

装置口外测量准备A：控力主杆长度；B：传力臂长度；C：推簧长度；b：种植钉与唇弓的垂直距离。"

图 3

装置安装A：口外安装；B：口内安装。"

图 4

装置固定"

图 5

推簧装置力的传递F1：推簧原始推力；F2：橡皮链等产生牵引力；F：终末推力。"

图 6

牙齿受力及移动方式分析红色线条为矫正前牙齿位置，白色线条为推力作用下牙齿前移，蓝色及红色箭头表示下颌牙列出现向前下的移动表现，深蓝色圆点表示下牙列的阻抗中心，浅蓝色圆点表示后牙单颗牙齿的阻抗中心。"

表 1

病例1矫治前后头影测量值分析"

测量项目矫正前矫正后
SNA/°85.3081.67
SNB/°76.8275.64
ANB/°8.486.03
FMA/°14.6215.49
U1-NA/mm1.900.77
U1-NA/°12.6510.27
U1-SN/°97.9591.95
L1-NB/mm4.364.70
L1-NB/°31.3941.07
L1-MP/°112.89122.42
UL-EP/mm2.41-0.57
LL-EP/mm0.130.13

图 7

病例1治疗前面颌像及X线片A~C：患者正面、微笑和侧面像；D：X线侧位片；E：全景片；F~H：患者口内右侧、正面和左侧咬合照；I、J：患者上颌、下颌口内照。"

图 8

病例1治疗中面颌像A~C：患者口内右侧、正面和左侧咬合照；D、E：患者上颌、下颌口内照。"

图 9

病例1治疗后面颌像及X线片A~C：患者正面、微笑和侧面像；D：X线侧位片；E：全景片；F~H：患者口内右侧、正面和左侧咬合照；I、J：患者上颌、下颌口内照。"

图 10

病例1保持1年后面颌像A~C：患者口内右侧、正面和左侧咬合照；D、E：患者上颌、下颌口内照。"

表 2

病例2治疗前后头颅侧位片分析测量值"

测量项目矫正前矫正后
SNA/°74.5981.15
SNB/°80.1679.73
ANB/°-0.561.43
FMA/°31.5633.05
U1-NA/mm4.415.05
U1-NA/°19.2122.98
U1-SN/°98.81104.13
L1-NB/mm5.524.84
L1-NB/°18.8622.17
L1-MP/°75.1377.76
UL-EP/mm-3.85-2.93
LL-EP/mm1.56-0.46

图 11

病例2治疗前面颌像及X线片A~C：患者正面、微笑和侧面像；D：X线侧位片；E：全景片；F~H：患者口内右侧、正面和左侧咬合照；I、J：患者上颌、下颌口内照。"

图 12

病例2治疗中面颌像A~C：患者口内右侧、正面和左侧咬合照；D、E：患者上颌、下颌口内照。"

图 13

病例2治疗后面颌像及X线片A~C：患者正面、微笑和侧面像；D：X线侧位片；E：全景片；F~H：患者口内右侧、正面和左侧咬合照；I、J：患者上颌、下颌口内照。"

图 14

病例2结束治疗1年后面颌像A~C：患者口内右侧、正面和左侧咬合照；D、E：患者上颌、下颌口内照。"

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