Musich David, Busch Matthew J
Department of Orthodontics, University of Pennsylvania, USA.
Alpha Omegan. 2007;100(1):17-24. doi: 10.1016/j.aodf.2006.07.003.
Although controversy remains about the value of EOT as ascertained by the randomized clinical trials for the class 11 malocclusion, this study clearly indicates that a variety of conditions benefit from a staged approach to the orthodontic correction. This study did not try to assess clinical efficiency of phase I treatment nor did it compare phase I appliances. but rather it attempted to survey referred early treatment case types and to illustrate successful outcomes frequently achieved with phase I therapy. Treatment acceptance of doctor recommendations (for early orthodontic intervention) was high (98%), illustrating excellent screening by referring dentists and a high level of parental awareness of the value of early intervention. Appliances selected for use were designed to be "user" friendly. Orthopedic appliances were prescribed to improve the harmony within the developing functional matrix of both the growing jaws and the dentoalveolar structures. All force systems were incorporated to use the basic principles of directional force mechanics to optimize favorable jaw growth and to create dentoalveolar changes that enhance function and esthetics while minimizing unfavorable responses. As part of the initial orthodontic treatment plan, most cases require a second phase (comprehensive treatment with full braces) to optimize the occlusal correction and to further enhance function and stability. We are convinced that EOT provides the following desirable benefits to the patient: Application of orthopedic appliances achieves predictable tissue response of muscle. growing bones, and sutures in younger patients (Figures 5-8). Improvement of the oral environment at a young age enhances self-esteem (Figures 5-8). Orthodontic intervention before all adult teeth erupt improves long-term stability (Figures 6-8). Patients spend less time in full braces (phase 11 treatment) during their teenage years. After analyzing the records of 100 consecutively referred patients for EOT, the findings verify that multistage orthodontic treatment is an important step in creating the treatment goals of improved function. enhanced facial and dental esthetics, and better health and stability for a select group of patients with significant skeletal and dental imbalances. In EOT teamwork, communication, case selection. and the recommendation of an effective treatment approach are essential elements of success.
尽管关于二期矫治对于安氏II类错牙合畸形的价值，随机临床试验仍存在争议，但本研究清楚地表明，多种情况受益于分阶段的正畸矫治方法。本研究并未试图评估一期治疗的临床效率，也未比较一期矫治器。相反，它试图调查转诊的早期治疗病例类型，并说明一期治疗经常取得的成功结果。医生建议（早期正畸干预）的治疗接受率很高（98%），这说明转诊牙医的筛选工作出色，且家长对早期干预的价值有很高的认识。所选用的矫治器设计得“用户”友好。使用矫形矫治器是为了改善正在生长的颌骨和牙牙槽结构的发育功能基质内的协调性。所有的力系统都采用定向力力学的基本原理，以优化有利的颌骨生长，并产生牙牙槽变化，在尽量减少不利反应的同时增强功能和美观。作为初始正畸治疗计划的一部分，大多数病例需要第二阶段（用全口矫治器进行综合治疗）来优化咬合矫治，并进一步增强功能和稳定性。我们确信，二期矫治为患者提供了以下理想的益处：对于较年轻的患者，使用矫形矫治器可实现对肌肉、生长中的骨骼和缝合线的可预测的组织反应（图5-8）。在年轻时改善口腔环境可增强自尊心（图5-8）。在所有恒牙萌出之前进行正畸干预可提高长期稳定性（图6-8）。患者在青少年时期佩戴全口矫治器（二期治疗）的时间较短。在分析了100例连续转诊进行二期矫治的患者记录后，研究结果证实，多阶段正畸治疗是为一组有明显骨骼和牙齿失衡的特定患者实现改善功能、增强面部和牙齿美观以及更好的健康和稳定性等治疗目标的重要步骤。在二期矫治团队合作中，沟通、病例选择以及有效治疗方法的推荐是成功的关键要素。
