Roberts W W, Chacker F M, Burstone C J
Am J Orthod. 1982 Mar;81(3):177-84. doi: 10.1016/0002-9416(82)90051-3.
Diagnosis and treatment in molar uprighting are discussed. The over-all objective in molar uprighting is ideal positioning of the molar which will eventually become an abutment tooth for a fixed prosthesis. The ideal position will provide an optimal periodontal environment for the molar(s). The specific objectives concerning protection against inflammatory periodontal diseases and occlusal traumatism, which together determine the optimal periodontal environment, are explained. Emphasis is placed on the biomechanics of molar uprighting which will achieve the desired periodontal treatment result. The specific technique recommended for the instances in which the molar is considerably angulated involves a segmental approach which utilizes a modification of the Burstone root spring. Proper application results in the dissociation of the correction of angulation and the extrusion of the molar tooth. When extrusion of the periodontally involved molar is required, then it should follow the correction of molar angulation. Other advantages of this approach involve the precision and ease of symmetrical preactivation, favorable load/deflection considerations, the low level of patient discomfort, and the reduced tendency of normal function distorting or dislodging the spring. This technique is compared by these parameters to other popular molar-uprighting techniques. It is recognized that a multidisciplinary approach to this type of dental therapy is ideal and that since treatment planning in individual cases varies greatly, each malocclusion and associated periodontal involvement should be evaluated on an individual case basis.
本文讨论了磨牙直立的诊断与治疗。磨牙直立的总体目标是使磨牙达到理想位置，最终成为固定修复体的基牙。理想位置能为磨牙提供最佳的牙周环境。文中解释了与预防炎症性牙周疾病和咬合创伤相关的具体目标，这两者共同决定了最佳的牙周环境。重点阐述了能实现预期牙周治疗效果的磨牙直立生物力学原理。对于磨牙严重倾斜的情况，推荐的具体技术是采用分段法，即对Burstone根弹簧进行改良。正确应用该技术可使磨牙倾斜度的矫正与牙齿的伸长分离。当需要伸长牙周受累的磨牙时，应在矫正磨牙倾斜度之后进行。该方法的其他优点包括对称预激活的精确性和简便性、良好的载荷/变形特性、患者不适感低以及正常功能使弹簧变形或移位的倾向降低。通过这些参数将该技术与其他常用的磨牙直立技术进行了比较。人们认识到，对于这类牙科治疗采用多学科方法是理想的，而且由于个别病例的治疗计划差异很大，每个错牙合畸形及相关的牙周病变都应根据具体情况进行评估。
