Wichelhaus A, Sander F G
Poliklinik für Kieferorthopädie, Universität Ulm.
Fortschr Kieferorthop. 1995 Jul;56(4):202-15. doi: 10.1007/BF02168133.
While planning treatment of the 30 patients with a dental and skeletal class II anomaly on which this study is based, the primary treatment goals were correction of the dental and skeletal structures and attenuation of vertical growth by means of influencing the maxillary skeletal structures and the resultant mandibular reaction. The desired treatment results were achieved in all patients. Even so, however, the effects on individual patients in respect to skeletal influences were markedly different. It was especially helpful that during therapy simultaneously with exerting influence on the maxillary base plane, the influencing of the occlusal plane occurred in the same direction. Through the additional application of high-pull headgear, maxillary growth was clearly restrained and the inclination of the maxillary base plane inhibited. Even difficult skeletal discrepancies, sagittal as well as vertical, can be treated with the bite-jump appliance in combination with a high-pull headgear. This also makes it possible to achieve protrusive repositioning of the mandible in patients with a pronounced vertical growth pattern without causing on open bite. In retrospective the patients' treatment plans proved to be completely appropriate, however, the fact should not be overlooked that changing the occlusal plane is essential for the realization of a positive therapeutic result.
在为本研究纳入的30例牙性和骨性II类错畸形患者制定治疗计划时,主要治疗目标是通过影响上颌骨结构及由此产生的下颌反应来矫正牙和骨骼结构,并减缓垂直向生长。所有患者均达到了预期的治疗效果。即便如此,然而,在骨骼影响方面,对个体患者的效果仍存在显著差异。特别有帮助的是,在治疗过程中,在上颌基平面受到影响的同时,咬合平面也朝着相同方向受到影响。通过额外使用高位牵引头帽,上颌生长明显受到抑制,上颌基平面的倾斜度也得到抑制。即使是严重的矢状向和垂直向骨骼差异,也可通过咬合跳跃矫治器联合高位牵引头帽进行治疗。这也使得在垂直生长型明显的患者中实现下颌前伸复位成为可能,而不会导致开。回顾性分析表明,患者的治疗计划完全合适,然而,不应忽视的事实是,改变咬合平面对于实现积极的治疗效果至关重要。