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对II类1分类深覆合病例正畸治疗多年后的咬合稳定性进行随访。

Occlusal stability in Class II, Division 1, deep bite cases followed up for many years after orthodontic treatment.

作者信息

Kondo E

出版信息

Am J Orthod Dentofacial Orthop. 1998 Dec;114(6):611-30. doi: 10.1016/S0889-5406(98)70193-3.

Abstract

This case report analyzes long-term occlusal stability that can be achieved in Class II, Division 1, deep bite cases with active treatment finished during the period of maxillomandibular growth. The analysis was designed to identify occlusal features common to two cases at the end of active treatment and to study how the occlusion changed with growth and jaw movement to achieve stability. The following occlusal features were shared by the two cases at the end of active treatment: (1) AB plane and axes of the maxillary and mandibular posterior teeth were perpendicular to functional occlusal plane; (2) the axis of the lower incisor was almost perpendicular to DC-L1i line; (3) the anterior occlusion was overcorrected to or near an edge-to-edge relationship. Items 1 and 2 remained unchanged throughout the follow-up periods, regardless of growth status, and the overjet and overbite increased during maxillomandibular growth after treatment. During the period of mandibular growth alone, after the end of retention, the axes of maxillary incisors tipped labially; as a result, F line became parallel to CDM line by the end of growth. The labial tipping of maxillary incisors brought the lower incisal edge into contact with or extremely near the inflection point (Bp).1 By the end of growth, the tangent of Bp became parallel to or coincident with DC-L1i line and perpendicular to the axis of the lower incisor, and the DC-L1i lines at various times posttreatment were almost parallel to each other in the two cases. Overjet increased as the maxillary incisors tipped labially, providing proper protrusive and retrusive paths for mandibular guidance. The angle between the functional occlusal plane and CDM line stayed almost the same as at the end of active treatment in the two cases, suggesting a possible change in the angle of eminence in harmony with the functional occlusal plane. These factors apparently contributed to the long-term occlusal stability in the two cases.

摘要

本病例报告分析了在上下颌生长期间完成积极治疗的安氏II类1分类深覆合病例中可实现的长期咬合稳定性。该分析旨在确定积极治疗结束时两个病例共有的咬合特征,并研究咬合如何随生长和颌骨运动而变化以实现稳定性。积极治疗结束时,两个病例具有以下共同的咬合特征:(1)AB平面以及上颌和下颌后牙的轴与功能咬合平面垂直;(2)下切牙的轴几乎垂直于DC-L1i线;(3)前牙咬合过度矫正至或接近对刃关系。项目1和2在整个随访期间保持不变,与生长状态无关,并且治疗后上下颌生长期间覆盖和覆合增加。仅在颌骨生长期间,保持结束后,上颌切牙的轴唇倾;结果,生长结束时F线与CDM线平行。上颌切牙的唇倾使下切缘与拐点(Bp)接触或极其接近。1生长结束时,Bp的切线与DC-L1i线平行或重合,并且垂直于下切牙的轴,并且在两个病例中治疗后不同时间的DC-L1i线几乎彼此平行。随着上颌切牙唇倾,覆盖增加,为下颌引导提供了适当的前伸和后退路径。两个病例中功能咬合平面与CDM线之间的角度与积极治疗结束时几乎相同,表明可能与功能咬合平面协调的牙合平面角发生了变化。这些因素显然有助于两个病例的长期咬合稳定性。

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