应用Smartclip自锁托槽矫治上颌牙列拥挤的临床研究(1)
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[摘要]目的：探讨Smart clip自锁托槽矫治上颌牙列拥挤病例的牙弓变化特点。方法：选取20例上牙轻中度拥挤的患者，不拔牙矫治，使用Smart clip自锁托槽排齐牙列，在治疗前和上牙排齐时分别进行模型测量，对比分析治疗前后上颌牙弓宽度、牙弓长度及周长的变化，应用SPSS12.0统计软件分析处理数据。结果：排齐后与治疗前阶段相比，上颌牙弓长度、周长、前磨牙间宽度和第一磨牙间宽度均显著增加，尖牙间宽度和第二磨牙间宽度无显著变化。结论：应用Smart clip自锁托槽系统排齐和整平上颌轻中度拥挤牙列，上颌牙弓宽度、牙弓长度及周长均显著增大，增加不拔牙矫治可能。
[关键词]自锁托槽；牙弓宽度；牙弓长度；牙弓周长
[中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455(2011)03-0485-03
Clinical study on correction of maxillary dental crowding with Smart clip self-ligating system
WANG Hai-yan1,LI Hu2
(1.Department of Stomatological,People's Hospital of Xinyi,Xinyi 221400,Jiangsu,China;2.The Research Institute of Stomatology,School of Stomatology,Nanjing Medical University)
Abstract: Objective To clarify changes in the dental arch on Nonextraction correction of maxillary dental crowding with Smart clip self-ligating system. Methods The Smart clip self-ligating system was used in 20 patients with mild and moderate crowding in the maxillary arch.Models of the maxillary arch were taken before treatment and at the end of leveling and aligning phase.Width,depth and perimeter of the dental arch were measured on the pre-treatment and post-treatment models.All data were analyzed by SPSS12.0 software. Results Compared with pre-treatment,on the post-treatment statistically significant increases were recorded in depth,perimeter and premolar widths and the first molar widths.No significant changes were found in the cuspid width and the the second molar width. Conclusion During the initial phase of leveling and aligning, the Smart clip self-ligating system produces significant increases in the dental arch width and depth and perimeter of the maxillary arch.
Key words:self-ligating brackets;arch width;arch depth;arch perimeter
自锁托槽是近年来研究的热门，可以更快地排齐整平牙列，减少患者复诊次数和椅旁时间，提高效率[1]。尤其是对牙列拥挤患者，自锁托槽矫治技术配合高弹力镍钛(Ni-Ti)弓丝通过扩大牙弓，实现了更多的非拔牙矫治。代表性的是Damon自锁托槽矫治器结合超弹性含铜Ni-Ti丝可以实现上颌牙弓宽度的显著增大[2]。通过Damon自锁托槽配合使用轻力弓丝改变口面肌肉的动力平衡，甚至对严重拥挤的病例也可以采取不拔牙矫治。牙弓扩大改建后形成新的形态容纳所有牙齿，即牙齿的位置由机体自身调节到合适的地方是最自然的，而不是由医生来决定。
本研究应用Smart clip自锁托槽系统对上颌牙列轻度到中度拥挤的正畸患者进行矫治，通过不同阶段模型测量对比研究，分析上颌牙弓各个方向形态的变化，为临床不拔牙矫治提供一定的理论依据。
1 资料和方法
1.1临床资料：选择20例(男10例，女10 例)恒牙期拥挤病例，面型较直，年龄18～30岁，平均21 ......
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