应用新型及特殊口腔正畸保持器的临床观察

Application of new and special retainers in orthodontic outcomes maintaining

目的综合评价新型保持装置(改良式热压膜联冠透明器、透明高强纤维舌侧保持器等)及特殊保持装置在正畸临床中的应用效果。方法通过新型保持器及特殊保持器对82例各类错畸形进行矫治后的疗效维持。结果①改良式热压膜透明保持器的综合性能(如患者主观认同感、保持疗效评价、保持器本身问题复诊率、技工室和临床椅旁操作时间、操作工序比较等方面)明显优于传统Hawley s保持器。②透明高强纤维舌侧保持器具有美观、舒适,操作简单,疗效维持确切,适应范围广等优点,但价格较贵。③改良式肌激动器用于骨性Ⅱ类错矫治后的疗效维持效果确切。④严重开矫治后的保持,要根据其成因、错机制、周围软组织维持、功能等综合考虑,但由于需患者配合部份较为繁琐、复杂,有些甚至需采用手术方法解除不稳定因素,故疗效稳定性难以确切保证。结论正畸临床应根据不同类型的口腔错畸形设计制作不同的保持装置,探索并开发符合医患双方需求的新型的具有特殊功效的保持装置势在必行。

Objectives To evaluate the effects of the new and special retainers in orthodontic outcomes maintaining. Methods 82 cases with severe malocclusions were worn with the reformed transparent full-arch wraparound retainer or the hngual fix retainer of ever stick ORTHOD or the special retainers after orthodontic treatment to maintain the outcomes respectively, then some objective and subjective items of different retainers were observed and evaluated. Results ① The reformed transparent fill-arch wraparotmd retainer had obvious advantages over Hawley retainer in such aspects as the patient compliances, the effects of outcomes retaining, the frequencies of further consultation because of the drawbacks of retainers,the laboratory time,chairtime and clinic procedures.②The lingual fix retainer of ever stick ORTHOD had the merits of esthetic treatment, comfortable feelings, sample clinic procedures, stable retaining effects and wide indications, but it was more expensive. ③The outcomes of skeletal class Ⅱ malecclusions after treatment could be maintained firmly by reformed activators. ④The methods chosen to retain the outcomes of open bite must be fully considered in temrs of causes and mechanism of malocchlsions, soft tissue and functions. But the stability of the or thodontic outcomes of severe open bite malocclusions were difficult to obtain because of the complexity of retainers and the high level of patient compliances. Some patients should be treated with surgical methods to get rid of the unstable factors. Conclusion Patients after orthodontic treatment should be worn different retainers according to different malocclusions. Development and application of the new and special retainers are important to achieve stable orthodontic treatment outcomes.