快速扩弓联合固定矫治技术探讨

Rapid maxillary expansion combined with fixed orthodontics

背景:在牙齿后期的固定矫治器治疗中,前期的扩弓效果是否可以得到保持?扩弓过程中导致的下颌后旋是否能够改善?高角病例是否适合使用快速扩弓器?目的:就快速扩弓联合固定矫治技术对牙牙合颅面三维方向、软硬组织、颞下颌关节的影响及其长期的稳定性等做一综述。方法:以电子检索方式对CNKI、PubMed数据库学术期刊和万方数据库中关于快速扩弓联合固定矫治的文献进行分析,采用"扩弓""固定矫治""高角""稳定"为检索词进行检索,应用数据库的分析功能。结果与结论:快速扩弓能有效地扩大牙弓,增加牙弓的宽度,提供排齐牙齿所需的足够间隙。固定矫治器在三维空间上能有效地控制牙齿移动,精细调整牙位,使牙列排成理想牙弓形态。两种矫治器联合应用,使矫治器的效能优势互补,缩短了矫治疗程。扩弓引起的下颌骨顺时针旋转和下颌平面角增大,随着上下颌固定矫治器的使用,可以更加精细的调整上下颌的咬合关系,下颌第一磨牙随上颌磨牙颊向移动,重新建立良好的咬合关系,使下颌平面角减小。所以在临床治疗中可以适当应用上颌快速扩弓联合固定矫治治疗牙弓狭窄的高角患者。

BACKGROUND： In the treatment of teeth later fixed appliance, whether the expansion effect can be maintained？ Whether the expansion in the process of mandibular rotation could be improved？ Whether the high angle cases are suitable for rapid palatal expansion？ OBJECTIVE： To sum the effect of rapid maxillary expansion combined with fixed orthodontic technique on the occlusion craniofacial three-dimensional direction, hard and soft tissues and temporomandibular joint, as well as its long-term stability. METHODS： The CNKI database, PubMed database and Wanfang database were searched for the academic journals and literatures on rapid maxillary expansion combined with fixed appliance with the key words of ＂maxillary expansion, fixed appliance, high angle, stable＂. The analysis function of database was used. RESULTS AND CONCLUSION： Rapid maxillary expansion can effectively obtain arch expansion, increase the arch width, and provide space of align teeth required. Fixed appliance can effectively control the tooth movement in three-dimensional space, precisely adjust the teeth, and make the tooth rows into the ideal arch form. Combination of these two kinds of appliances can obtain the complementary efficiency advantages of the appliances, and shorten the treatment course. Expansion can cause mandibular clockwise rotation and mandibular plane angle increasing, while with the application of upper and lower fixed appliance, the occluding relation between maxilla and mandible can be adjusted more precisely in order to make the mandibular first molar move to the maxillary molar buccal, establish good occlusal relationship, so that decrease the mandibular plane angle. So the rapid maxillary expansion combined with fixed orthodontic can be used appropriately in the treatment of the patients with high angle intraversion.