目的 评价应用改良无托槽隐形矫治器压低过长磨牙辅助种植修复治疗的有效性.方法 本研究包括25名种植修复前正畸患者,平均年龄39.2±10.1岁.样本人群总计41颗过长磨牙需正畸压低治疗,其中上颌第一磨牙21颗,上颌第二磨牙16颗,下颌第一磨牙1颗,下颌第二磨牙3颗.完善牙周治疗并达到健康牙周状况.所有患者均接受了无托槽数字化隐形矫治器(IROK隐形矫治系统,西安恒惠科技有限公司)治疗.为了使压低磨牙的力量有更好的贮存和释放形式,我们改良设计了无托槽隐形矫治器压低牙齿的结构形式.过长磨牙压低治疗前后分别拍摄头颅侧位定位片,并进行头影测量的分析比较.结果 25名患者的41颗过长磨牙均取得良好的正畸压低治疗效果,压低治疗的平均时间7.4±2.3个月.21颗过长上颌第一磨牙和16颗过长上颌第二磨牙,相对于腭平面,分别平均压低3.3 mm(P＜0.001)和2.8 mm(P＜0.001).相对于下颌平面,3颗过长下颌第二磨牙平均压低2.7mm,一颗过长下颌第一磨牙治疗后压低3.5 mm.磨牙压低治疗后未见明显根吸收.结论 应用改良无托槽数字化隐形矫治器压低过长磨牙,是一种有效的辅助种植修复的正畸治疗方法.

Objective The purpose of this study was to evaluate the efficacy of modified Clear Aligners for intrusion of overeruped molars in implant-prosthodontic patients.Methods 25 implantprosthodontic patients (aged 39.2± 10.1 years) who needed molar intrusions before implant denture therapy were selected.There were 41 overerupted molars altogether,including 21 upper first molars,16 upper second molars,1 lower first molars and 3 lower second molars.The periodontal treatments were performed before orthodontic intrusion if necessary.All the patients were treated with Clear Aligners (IROK,Align Technologies,Xi''an,China).The aligners were modified to improve the applied intrusion force.Cephalographs before and after intrusion treatment were measured and compared.Results All patients had achieved satisfactory orthodontic and prosthodontic treatment effects.The average treatment period was 7.4±2.3 months.Intrusion distance relative to the palatal plane were 3.3 mm (P＜0.001) and 2.8 mm

目的 评价使用改型腭杆辅助压低过长上颌第二磨牙的临床效果.方法 选取13名需要压低过长上颌第二磨牙的成年患者,共18颗牙.采集矫治前、后记存模型进行激光扫描,在Rapidform 2006软件中进行三维测量,明确过长牙和支抗牙各牙尖点在三维方向上的移动量,通过曲面断层片观察过长牙与支抗牙压低前后的牙根吸收情况.结果 13名患者均完成过长牙的压低,平均疗程为5.5个月.过长后牙各牙尖点(近中颊尖、远中颊尖、近中腭尖、远中腭尖)分别被压低了0.90 mm、0.94 mm、1.78 mm和1.78 mm,远中移动了1.06 mm、1.06 mm、1.03 mm、0.92 mm,腭向移动了0.95 mm、0.88 mm、1.10 mm、0.85 mm,配对样本t检验显示差异具有极显著统计学意义(P＜0.001).而支抗牙的移动量不明显.X线片显示被压低的过长牙与支抗牙均未出现明显牙根吸收.结论 改型腭杆辅助压低过长上颌第二磨牙是一种有效便捷的正畸治疗手段.

Objective To evaluate the clinical effect on intrusion of overerupted upper second molars with modified transpalatal arch.Methods Thirteen adult patients with eighteen overerupted upper second molars were treated with modified transpalatal arch.Record models were taken before and after orthodontic treatment.After models scanning,the movements of overerupted second molars and anchorage teeth were measured three dimensionally by Rapidform 2006 software.The root resorptions were assessed with panoramic radiographs.Results All overerupted upper second molars were intruded successfully.The average treatment time was 5.5 months.The movement of four cusps of overerupted molars were measured at cusp apex of MB,DB,MP and DP.The intrusion distances were 0.90 mm,0.94 mm,1.78 mm,and 1.78 m.The distallization distances were 1.06 mm,1.06 mm,1.03 mm and 0.92 mm.The palatal movement distances were 0.95 mm,0.88 mm,1.10 mm and 0.85 mm.T-test for paired samples showed a statistically significant differen

目的：观察压低力对大鼠牙龈区血流的变化，探讨压低过程中牙周膜微循环的变化。方法对15只大鼠上颌第一前磨牙施加100g垂直向压入力，另一侧同名牙为对照组，1h后观察结果，采用显微电视记录仪直接观察牙龈区血流，利用计算机图像分析系统进行分析。结果100g力压低大鼠上颌第一前磨牙1h后，牙周膜微循环发生了明显改变，表现为牙龈基础和峰值血流量明显减少，毛细血管直径变细。结论100g压低力引起的即期反应为牙龈区血流受阻，牙周膜微循环的适应性改变，避免牙周膜受到过大负荷，减轻组织损伤。

Objective To observe the changes of gingival blood lfow induced by tooth intrusion,and investigate the microcirculation reaction of periodontal ligaments.Methods 15 rats with the maxillary ifrst premolar molar was applied 100g intrusion force for 1h,the other side of the same teeth as the control group.The microvascular blood lfow was observed and recorded through a microscopic television system and analyzed by speciifcally designed software.Results Periodontal ligament microcirculation signiifcantly changed after the maxillary ifrst premolar had been intruded for 1h.The diameter of the capillary turned small,and basic and peak value of gingival blood lfow decreased.Conclusion After the tooth intrusion with 100g force for 1h,the gingival blood lfow has been blocked. The microcirculation of periodontal ligaments changes to avoid overload on the periodontal ligament and decreased the injury of tissue.

目的探讨以微种植体为支抗压低伸长磨牙的有效性。方法选择2010年6月至2012年3月来大连博大口腔诊所就诊的13例需正畸压低伸长磨牙患者。其中9例因下颌第一磨牙长期缺失未进行修复，致上颌第一磨牙过度伸长，造成垂直向修复空间不足，不能直接进行义齿修复，需要压低上颌第一磨牙；另外4例因单侧第二磨牙正锁矜致上颌第二磨牙伸长、颊倾，对应的下颌第二磨牙舌倾。所有患者均利用微种植体作为支抗。使用弹力链施力于伸长的磨牙，产生根向压入力，同时对于正锁铪磨牙调整其不良颊舌向倾斜。治疗前后拍摄头颅侧位片和曲面断层片。结果9例因修复需要压低伸长磨牙的患者，伸长的磨牙均成功压低，获得了足够的义齿修复空间，并进行了种植义齿或固定义齿修复；4例单侧第二磨牙正锁袷的患者，上颌伸长的第二磨牙得到压低。且颊向倾斜得到改正。13例患者伸长的磨牙平均压入（3．00±0．65）mm，治疗时间平均为（6．50±0．59）个月。结论采用微种植体作支抗可有效压低伸长的上颌磨牙，且方便、快捷。

Objective To evaluate the efficiency of mini-screw implants as anchorage for extruded molar intrusion. Methods Thirteen patients with over-erupted maxillary molars were selected,including 9 patients with extruded maxil-lary first molars because mandibular first molars missed,and 4 patients with extruded maxillary second molars because of molars scissors bite on one-side posterior teeth. All the extruded first maxillary molars were intruded in gingival direc-tion with mini-screw implants anchorage. Lateral cephalograms and orthopantomograph were taken at the beginning and the end of the treatment. The movement of molars in vertical dimension was analyzed. Results The extruded first maxil-lary molars were intruded(3.00±0.65)mm averagedly in 6.5 months. Conclusion Mini-srcew implant as anchorage is an effective method to intrude the extruded maxillary molars.

目的探讨微型种植支抗高位植入上颌第二前磨牙与第一磨牙颊侧龈方内收压低前牙的临床疗效。方法选择10例上颌需强支抗的前突露龈笑正畸患者,植入微型种植体共20枚,植入1周后加载1.0~1.5 N力,观察种植体产生的牵引效果。结果所有病例矫治结束时均达到前牙有效内收压低,微笑露龈明显改善。结论正畸治疗中应用种植支抗高位植入牵引可有效内收压低前牙。

Objective To analyze retraction and intrusion effects of high positioned mini screws which were put between upper sec-ond premolars and first molars.Methods Ten Orthodontic patients with anterior teeth protrusion and gummy smile were included. Twenty mini screws were put and 1 .0 -1 .5 N force were added to retract anterior teeth one week later.Effects of retraction and intru-sion were analyzed.Results Profiles of all cases improved effectively and gummy smiles were corrected.Conclusions High posi-tioned mini screws can effectively retract and intrude anterior teeth.