運用新式微形骨釘作為矯正治療的錨定

The Application of a New Osseous Miniscrew for Orthodontic Anchorage

林政毅(James Cheng-Yi Lin) ； 劉人文(Eric Jein-Wein Liou) ； 廖炯琳(Johnny Joung-Lin Liaw)

《中華民國齒顎矯正學雜誌》 14卷2期 (2002/06) Pp. 33-38

https://doi.org/10.30036/TJO.200206.0005

摘要

為了解決上顎發育不良所形成中臉部塌陷及牙弓過窄問題，臨床上，常使用快速上腭擴大裝置來治療。此裝置的主要作用，在於將腭正中骨縫打開，以改善上顎牙弓横向缺乏及牙齒擁擠的情形，有時合併使用頭罩加以前引，以治療前牙錯咬的現象。自西元1860年，Angell將快速上腭擴大之原理應用於牙齒矯正治療，並針對臨床使用步驟提出報告後，百餘年來，已發展出各式各樣的擴大器。目前臨床上使用的上腭擴大器，患者在治療後，由咬合面觀察上腭骨擴大之情形，發現上腭正中骨縫呈現鍥形(Wedged-shape)擴大，即以前寬後窄的方式，向兩側不等量分開。根據幾何學原理，上述現象會造成上顎前緣後移，如此，雖解決了牙弓横向寬度的問題，對於上下顎之間，前後相對位置的問題卻無改善。基於此發現，應用不同的幾何觀念，重新設計上腭擴大器，改變旋轉中心的位置，以確保治療後，同時改善牙弓横向及顎間前後之關係。六位使用此新裝置治療的患者，治療前後均印取上顎石膏模型，並加以測量牙齒移動的距離，據此比較治療前後之差異。結果顯示，此新型快速上腭擴大器，治療後確實可達到牙齒左右分開及前移之要求。臨床上，解決中臉部塌陷及牙弓過窄的方法上，又多了一項利器。(J.Taiwan Assoc.Orthod.14(2):39-46,2002)

關鍵字

骨釘錨定

並列摘要

It has been more than 100 years since Angell's first report in 1860 of using rapid maxillary expanders forincreasing maxillary transverse dimension.The expander is now becoming one of the contemporarytechniquesformaxillary protraction.It is claimed that rapid maxillary expansion disarticulates circum-maxillary sutures and makesmaxillary protraction easierfor facemask.The expander expands the intermaxillary suture in a V-shaped mannerwith the center of rotation around the posterior nasal spine,at which each half of the maxilla is rotated outward andbackward geometrically.This may entail posterior displacementofmaxillathatisnot favorablefortreating a hypoplastic maxilla.The purpose of this study is to report a new expander(2-hinged expander)that entails consistentanterior displacement of maxilla during expansion.Six cleft lip and palate patients with hypoplastic maxillae wereincluded in this study.Maxillary dental casts were taken for measuring the geometric changes of the maxillarydentition right before and after maxillary expansion by the 2-hinged expanders.The results revealed that the maxillarydentition,specially the anteriorteeth,was anteriorly displaced consistently.We concluded that the 2-hingedexpander is a useful device for treating a patient with anterior crossbite and midface retrusion.(J.Taiwan Assoc.Orthod.14(2):39-46,2002)

並列關鍵字

Bone-Screw Anchorage