深覆合的矫治.pptx

深覆合的矫治深覆合的矫治deep overbite correction开合的矫治开合的矫治open bite correction复发与保持复发与保持Relapse and Retention深覆合的矫治深覆合的矫治deep overbite correction一、机制一、机制l1.前牙区牙、牙槽高度发育过度前牙区牙、牙槽高度发育过度lOvereruption of the anterior teethl2.后牙区牙、牙槽高度发育不足后牙区牙、牙槽高度发育不足lLack of eruptiontion of the posterior teethl3.两者皆有两者皆有二、分级二、分级l度度l度度l度度三、病因三、病因l1.遗传因素遗传因素l2.发育因素发育因素l3.咬合因素咬合因素l4.替牙因素替牙因素l5.功能因素功能因素四、临床表现四、临床表现五、诊断五、诊断l1.牙性牙性(dental type)l2.骨性骨性(skeletal type)l X线头影测量线头影测量l ANBl S-Go/N-Mel PP OP MP六 深覆合矫治深覆合矫治l 关键是如何打开咬合关键是如何打开咬合l1.前牙区牙、牙槽高度发育过度前牙区牙、牙槽高度发育过度 原则原则 压低前牙为主压低前牙为主 方法：多用途弓方法：多用途弓(utility arch)l by pass archl 片断弓片断弓 segmented archl J钩钩 100g力力l 后倾曲后倾曲 六、深覆合矫治六、深覆合矫治l2.后牙区牙、牙槽高度发育不足后牙区牙、牙槽高度发育不足l 原则：原则：升高后牙为主升高后牙为主l 方法：方法：a 活动矫治器活动矫治器 舌簧上附平面导板舌簧上附平面导板（生长（生长l 期）期）(removable biteplate appliances)l b 口外弓口外弓 颈支抗颈支抗(cervical headgear)l 上后牙伸长上后牙伸长l c功能矫治器功能矫治器 上、下磨牙伸长上、下磨牙伸长l （Herbst twin block)六、深覆合矫治六、深覆合矫治l2.后牙区牙、牙槽高度发育不足后牙区牙、牙槽高度发育不足l非生长期非生长期l 轻度轻度 a 固定矫治器结合固定矫治器结合类牵引类牵引,对上前牙压对上前牙压l 低力应大于垂直分力低力应大于垂直分力l 整平整平Spee曲线曲线l b 结合小平导结合小平导l 托槽位置托槽位置 对前磨牙区伸长，托槽偏龈方对前磨牙区伸长，托槽偏龈方1mml 重度重度 手术手术l3.两者皆有两者皆有l 加大补偿曲线，反加大补偿曲线，反Spees曲线曲线开合的矫治开合的矫治open bite correction一、机制一、机制l1.前牙区牙、牙槽高度发育不足前牙区牙、牙槽高度发育不足lLack of eruptiontion of the anterior teethl2.后牙区牙、牙槽高度发育过度后牙区牙、牙槽高度发育过度lOvereruption of the posterior teethl3.两者均有两者均有二、分级二、分级l度度l度度l度度三、病因三、病因口腔不良习惯口腔不良习惯牙齿萌出异常牙齿萌出异常佝偻病佝偻病四、临床表现四、临床表现五、诊断l1.牙性牙性l2.骨性骨性l X线头影测量线头影测量l S-Go/N-Mel PP OP MP六、矫治l1.生长期生长期l（1）牙性）牙性l a 活动矫治器活动矫治器 舌屏、腭刺舌屏、腭刺l b 固定矫治器固定矫治器 垂直牵引垂直牵引 l（2）骨性）骨性l 矫形治疗矫形治疗 High pull headgearl 控制垂直生长，下颌向前上旋转控制垂直生长，下颌向前上旋转六、矫治六、矫治l2.非生长期非生长期 拔牙矫治拔牙矫治l（1）牙性）牙性 lA.前牙区牙、牙槽高度发育不足前牙区牙、牙槽高度发育不足l 固定矫治器固定矫治器 垂直牵引垂直牵引 lB.后牙区牙、牙槽高度发育过度后牙区牙、牙槽高度发育过度l 配合合垫配合合垫 横腭杆横腭杆l 采用采用Tweed技术、技术、MEAW技术技术l 伸长下前牙伸长下前牙 允许有一点允许有一点Spee曲线曲线六、矫治六、矫治l2.非生长期非生长期 拔牙矫治拔牙矫治（2）骨性）骨性l 轻度：增加牙代偿轻度：增加牙代偿 摇椅弓摇椅弓 种植体支抗种植体支抗l 采用采用MEAW技术、技术、MBT技术技术l 重度：正畸重度：正畸-正颌外科正颌外科l 低角低角 下颌骨矢状劈开，前移并后旋下颌下颌骨矢状劈开，前移并后旋下颌l 体，上颌体，上颌Lefort型手术，下移上颌型手术，下移上颌l 高角高角 上颌骨整体上移上颌骨整体上移l 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