正畸和正颌治疗中的牙合学问题56.pptVIP

正畸和正颌治疗中的牙合学问题Occlusion study in orthodontics and orthognathic treatment;Two upper first premolars were extracted to correct open bite , but after the treatment TMD appeared.; 　CASE; 病人起诉外科医生，要求赔偿2500美元。 法官最终认为是正畸医生内收上前牙迫使下颌后退造成关节病，判决赔偿一百万美元。;颞下颌关节紊乱症 TMD;错牙合畸形的致病机制;与TMD的发生有明显关系的特征性错牙合Characteristic malocclusions;深覆牙合Deep Overbite;　深覆盖　Deep Overjet;反牙合 Crossbite;正畸中的牙合学The occlusion during orthodontic treatment正畸治疗是牙位置的改变，也是咀嚼系统的重建过程，因此，需注意任何可能的诱因。Orthodontic treatment is tooth movement, as you know, is also a rebuilding progress of mastication systemtherefore, pay attention to any possible reaseson.;初诊First visit;牙列拥挤 前牙对刃 Dentition crowding Anterior teeth edge to edge;;;;排齐和整平 Alignment and leveling;;;;b.关闭前牙间隙 Closing space at anterior region;上切牙内收Upper incisors moving palatally;颌间牵引Intermaxillary traction ;颌间高度的控制Control of intermaxillary height;3.精细调整fine adjustment ;;治疗后 Post-treatment;;;牙合的六项标准;;治疗中以下情况需注意Following situations should be paid attention during treatment;治疗中处理Managements;对咀嚼系统功能影响较大的正畸治疗因素Major factors;1. 矫治时机 上下颌骨存在骨性不调,希望进行功能矫形治疗时,一定要检测患者的生长发育情况。 If skeletal discrepancy is shown and the functional treatment is wanted, making sure to examine the patient’s growth and development.;2. 施加力量 III类颌间牵引力过大 下颌后移过多 关节区疼痛。 II类颌间牵引力过大 继发下颌髁突后移位 关节症状。 局部牙齿用力不当 牙合创伤。 Force ClassIII Intermaxillary traction force is too heavy mandible move posteriorly too much , pain of the joint. ClassII intermaxillary traction force is too heavy secondary posterior displacement of condyle joint symptoms. Force of partial teeth is inappropriate occlusal trauma.;3. 牙合的改变： 正畸治疗牙移动过程中可能有早接触。 病人配合不好。 长期使用过高合垫 髁突发生代偿性前移。 重度错位牙，严重的牙合干扰。 矫治不当，形成早接触。 Occlusal changes: There maybe premature contacts when moving teeth during treatment. Patients don’t follow the doctor’s advice. Utilizing overhigh occlusal splint for a long time anterior condy