高角和低角病例的诊断、临床特征及正畸治疗特点

高角和低角病例的诊断、 高角和低角病例的诊断、临床特征及 正畸治疗特点High angle and low angle cases, diagnosis, clinical features and orthodontic treatment

由于以往的诊断是以安氏 分类为主, 分类为主 正畸医生常常 只注意到矢状向错牙合而 忽略了垂直向不调。 忽略了垂直向不调。 近年来 学者们逐渐认识 近年来, 到垂直面型在错畸形诊断 和治疗中的重要性: 和治疗中的重要性 它不 仅为颅面复合体的生长方 向提供了线索, 向提供了线索 而且直接 影响治疗的成功与否。 影响治疗的成功与否。

Previous diagnosis was based on Angle's classification so orthodontists often only noticed the sagittal malocclusion while ignoring the vertical dimension. In recent years, scholars have come to realize the importance of the vertical dimensions in the diagnosis and treatment of malocclusion it not only provides clues to the direction of growth of the craniofacial complex, but also directly affects the success of treatment.2

垂直向异常有高角和低角两种类型, 垂直向异常有高角和低角两种类型 在Ⅲ类 安氏错牙合中约有50%左右的患者存在不同程度 安氏错牙合中约有 左右的患者存在不同程度 的垂直向异常。 的垂直向异常。Vertical anomaly are of two types of high-angle and low angle, about 50%of patients with angle class III malocclusion have varying degrees of abnormal vertical dimension

high-angle and low angle cases, diagnosis, clinical features, and orthodontic treatment

一、高角病例和低角病例的诊断和形成机制High angle and low angle cases diagnosis and form 文献中用来描述垂直向异常的说法很多,常用的有开张面 型( hyperdivergent ) 、向后旋转型( backward rotation ) 、 垂直生长型(vertical type) 、长面型( dolichocephalic ) 、 高角型( high -angle face ) , 均指垂直向异常以发育过度 ( vertical excessive ) 为主, 而聚合面型( hypodivergent ) 、 向前旋转型( forward rotation) 、水平生长型( horizontal type) 、短面型( brachypechalic) 、低角型( low -angle face) 则是指垂直发育不足( vertical deficiency ) 。 由于诊断标准和侧重点不同, 从严格意义上讲, 这些概念之 间是有差异的, 但在临床中描述垂直面型时经常通用。 Diagnostic criteria and a different focus, in the strict sense, these concepts there is a difference, but often common in the clinical description of vertical type.4

高角病例和低角病例的诊断和形成机制High angle and low angle cases diagnosis and form

本文中统称为高角和低角, 但不能误解为下 颌平面角大者即为高角型、小者即为低角型, 这 是因为下颌角和下颌下缘在生长改建过程中变 化较大, 所以单纯以下颌平面角作为诊断标准可 能掩盖了下颌真实的旋转方向,对垂直

面型的正 确诊断还应结合其他指标。Referred to article as high-angle and low angle, should not be confuse with the mandibular plane angle, if it is high, called high angle case, and if small than low angle case. Because the mandibular angle and mandibular margin changes with growth,so simple mandibular plane angle as the diagnostic criteria may mask the true mandibular rotation and direction of the vertical growth.The correct diagnosis should be combined with other indicators5

目前常用的诊断标准是: 目前常用的诊断标准是The commonly used diagnostic criteria are: ( 1) 下颌平面角Mandibular plane angle: 高角病例前颅 底—下颌平面角( SN - MP) 大 于40°,FH 平面—下颌平面角 ( FH- MP) 大于32°;低角病例 SN- MP 小于29°,FH- MP 小 于22°。 ( 2) 后面高与前面高比值 anterior to the posterior facial height ratio ( S- Go/ N- Me) : 高角病例大于68%; 低角病例 小于62% 。 ( 3) 下前面高与前面高比值 lower to the upper facial height ratio( ANS- Me/ N Me) : 高角病例大于58% ; 低 角病例小于55%。

高角病例或低角病例的形成主要与前后面部高度的生长发育失调有关。high-angle or low angle cases with a high level of growth and development before and after facial disorders

后面部高度生长不足( 升支短小、关节窝靠前靠上) 和/ 或前面部高度 生长过度( 髁突向后生长、上颌骨垂直发育过度、后牙垂直萌出过度) 形成了高角型。Lack of posterior facial growth ( ascending branchof the glenoid fossa small ) and/or anterior facial height overgrowth(condylar backward growth, excessive eruption of the maxillary posterior teeth) is responsible for a high-angle case.

后面部高度生长过度( 升支较长、关节窝靠后靠下) 和/ 或前面部高度 生长不足( 髁突向上向前生长、上颌骨垂直发育不足、后牙萌出不足) 形成了低角型。 posterior height overgrowth (the ascending branchof a glenoid fossa long) and/or in lack of posterior facial growth (upward and forward rotation of condyle,lack of eruption of maxillary posterior teeth) is resposible for low-angle case.

二、高角病例和低角病例的临床特征The case of high-angle and low angle of the clinical features 1、面型: 正面观 、面型 高角病例多为窄长脸 两侧下颌角不明显, 型,两侧下颌角不明显 鼻 两侧下颌角不明显 根部较窄, 根部较窄 常伴有唇功能 不足、开唇露齿; 不足、开唇露齿

低角病例则多为宽短脸型, 低角病例则多为宽短脸型 两侧下颌角呈方形, 两侧下颌角呈方形 鼻根部 较宽, 唇闭合十分自然。 较宽 唇闭合十分自然。8

clinical features of high-angle and low angle casesA face: front view: High-angle: long and narrow face, both sides of the mandibular angle is not distinct, the nasion is narrow, often accompanied with incompetent lip.

Low

-angle cases are much more wide and short face. Both sides of the mandibular angle was a square, nasion is wide, lip closure is normal9

侧面观Lateral view :高角病例呈开张面型, 面 下1/ 3 长,凹面型多见, 上唇 较厚, 颏部和颏唇沟均不明 显, 头位略前伸; High anglecases, length of the lower 1/3 of the face is long, the concave type profile more common, thick upper lip, chin and chin lip groove are not prominent.

低角病例呈聚合面型, 面 下1/ 3 段短, 凸面型多见, 上唇较薄,颏部和颏唇沟明 显。 low-angle cases the lower1/3 of the face generally shorter convex facial profile, thin upper lip, chin and chin lip groove are prominent.10

二、高角病例和低角病例的临床特征The case of high-angle and low angle of the clinical features 2、牙Tooth : 高角病例常见上牙弓狭窄、腭盖高拱, 由于切牙多唇向倾斜前牙拥挤较少见, 前牙 覆浅甚至呈现开或开倾向, 后牙的临床冠高 度较大, 曲线平坦甚或反向, 上下颌之 …… 此处隐藏：4990字，全部文档内容请下载后查看。喜欢就下载吧 ……