简介:摘要目的探讨无托槽隐形矫治器联合微种植钉内收上前牙时,先远移尖牙与整体内收两种方式内收时上颌前后牙生物力学效应。方法采集患者上颌骨及上牙列的CBCT数据信息,使用Mimics、Geomagic Studio、HyperMesh等软件,采用逆向工程方法建立拔除上颌第一前磨牙使用无托槽隐形矫治器联合微种植钉整体内收上前牙的三维有限元模型,分析:①矫治器加力远移尖牙;②矫治器加力+矫治器牵引钩处150 g牵引力远移尖牙;③矫治器加力+尖牙舌钮处150 g牵引力远移尖牙;④矫治器加力整体内收上前牙;⑤矫治器加力+矫治器牵引钩处150 g牵引力整体内收上前牙;⑥矫治器加力+尖牙舌钮处150 g牵引力整体内收上前牙,六种工况下前后牙的牙周膜等效应力和初始位移。结果只远移尖牙时,尖牙所受牙周膜等效应力最大,分别为5.23E-02 MPa、5.65E-02 MPa、5.87E-02 MPa;上中切牙的唇侧位移量分别为-5.08E-03 mm、-9.67E-04 mm、-1.68E-03 mm,第一磨牙牙冠近移量分别为-1.53E-02 mm、-1.40E-02 mm、-1.51E-02 mm。整体内收上前牙时,中切牙所受牙周膜等效应力最大,分别为4.69E-02 MPa、6.26E-02 MPa、4.84E-02 MPa;中切牙的冠根位移差分别为1.44E-01 mm、1.35E-01 mm、1.29E-01 mm,第一磨牙牙冠近移量分别为-2.93E-02 mm、-2.61E-02 mm、-2.33E-02 mm。结论只远移尖牙时,切牙会为尖牙的远移提供支抗,在矫治器上牵引能够更有利于前后牙支抗的保护;整体内收上前牙时,在尖牙上牵引更有利于后牙支抗的保护和切牙的整体移动。
简介:目的探讨无托槽隐形矫治器结合微种植体支抗远移上颌磨牙的效率及在三维方向上的特点,以期为无托槽隐形矫治器的设计提供理论依据。方法选取需进行上颌磨牙远移的安氏Ⅱ类错患者12例,应用无托槽隐形矫治器远中移动上颌磨牙、前磨牙,其中7例结合微种植体牵引尖牙增加支抗,所有患者定期制取阶段研究模型并使用三维扫描仪将模型数字化。通过重叠治疗前与各阶段的三维数字化模型,分析在不同矫治阶段磨牙、前磨牙的远移效率以及在三维方向上的移动特点;对比有无微种植体支抗对磨牙远移效率及前牙支抗的影响。结果微种植体支抗组上颌第二、第一磨牙的远移效率分别为89.20%和83.53%,均比无微种植体支抗组远移效率高,但差异无统计学意义(P〉0.05);上颌磨牙远移会造成切牙轻度唇向及近中移位,其中微种植体支抗牵引尖牙组前牙支抗损失量较小,但差异无统计学意义(P〉0.05)。当上颌第一磨牙开始远移时,第二磨牙的远移效率明显下降(P〈0.05)。上颌磨牙远移过程中磨牙未见明显旋转,有轻度压低和颊移(P〉0.05),而上颌前磨牙远移过程中发生明显颊舌向旋转(P〈0.05)。结论无托槽隐形矫治器可以有效地远移上颌磨牙、前磨牙,前磨牙远移时易发生颊舌向旋转,磨牙在远移过程中有轻度的压低及颊向移位;使用微种植体支抗可以在一定程度上增加磨牙的远移效率、减小前牙支抗丧失。
简介:摘要目的在三维有限元模型中,探讨舌侧矫治器预置不同转矩角度弓丝对上前牙牙周膜应力分布的影响。方法建立整体舌侧矫治三维有限元模型,模拟滑动法关闭拔牙间隙:弓丝预置0°、9°、13°、17°正转矩,分别在腭侧加力1.50 N以及颊侧加力1.00 N+腭侧加力0.50 N条件下关闭间隙,分析上前牙牙周膜范·米塞斯(von Mises)应力分布情况。结果①弓丝预置9°、13°、17°正转矩时,随着预置正转矩角度加大,侧切牙、切牙牙周膜所受应力增大,并且牙周膜应力集中区位于牙颈部;尖牙未出现明显的应力集中区;②腭侧加力1.50N关闭间隙情况下,预置0°转矩时,牙周应力在尖牙牙颈部及根中,中切牙及侧切牙未见明显分布。随预置转矩角度增大时,牙周膜应力集中区从尖牙牙根颈部牙周膜扩展到牙根中部牙周膜;侧切牙、中切牙牙周膜所受应力也随预置正转矩角度增大逐渐增大,但始终集中在牙周膜颈部区域;③颊侧加力1.00 N+腭侧加力0.50 N关闭间隙情况下,预置0°转矩时,上前牙牙周膜应力集中区分布在侧切牙及尖牙牙颈部。随预置正转矩角度增大,牙周膜应力集中区开始分布在侧切牙颊侧远中牙颈部,随后中切牙腭侧颈部偏近中区域及尖牙颈部近中牙周膜出现应力集中区。结论在个体化舌侧矫治器滑动法关闭间隙过程中,预置转矩弓丝对上前牙牙周膜应力分布有不同的影响;随着预置正转矩的增大,上前牙牙周膜所受应力水平及应力集中区域也随之扩大。颊腭侧同时加力关闭间隙,比单纯腭侧加力关闭间隙时上前牙牙周膜应力集中区域分布更加均匀,同时应力水平更小。
简介:摘要目的研究对阻塞性睡眠呼吸暂停低通气综合征患儿采取前导下颌型功能矫治器后的治疗效果。方法选取本院阻塞性睡眠呼吸暂停低通气综合征患儿50例,选取时间为2015年7月到2016年8月;50例OSAHS患儿均采取前导下颌型功能矫治器治疗,记录并对比OSAHS患儿治疗前后的上气道结构变化情况和PSG指标变化情况。结果OSAHS患儿的V总、Amin、L矢和L横在治疗后明显有所增大,与治疗前相比有明显差异,P<0.05;OSAHS患儿在治疗后,夜间SaO2明显升高,而MAX、AHI、AI均要比治疗前低,P<0.05。结论为OSAHS患儿采用前导下颌型功能矫治器,有助于改善患儿的上气道结构,有效缓解患儿的病情,值得临床推广。
简介:目的评价改良型软压膜式口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapnea-hypopneasyndrome,OSAHS)的临床疗效。方法选择2008年1月至2010年7月在阜阳市人民医院体检中心口腔科经改良型软压膜式口腔矫治器治疗的OSAHS患者12例,观察戴用矫治器前、后的临床表现,并将其戴用矫治器前、后的多导睡眠仪(PSG)监测数据及X线头影测量结果进行分析。结果OSAHS患者戴用改良型软压膜式口腔矫治器3个月至1年后,呼吸紊乱指数(AHI)、呼吸暂停指数(AI)、低通气指数(HI)均较戴用前明显降低,而血氧饱和度(SaO2)则有明显升高;X线头影测量显示治疗后的上气道宽度增加;达到改善患者生存质量的目的。结论改良型软压膜式口腔矫治器治疗OSAHS具有广阔的临床应用价值,尤其以无创伤性、可逆性、经济实用、戴用舒适感较强、便于携带而日益受到重视。
简介:【摘要】目的 探讨无托槽隐形矫治器对患者牙周健康、微生物菌群及龈沟液炎性指标的影响。方法 研究对象60例为接受口腔正畸治疗的患者,入院后以电脑随机法分为A(n=30)、
简介:AbstractThe pathophysiology of twin-to-twin transfusion syndrome (TTTS) is complex, and its understanding has evolved along with the evolution and revolution of fetal diagnostic and therapeutic techniques. Over the last few decades, several therapeutic interventions have been researched for improving the outcomes in TTTS. We present a summary of the current protocols for surveillance, diagnosis, and staging of TTTS in monochorionic pregnancies. We also describe in detail the technique for treatment of TTTS by endoscopic laser photocoagulation.
简介:AbstractThe rate of twin pregnancies has increased over the last decades, largely because of the ongoing development of assisted reproductive technology and increased maternal age at childbearing. Twins have a higher risk of adverse outcomes during pregnancy and the perinatal period. The prevalence of umbilical cord abnormalities is higher for twin pregnancies compared with singleton pregnancies. Some of these abnormalities are nonspecific to twinning and can also be found in singleton gestations (such as velamentous cord insertion, vasa previa, and single umbilical artery). Other abnormalities are associated with monochorionic twins, such as umbilical cord entanglement, and umbilical proximate cord insertion. Most of these abnormalities can be detected by ultrasound evaluation. The early and accurate ultrasound diagnosis of chorionicity, amnionicity, and placental and umbilical cord characteristics is crucial if we are to predict the risk of complications and to determine the best management for twin pregnancies. Histopathological examination of the placenta and umbilical cord after delivery can help to confirm prenatal diagnosis and to provide a better understanding of the physiopathology of their abnormalities. The aim of this review was to emphasize the role that the umbilical cord plays in twin complications and to describe the management of these high-risk pregnancies.
简介:AbstractMode of delivery in twin gestation has been a matter of debate for decades. In 2013, the only randomized controlled trial concerning mode of delivery in twin gestations was published, answering some of the most pressing questions in this matter. The Twin Birth Study randomized patients carrying dichorionic-diamniotic or monochorionic-diamniotic twins, with the first twin in cephalic presentation, between 32 and 39 weeks of gestation, to planned vaginal vs. planned cesarean delivery, and found no significant differences in perinatal or maternal outcomes. These clinical findings greatly benefit our clinical practice, but there lacks related study investigating how the practices have changed. In this review, we searched PubMed from 1980 through January 2021 using combinations of the following terms: twin, delivery, vaginal delivery, and cesarean section. We will try to address the known literature before and after the publication of the Twin Birth Study in western countries and compare that to what has been practiced in China.
简介:有部分微分方程的优化问题在科学和工程的许多区域广泛地作为限制产生,特别地处于设计的问题。抑制PDE的优化问题的如此的类的解决方案通常是一项主要计算任务。因为为直接寻求抑制PDE的优化问题的答案的肤色,我们由使用Galerkin把它转变成僵绳点形式的线性方程的一个系统有限元素的discretization。为discretized线性系统,在这份报纸,我们构造一块对称并且block-lower-triangularpreconditioner,为解决抑制PDE的优化问题。两preconditioners利用系数矩阵的结构。为相应preconditioned矩阵的特征值和特徵向量的明确的表情被导出。当规则化参数是合适小的时,数字实现证明这些块preconditioners能为preconditionedGMRES方法导致令人满意的试验性的结果。[从作者抽象]