【作者】 董作英；

【导师】 刘东旭；

【作者基本信息】 山东大学 ， 口腔临床医学， 2008， 硕士

【摘要】 目的:以正常(牙合)为标准,比较上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)的牙弓形态差异,分析上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)上下颌牙弓形态的特点,为此类错(牙合)的正畸诊断分析和矫治设计提供理论依据。材料与方法:选取年龄均为17～25岁的具有上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)和正常(牙合)的个体各30名为研究对象,其中男女各15名,利用三维激光扫描仪扫描所有个体的上下颌原始模型,用三维测量软件标定对应于牙尖和切缘中点的标志点并进行测量,利用欧几里德距离矩阵分析法(EDMA)比较并分析:(1)正常(牙合)上下颌间牙弓形态的差异;(2)正常(牙合)男女间牙弓形态的差异;(3)上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)与正常(牙合)间牙弓形态的差异。结果:(1)无论男性还是女性,正常骀的上下颌间牙弓形状存在显著性差异(p＜0.05):男性形状差异范围为1.281,女性为1.193,前牙标志点对形态差异所起的作用相对较大。上牙弓大于下牙弓,男性大2.2%,女性大1.9%。(2)正常(牙合)男性和女性之间的牙弓形状无显著性差异(p＞0.05),上下颌变化规律相同,其中上颌形状差异范围为1.092,下颌为1.102,但男性的牙弓显著大于女性(p＜0.05),上颌大2.3%,下颌大2.1%。(3)无论男性还是女性,上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)与正常(牙合)之间的上颌牙弓形态存在显著性差异(p＜0.05),男性形状差异范围为1.122,女性为1.120。后牙标志点对形态差异所起的作用相对较大。上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)的上颌牙弓大于正常(牙合),男性大1.4%,女性大1.2%。无论男性还是女性,上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)和正常(牙合)之间的下颌牙弓形态也存在显著性差异(p＜0.05),男性形状差异范围为1.130,女性为1.123。前牙标志点对形态差异所起的作用相对较大。上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)的下颌牙弓明显大于正常(牙合),男性大2.6%,女性大2.4%。结论上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)的上颌与下颌牙弓均存在异常。上颌正常、下颌前突型骨性安氏Ⅲ类错(牙合)与正常(牙合)的上颌牙弓形状有显著性差异,差异主要存在于牙弓后部,前者的牙弓后部宽度显著大于后者。与上颌牙弓相同,两者的下颌牙弓形状也有显著性差异,但差异主要存在于牙弓前部,且前者的下牙弓前后部宽度均大于后者。更多还原

【Abstract】 Objective:The purpose of this study is to study the characteristics of the arch form of skeletal classⅢwith normal maxilla and protruding mandible and to provide evidence for the diagnosis and design of the treatment of orthodontics for classⅢmalocclusion by evaluating differences in dental arch forms between skeletal classⅢwith normal maxilla and protruding mandible and normal occlusion.Materials and Methods:30 skeletal classⅢpatients with normal maxilla and protruding mandible and 30 normal occlusion subjects aged 13～17 years old were selected.Every group includes 15 males and 15 females.Fourteen landmarks, corresponding to the cusp tips and incisor edges,were identified on the upper and lower dental casts of all subjects by three dimension measuring machine and measured.Arch form differences as followings are assessed by Euclidean distance matrix analysis(EDMA):(1)differences of dental arch form between maxilla and mandible of normal occlusion.(2)differences of dental arch form between male and female with normal occlusion.(3)differences of dental arch form between keletal classⅢmalocclusion with normal maxilla and protruding mandible and normal occlusion. Results:(1)In both sexes,arch shape difference was significant betweent the maxilla and mandible of normal occlusion(p＜0.01),by deleting the group of teeth,the results showed that the anterior teeth explain most of the arch-form differences between the two groups.The maxillary arch was larger than the mandibular one.The arch size was 2.2%larger in males and 1.9%larger in females.(2)The normal occlusion data showed no arch-shap difference by sex in either arch,but arch sizes were 2.3%larger in boys in the maxillary arch and 2.1%larger in the mandibular arch.(3)In both sexes,arch shape difference of maxilla was significant betweent skeletal classⅢpatients with normal maxilla and protruding mandible and normal occlusion(p＜0.01),by deleting the group of teeth,the results showed that the posterior teeth explain most of the arch-form differences between the two groups.The maxillary arch of skeletal classⅢpatients with normal maxilla and protruding mandible was larger than that of normal occlusion.The arch size was 2.2%larger in males and 1.9%larger in females.In both sexes,arch shape difference of mandible was also significant betweent skeletal classⅢpatients with normal maxilla and protruding mandible and normal occlusion(p＜0.01),by deleting the group of teeth,the results showed that the anterior teeth explain most of the arch-form differences between the two groups.The mandibular arch of skeletal classⅢpatients with normal maxilla and protruding mandible was larger than that of normal occlusion.The arch size was 2.6%larger in males and 2.4%larger in females.Conclusion:It is concluded that the maxillary and the mandibular arch form of skeletal classⅢsubjects with normal maxilla and protruding mandible significantly differed from that of normal occlusions.The results showed that arch forms in maxillary skeletal classⅢsubjects with normal maxilla and protruding mandible significantly differed from subjects with normal occlusions in both size and shape regardless of sex,and posterior areas contribute most to the arch-form difference.Maxillary posterior arch width was larger than that of normal occlusion.As the same as the maxillary arch,the results showed that arch forms in mandibular skeletal classⅢsubjects with normal maxilla and protruding mandible significantly differed from subjects with normal occlusions in both size and shape regardless of sex,but anterior areas contribute most to the arch-form difference.Mandibular anterior and posterior arch width were both larger than that of normal occlusion.更多还原