Soft tissue limitations in orthodontics: treatment planning guidelines.
Soft tissue limitations in orthodontics: treatment planning guidelines.
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正畸中的软组织限制：治疗计划指南。
DOI：
10.1043/0003-3219(1997)067
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Proffit,WR
中科院分区：
文献类型：
--
作者：
Ackerman,JL;Proffit,WR
正畸医生传统上认为结构差异是治疗的主要限制。事实上，软组织更密切地决定了治疗的可变性。根据唇部、脸颊和舌头对牙齿施加的压力、牙周附着的局限性、神经肌肉对下颌位置的影响以及软组织面罩的轮廓来确定潜在颌骨差异的牙齿补偿界限。在矫正咬合关系方面，软组织适应牙颌关系变化的能力远远小于解剖极限。从平衡、牙周和面部平衡的角度来看，软组织适应的容差范围为2~3 mm，对于下颌弓的扩张，对于髁状突位置的改变，容差更小。因此，软组织分析是正畸决策中的关键步骤，而这只能通过患者的体检来完成。虽然定量测量不能严格应用，但软组织评估指南，特别强调面部美学，被提出。从这个角度，提出了一种当代的正畸实践哲学，包括非拔牙、拔牙和外科治疗的一般适应症和禁忌症。
Orthodontists have traditionally viewed structural discrepancies as the major limitation of treatment. In reality, it is the soft tissues that more closely determine therapeutic modifiability. The boundaries of dental compensation for an underlying jaw discrepancy are established by pressures exerted on the teeth by the lips, cheeks, and tongue; limitations of the periodontal attachment; neuromuscular influences on mandibular position; and the contours of the soft tissue facial mask. The ability of the soft tissues to adapt to changes in tooth-jaw relationships are far narrower than the anatomic limits in correcting occlusal relationships. The tolerances for soft tissue adaptation from equilibrium, periodontal, and facial balance standpoints are in the range of 2 to 3 mm for expansion of the mandibular arch and even less for changes in condylar position. Thus, analysis of the soft tissues is the critical step in orthodontic decision making, and this can only be accomplished through physical examination of the patient. Although quantitative measurements cannot be rigorously applied, guidelines for soft tissue assessment, with particular emphasis on facial esthetics, are proposed. From this perspective, a contemporary philosophy of orthodontic practice is offered, with general indications and contraindications for nonextraction, extraction, and surgical treatment.