A SURGICAL PROCEDURE TO ELIMINATE ROTATIONAL RELAPSE
A SURGICAL PROCEDURE TO ELIMINATE ROTATIONAL RELAPSE
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DOI：
10.1016/0002-9416(70)90203-4
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发表时间：
1970-01-01
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影响因子：
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通讯作者：
EDWARDS, JG
中科院分区：
文献类型：
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作者：
EDWARDS, JG
许多正畸医生将正畸治疗的固位期评价为治疗中最困难的问题。事实上，正畸医生越认真，他就越可能将固位视为治疗中的问题。 Angle1 将正畸固位总结如下：“错位牙齿移动到所需位置后，必须对其进行机械支撑，直到所有参与支撑和维持新位置的组织在结构和功能上都得到彻底修改，以满足新的要求。”然而，正如每位临床正牙医生所认识到的那样，总结成功的固位计划的理想远比在实际治疗过程中实现它们容易得多。不同的保持措施的类型和持续时间在临床上由多种因素决定——移动的牙齿数量、正畸移动的程度、患者先前的咬合和年龄、特定咬合不正的所谓原因、与口腔相关的习惯、所涉及牙齿的实际牙尖解剖结构、牙周组织的健康状况、口腔区域的肌肉压力、根尖基底限制问题、面部生长变化，甚至可能还有大气压力。 5l I31 14, 22 无论如何，很少有医生低估固位在成功的正畸治疗中的重要性。面部生长和发育的更多知识、正畸力学技术的极大改进以及与牙面畸形相关的各种因素的诊断的最新进展都使正牙医生能够获得更好的治疗结果——这些结果似乎不太可能在治疗的固位阶段引起问题。然而，在经过治疗的错牙合畸形中，复发倾向仍然存在相当高的比例，特别是在积极矫正后多年研究的病例中。关于保留失败的原因和预防的文章已经有很多，但迄今为止，HellmanP 的抱怨仍然存在很大的合理性：“我们几乎完全不知道导致复发和失败的具体因素。”尽管今天的正牙医生有能力取得显着的成就
M any orthodontists evaluate the retention phase of orthodontic treatment as the most difficult problem of therapy. In fact, the more conscientious the orthodontist, the more he might regard retention as the problem in treatment. Angle1 summarized orthodontic retention as follows:“After malposed teeth have been moved into the desired position they must be mechanically supported until all the tissues involved in their support and maintenance in their new positions shall have become thoroughly modified, both in structure and in function, to meet the new requirements.” As every clinical orthodontist realizes, however, it is far easier to summarize the ideals of a successful retention program than to accomplish them during actual treatment. The type and duration of the varying retentive measures are clinically determined by a myriad of factors-the number of teeth moved, the extent of orthodontic movement, the previous occlusion and age of the patient, the alleged cause of the particular malocclusion, habits related to the mouth, the actual cuspal anatomy of the teeth involved, the health of the periodontium, muscular pressures in the oral region, problems of apical base limitations, facial growth changes, and perhaps even atmospheric pressure. 5l I31 14, 22 In any event, very few practitioners underrate the significance of retention in successful orthodontic therapy.Additional knowledge of facial growth and development, greatly improved techniques of orthodontic mechanics, and recent advances in diagnosis of the various factors related to dentofacial deformities have all enabled the orthodontist to obtain better treatment results-results which would seem less likely to cause problems in the retention phases of treatment. Nevertheless, relapse tendencies still exist in a fairly high percentage of treated malocclusions, especially in the cases studied over a period of years following active correction. Volumes have been written on the causes and prevention of retention failures, but to date there still exists great validity to HellmanP complaint:“We are in almost complete ignorance of the specific factors causing relapses and failure.” Although an orthodontist today has the capabilities to achieve dramatic