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非拔牙矫正介绍

2009-05-13 09:27:00海峡名医网admin查看次数：1722

非拔牙矫治，即在治疗过程中不需因正畸目的而拔牙齿的矫治方法。

　　在正畸始疗中拔牙与否历来是争论的焦点。非拔牙矫治在近一个世纪的时间内经历了一个从高一低一高的轮回过程。本世纪初，Angle主张通过促进咀嚼功能来刺激颌骨生长,为牙弓提供足够的间隙。他的牙弓决定基骨论，即强调必须保留全部牙齿，通过扩弓来解除拥挤的理论，经他的学生Tweed多年实践。发现80％的患者有畸形复发的情况，因而认识到扩大牙弓是有限的，颅骨的生长主要取决于遗传。

1944年Tweed确立矫治中使用拔牙的理论。受Tweed拔牙矫治理论的影响，拔牙率较以前有了大幅度上升。

　　本世纪60年代初，Begg通过对石器时代澳洲土著人群牙齿的研究，得出现代人牙齿的拥状是由于缺乏生理性磨耗的结论。Begg认为矫治牙列拥扭采用保留完整牙列的概念是错误的。Begg理论在60～对年代风行于世界，正畸拔牙矫治亦急剧上升到正畸拔牙史的顶峰。近年来，直接粘结托槽于牙面替代了多带环装置，使牙弓重新获得了被带环所占据的有效空间，为不拔牙矫治创造了有利条件。

　　70年代初功能性矫治器广泛应用于正畸治疗，人们从中体会到生长发育期病人的治疗潜能，早期治疗使许多原来必须拔牙的病人通过非拔牙矫治达到了目的。同时，钛镍记忆合金丝的发明缩短了排齐和扩弓的时间，使不拔牙矫治的疗程短于拔牙矫治的患者。这些正畸技术的改进，使非拔牙矫治的病例又逐渐增多。牙颌畸形的非拔牙矫治有其～定的适应证，对于牙颌畸形要做科学的诊断分析；制订矫治方案，决定拔牙与非拔牙。对于拥挤度在3mm以下的错合以及拔牙后不利于患者侧面外形突度的病例可以采用非拔牙矫治。有时某些为拔牙矫治适应证的病例采用非拔牙矫治，往往导致拥挤复发，矫治后牙齿及颔骨前突，只有掌握好非拔牙矫正的适应证，才能成功地矫正错合畸形。

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非拔牙矫正介绍

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