1、加快正畸牙齿移动的方法1加快正畸牙齿移动的方法加快正畸牙齿移动的方法 加快正畸牙齿移动的方法2研究的三个方向:研究的三个方向:l药物刺激l机械生理性刺激l手术加速加快正畸牙齿移动的方法3药物刺激药物刺激l激素类药物:前列腺素(PG)、甲状旁腺素(PTH)、肾上腺皮质激素等l钙调节剂:骨钙素(OC)等l中药类:丹参、灯盏花等加快正畸牙齿移动的方法4机械生理性刺激机械生理性刺激l激光l磁场l超声波:选择了13 例对称拔牙正畸病例,实验侧局部给予超声波,10 mind14 d。结果实验侧尖牙移动速度比对照侧提高28.67%。l振动加快正畸牙齿移动的方法5手术加速手术加速l骨皮质切开术 cortico
2、tomyl牙周辅助加速成骨治疗 periodontally accelerated osteogenic orthodontics,PAOOl牵张成骨 Dentoalveolar Distraction(DAD)l手术优先矫治 surgery first orthognathic approach加快正畸牙齿移动的方法6l正畸力作用于牙齿,引起牙槽骨的改建,压力侧出现骨吸收,张力侧出现骨沉积,从而产生牙齿移动。理论上,凡能促进骨组织改建的外源性因素均可加速正畸牙齿移动。加快正畸牙齿移动的方法7A novel device in orthodontics -AcceleDent加快正畸牙齿移动的
3、方法8加快正畸牙齿移动的方法9What is AcceleDent Aura?lA simple-to-use,hands-free device designed for faster orthodontic treatment with only 20 minutes daily use.加快正畸牙齿移动的方法10Its FastlClinically proven to move teeth up to 50%faster in a US clinical trial.加快正畸牙齿移动的方法11lAcceleDent is designed to work with all existi
4、ng orthodontic appliances including fixed appliances and clear aligners.加快正畸牙齿移动的方法12Its SafelCleared by the United States Food and Drug Administration(FDA)and available only by prescription from your orthodontist 加快正畸牙齿移动的方法13Its GentlelAcceleDent patients have reported reduced discomfort with thei
5、r orthodontics.加快正畸牙齿移动的方法14AcceleDent Aura Components:ActivatorlThe heart of AcceleDent Auralthe small,lightweight Activator generates gentle micropulses to safely accelerate bone remodeling.lIt includes a USB interface,whch can be plugged directly into a computer to view patient usage history via
6、the FastTrac Report.加快正畸牙齿移动的方法15AcceleDent Aura Components:MouthpiecelThe Mouthpiece provides a comfortable fit l snaps easily on and off the Activator for transport and cleaning.加快正畸牙齿移动的方法16AcceleDent Aura Components:USB extension cable with power adapterAllows for easy,convenient charging 加快正畸牙齿
7、移动的方法17AcceleDent Aura Components:Travel Case The Travel Case keeps the components safe,clean and secure.加快正畸牙齿移动的方法18How AcceleDent Aura Works?So Technology l Part of the way that orthodontics works is by changing or remodeling the bones surrounding your teeth.As this remodeling process is accelera
8、ted,your teeth move more quickly.lSo Technology is designed to speed up bone remodeling,accelerating tooth movement 加快正畸牙齿移动的方法19lThe device uses the application of cyclic forces to move teeth in bone faster through accelerated bone remodeling.加快正畸牙齿移动的方法20lThe applied force (0.2 Newtons or 20 grams
9、)is intended to be barely noticeable and should not be uncomfortable.lsome researchers have theorised that the pulsing may actually decrease pain associated with standard ortho-dontic adjustments加快正畸牙齿移动的方法21SCIENTIFIC EVIDENCE Suture Growth Modulated by the Oscillatory Component of Micromechanical
10、Strain加快正畸牙齿移动的方法22SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法23SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法24SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法25SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法26SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法27SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法28SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法29SCIENTIFIC EVIDENCE加快正畸牙齿移动的方法30CLINICAL EVIDENCElAcceleD
11、ent Increases the Rate of Orthodontic Tooth Movement:Results of a Randomized Controlled Clinical Trial加快正畸牙齿移动的方法31加快正畸牙齿移动的方法32CLINICAL EVIDENCE加快正畸牙齿移动的方法33CLINICAL EVIDENCE加快正畸牙齿移动的方法34CLINICAL EVIDENCE加快正畸牙齿移动的方法35CLINICAL EVIDENCEThe perimeter was defined by tracing the labiolingual centers of
12、each tooth from canine to canine.加快正畸牙齿移动的方法36CLINICAL EVIDENCE加快正畸牙齿移动的方法37CLINICAL EVIDENCE加快正畸牙齿移动的方法38CLINICAL EVIDENCE加快正畸牙齿移动的方法39CLINICAL EVIDENCE加快正畸牙齿移动的方法40CLINICAL EVIDENCE加快正畸牙齿移动的方法41CLINICAL EVIDENCElThe results of the randomized controlled clinical trial demonstrate that AcceleDent ca
13、n increase the rate of tooth movement when used in conjunction with conventional orthodontics.lUse of AcceleDent did not increase the risk of either root resorption加快正畸牙齿移动的方法42CASE REPORT18 year old maleClass III combination ortho&surgical case加快正畸牙齿移动的方法43CASE REPORT加快正畸牙齿移动的方法44CASE REPORT9 Weeks
14、加快正畸牙齿移动的方法45CASE REPORT5 days post orthognathic surgery(9 months into treatment&2 months of delay with travels and parents away)加快正畸牙齿移动的方法46CASE REPORT6.5 weeks post surgery46 Weeks Total Treatment Time加快正畸牙齿移动的方法47corticotomy-assisted orthodontic treatment (CAOT)加快正畸牙齿移动的方法48发展过程发展过程l1893年Bryan 提
15、出骨皮质切开加速牙齿移动这一概念。l1959年Kole等首先应用了骨皮质首先应用了骨皮质切开术结合根尖下截骨术,证实能够有效加快正畸牙齿的移动。l2001年Wilcko等提出了牙周加速成骨正畸(periodontally accelerated osteogenic orthodontics,PAOO)的新理念,主要通过切开正畸牙牙根周围颊侧骨皮质至骨髓质深度,并在切开骨表面放置可吸收人工骨材料以增加骨量。加快正畸牙齿移动的方法49理论基础理论基础l骨块移动理论(bone block theory):颌骨骨皮质切开加速正畸牙齿移动的理论基础早期在手术中于牙齿近远中颊舌侧骨板进行骨皮质切开,保留
16、骨松质的连续性,通过根尖下截骨术连接骨皮质切口以形成完整牙骨块,他认为去除骨皮质阻力后,牙齿与周围骨块形成整体在正畸力作用下加速移动,即为骨块移动理论。加快正畸牙齿移动的方法50理论基础理论基础l局部骨加速现象(regional acceleratory phenomenond RAP)被认为是骨皮质切开术加速牙齿移动的根本原因,而不是骨块移动理论。加快正畸牙齿移动的方法51理论基础理论基础l局部骨加速现象(regional acceleratory phenomenond RAP)为术后局部骨质产生的暂时性脱矿与再矿化l表现为:在骨组织创伤后术创附近的牙槽骨进入短暂可逆的骨质减少状态,骨吸收
17、及溶骨现象随即出现;在这一分解代谢的过程中骨密度虽然降低,但牙槽骨骨量并没有减少;正畸力施加使得牙根周围骨基质及骨胶原软组织基质随之移动;在随后的再矿化过程中新骨沉积,类骨质基质再矿化,重新包绕牙根周围。加快正畸牙齿移动的方法52l骨皮质切开术后一段时间可以加快正畸牙齿移动的速度,而该过程是基于引发现象后牙槽骨吸收和重建过程(RAP).加快正畸牙齿移动的方法53临床应用临床应用l解除拥挤l矫正上前牙唇倾,加速前牙内收,改善前突面型l骨性 三类错合畸形下前牙舌倾的去代偿l个别牙齿的错合畸形也有很好的疗效,压低伸长磨,牵引埋伏牙,根骨黏粘牙齿l解除后牙反牙合加快正畸牙齿移动的方法54 Lower
18、Incisor Retraction with a Modified Corticotomy Angle Orthodontist,Vol 76,No 5,2006加快正畸牙齿移动的方法55加快正畸牙齿移动的方法56加快正畸牙齿移动的方法57加快正畸牙齿移动的方法58加快正畸牙齿移动的方法59加快正畸牙齿移动的方法60加快正畸牙齿移动的方法61加快正畸牙齿移动的方法62加快正畸牙齿移动的方法63加快正畸牙齿移动的方法64加快正畸牙齿移动的方法65加快正畸牙齿移动的方法66加快正畸牙齿移动的方法67加快正畸牙齿移动的方法68lIn the current case report,the total orthodontic treat-ment time(16 months)was dramatically reduced whencompared with the average treatment time for extrac-tion therapy(31 months).In corticotomy-facilitatedorthodontics,the reduction of orthodontic treatmenttime by approximately 50%was observed.