片段弓结合Nance弓远中移动第一磨牙的临床应用［摘要］目的:评价采用片段弓结合Nance弓远移上颌磨牙的效果及对牙颌面结构的影响，探讨通过口内支抗远移上磨牙来解除拥挤和矫正牙性II类关系的有效方法。方法：选择13例安氏II类错牙合、上牙弓中度拥挤患者，其中，女8例，男5例，年龄10.5〜16.4岁，平均12.6岁。采用在44上做带环焊Nance弓，颊侧在第一双尖牙和第一磨牙间应用弯有连续垂直开大曲的片段弓远移上磨牙，获得间隙排齐牙齿。疗程3〜7个月，平均4.2个月。在应用片段弓结合Nance弓远移磨牙前示进行头影测量分析。结果：①磨牙远中移动4.80mm,远中倾斜4.03°；②切牙近中移动1.72nun,近中倾斜3.16°；③磨牙垂直向移动较少，下颌平面角无明显变化；④片段弓结合Nance弓远移磨牙对牙颌血结构无明显直接影响。结论:片段弓结合Nance弓能快速远小移动磨牙，开辟间隙，是一种简便、对患者依赖少的上磨牙远移装置。［关键词］片段弓；Nance弓；磨牙；远中移动；支抗［中图分类号］R783［文献标识码］A［文章编号］1673-7210(2008)02(c)-051-02ClinicalapplicationofsectionalarchassociatedwithnanceplateindistalmovementoffirstmolarsWANGZhao-linl,ZHANGChun-leil,ZHAOJianl,ZHANGYi-kun2(1.DepartmentofOrthodontics,NanyangStomatologyHospital,HenanProvince,Nanyang47：3013,China:2.ShangqiuVocationalTechnicalCollegeofNenanProvince,Shangqiu476000,China)［Abstract］0bjective:Todiscussaneffectivemethodtocorrectdenture-crowdingandAngleIIocclusionbyevaluatingtheeffectondistalmovementofmolarsreducedbysectionalarchassociatedwithNanceplate.Methods:13paticntsofAngleIImalocclusionandmidrangecrowdinginupperdentaiarchwereinvestigated,8femalesand5males,from10.5yearsto16.4yearsold,12.6yearsoldinaverage.Foreverypatient,nanceplatewassolderedonthebandswhatweremadeon44andsectionalarchwithcontinuousopenverticalloopswasplacedbetweenthefirstbicuspidandthefirstmolaronltitero-sidetomovethefirstmolarindistaldirectioruCourseoftreatmentofal1patientswerefrom3monthsto7months,4.2monthsinaverage.Cephalometricanalysishavebeendonebeforeandafterusingthismethod・Results:①theaverageamountofthedistalmovementandtheaverageangleofdistalobliquityofallfirstmolarswere4.80mmand4・03°respectively.②theaverageamountofthemesialmovementandtheaverageangleofmesialobliquityofallincisorswere1.72mmand4.03°respectively.③theaverageamountoftheverticalmovementofallfirstmolarswasverysmall,andthechangesofFMAwerenotsignificant.④theeffectofthismethodontheeraniofacialstructurewasinsignificant.Conclusion:Sectionalarchassociatedwithnanceplateisasimplemethodindependentonpatients'cooperation,bywhichfirstmolarscouldbemovedindistaldirectioninahigherspeed.［Keywords］Sectionalarch;Nanceplate;Molar;Distalmovement;Anchorage随着矫治理念的更新和矫治技术的不断完善，为了避免正畸面容，对牙源性安氏II类错牙合或者中度拥挤错牙合的矫治，现趋于不拔牙矫治。如何有效地推磨牙向远小，从而为前牙排齐创造间隙并矫正磨才II类关系成为研究热点。我们设计的片段弓结合Nance弓远移上磨牙是一种口内远移磨牙装置，较少依赖患者配合，且临床操作简单。木研究旨在通过头影测量分析，评价片段弓结合Nance弓远移上磨牙的效果及对牙颌面结构的影响。1材料与方法1.1病例选择南阳市口腔医院正畸科患者13例，其中，女8例，男5例。年龄10.5〜16.4岁，平均12.6岁，均为恒牙列。第二磨牙完全萌出3例，余为萌出不全或未萌。上牙弓中度拥挤，下牙弓整齐，且上下颌骨大小协调，采用不拔牙矫治。1.2治疗方法采用片段弓结合Nance弓远移上颌磨牙。在44上做带环焊Nance弓，颊侧在第一双尖牙和笫一磨牙河，通过丿应用0.016X0.022英寸的不锈钢方丝弯制的带有连续垂育开大曲的片段弓，通过调整垂直开大曲加力，产生远中移动磨牙的力量...