{"title":"改善牙龈笑的有效方法:使用腭中微型螺钉和改良的跨腭弓,向上移动上颌咬合平面。","authors":"Ken Miyazawa, Yuka Tamada, Masako Tabuchi, Misuzu Kawaguchi, Momoko Shibata, Takuma Sato, Kyoko Okamoto, Natsuki Saito, Shigemi Goto","doi":"10.1007/s00056-022-00417-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Correction of a gummy smile by orthodontic treatment alone has recently become feasible with the use of miniscrews. However, the optimal treatment mechanics remain unclear. Here we cephalometrically evaluated jaw and tooth displacement in cases where a gummy smile was improved using a level anchorage system (LAS).</p><p><strong>Methods: </strong>Sixteen patients underwent orthodontic treatment using an LAS consisting of a modified transpalatal arch and midpalatal miniscrews. Cephalometric pretreatment and posttreatment measurements were compared using the paired t‑test to determine significant skeletal and dental changes. The Mann-Whitney U test was used for nonparametric data. Spearman's rank correlation coefficient was used to evaluate correlations between different variables and the vertical change in prosthion position which was used to indicate the amount of gingival exposure.</p><p><strong>Results: </strong>The changes noted after treatment were intrusion of the maxillary first molars (P < 0.001) combined with only minor extrusion of the mandibular first molars. Suppressed extrusion of the mandibular first molars was significantly correlated with greater upward movement of the prosthion (r = 0.676, P < 0.01). Upward movement of the prosthion was also significantly correlated with intrusion of the maxillary and mandibular incisors, anterior upward movement of the maxillary occlusal plane, and an increase of the SNP angle.</p><p><strong>Conclusions: </strong>Treatment involving the combined use of miniscrews and a modified transpalatal arch resulted in intrusion of the maxillary first molars and maxillary incisors and consequently elevated the maxillary occlusal plane. The results of this study suggest that intruding the maxillary occlusal plane and minimizing mandibular molar extrusion were effective to induce autorotation of the mandible and to improve a gummy smile.</p>","PeriodicalId":54776,"journal":{"name":"Journal of Orofacial Orthopedics-Fortschritte Der Kieferorthopadie","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effective approach for improving a gummy smile : Upward movement of the maxillary occlusal plane using midpalatal miniscrews and a modified transpalatal arch.\",\"authors\":\"Ken Miyazawa, Yuka Tamada, Masako Tabuchi, Misuzu Kawaguchi, Momoko Shibata, Takuma Sato, Kyoko Okamoto, Natsuki Saito, Shigemi Goto\",\"doi\":\"10.1007/s00056-022-00417-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Correction of a gummy smile by orthodontic treatment alone has recently become feasible with the use of miniscrews. However, the optimal treatment mechanics remain unclear. Here we cephalometrically evaluated jaw and tooth displacement in cases where a gummy smile was improved using a level anchorage system (LAS).</p><p><strong>Methods: </strong>Sixteen patients underwent orthodontic treatment using an LAS consisting of a modified transpalatal arch and midpalatal miniscrews. Cephalometric pretreatment and posttreatment measurements were compared using the paired t‑test to determine significant skeletal and dental changes. The Mann-Whitney U test was used for nonparametric data. Spearman's rank correlation coefficient was used to evaluate correlations between different variables and the vertical change in prosthion position which was used to indicate the amount of gingival exposure.</p><p><strong>Results: </strong>The changes noted after treatment were intrusion of the maxillary first molars (P < 0.001) combined with only minor extrusion of the mandibular first molars. Suppressed extrusion of the mandibular first molars was significantly correlated with greater upward movement of the prosthion (r = 0.676, P < 0.01). Upward movement of the prosthion was also significantly correlated with intrusion of the maxillary and mandibular incisors, anterior upward movement of the maxillary occlusal plane, and an increase of the SNP angle.</p><p><strong>Conclusions: </strong>Treatment involving the combined use of miniscrews and a modified transpalatal arch resulted in intrusion of the maxillary first molars and maxillary incisors and consequently elevated the maxillary occlusal plane. The results of this study suggest that intruding the maxillary occlusal plane and minimizing mandibular molar extrusion were effective to induce autorotation of the mandible and to improve a gummy smile.</p>\",\"PeriodicalId\":54776,\"journal\":{\"name\":\"Journal of Orofacial Orthopedics-Fortschritte Der Kieferorthopadie\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orofacial Orthopedics-Fortschritte Der Kieferorthopadie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00056-022-00417-3\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/8/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orofacial Orthopedics-Fortschritte Der Kieferorthopadie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00056-022-00417-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/25 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的:最近,通过使用微型螺钉,仅靠正畸治疗来矫正牙龈笑已变得可行。然而,最佳的治疗机制仍不明确。在此,我们对使用水平固定系统(LAS)改善牙床笑的病例的颌骨和牙齿移位情况进行了头颅测量评估:方法:16 名患者接受了由改良的跨腭弓和腭中小螺钉组成的 LAS 正畸治疗。采用配对 t 检验比较治疗前和治疗后的头颅测量结果,以确定骨骼和牙齿的显著变化。非参数数据采用曼-惠特尼 U 检验。斯皮尔曼秩相关系数用于评估不同变量与修复体位置垂直变化之间的相关性,而修复体位置垂直变化用于表示牙龈暴露量:结果:治疗后发现的变化是上颌第一磨牙内陷(P结论):联合使用微型螺丝和改良的跨腭弓进行治疗后,上颌第一磨牙和上颌切牙发生了内陷,从而抬高了上颌咬合平面。该研究结果表明,内收上颌咬合面和减少下颌臼齿挤压可有效诱导下颌自转,改善牙龈笑。
Effective approach for improving a gummy smile : Upward movement of the maxillary occlusal plane using midpalatal miniscrews and a modified transpalatal arch.
Purpose: Correction of a gummy smile by orthodontic treatment alone has recently become feasible with the use of miniscrews. However, the optimal treatment mechanics remain unclear. Here we cephalometrically evaluated jaw and tooth displacement in cases where a gummy smile was improved using a level anchorage system (LAS).
Methods: Sixteen patients underwent orthodontic treatment using an LAS consisting of a modified transpalatal arch and midpalatal miniscrews. Cephalometric pretreatment and posttreatment measurements were compared using the paired t‑test to determine significant skeletal and dental changes. The Mann-Whitney U test was used for nonparametric data. Spearman's rank correlation coefficient was used to evaluate correlations between different variables and the vertical change in prosthion position which was used to indicate the amount of gingival exposure.
Results: The changes noted after treatment were intrusion of the maxillary first molars (P < 0.001) combined with only minor extrusion of the mandibular first molars. Suppressed extrusion of the mandibular first molars was significantly correlated with greater upward movement of the prosthion (r = 0.676, P < 0.01). Upward movement of the prosthion was also significantly correlated with intrusion of the maxillary and mandibular incisors, anterior upward movement of the maxillary occlusal plane, and an increase of the SNP angle.
Conclusions: Treatment involving the combined use of miniscrews and a modified transpalatal arch resulted in intrusion of the maxillary first molars and maxillary incisors and consequently elevated the maxillary occlusal plane. The results of this study suggest that intruding the maxillary occlusal plane and minimizing mandibular molar extrusion were effective to induce autorotation of the mandible and to improve a gummy smile.
期刊介绍:
The Journal of Orofacial Orthopedics provides orthodontists and dentists who are also actively interested in orthodontics, whether in university clinics or private practice, with highly authoritative and up-to-date information based on experimental and clinical research. The journal is one of the leading publications for the promulgation of the results of original work both in the areas of scientific and clinical orthodontics and related areas. All articles undergo peer review before publication. The German Society of Orthodontics (DGKFO) also publishes in the journal important communications, statements and announcements.