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Dental and Skeletal Indicators of Growth Spurt in Orthodontics 正畸学中生长突增的牙齿和骨骼指标
Pub Date : 2024-05-02 DOI: 10.61110/50111
Lenka Dostálová, Iva Voborná, Eva Sedlatá Jurásková, Ivana Dubovská
Aim: The aim was to confirm the correlation between chronological age, skeletal age according to X-ray picture of the hand and wrist, and the stages of teeth development, and to determine whether the assessment of teeth development can be used to establish the stage of growth of an individual. Material and method: 362 adolescents were included in the study; 180 boys between the age 11.5–15.5, 182 girls between the age 10.5–14.5. To assess teeth in OPG Demirjian’s classification was used. We assessed teeth 43, 44, 45 and 47 in the mandible, and 13, 14, 15, 17 and 18 in the maxilla. To assess radiographs of the hand and wrist Björk, Grave and Brown classification was applied. Results: The correlation of skeletal and dental age was proved. The highest correlation was found in lower permanent canine, both in girls and boys. S-stage in radiograph of the hand (the stage prior to the maximum growth spurt) corresponds to the stage of the lower canine root with parallel walls (G-stage according to Demirjian). Thus, in case OPG of lower permanent canine shows parallel walls of the root canal the maximum of growth spurt occurs within 0.5–1 year. The maximum growth spurt (MP3cap stage) and the following stages correspond to the situation when lower canine apex is closed (H-stage according to Demirjian). This can help us in the correct timing of orthodontic treatment. ORTODONCIE | ročník 33 | č. 2/2024 ODBORNÉ PRÁCE / ORGINAL ARTICLES Recenzovaný časopis České ortodontické společnosti 14 Conclusion: The assessment of the developmental stages of teeth, namely lower permanent canine, is used in the planning of orthodontic treatment, and can serve as
目的:该研究旨在确认实测年龄、根据手部和腕部 X 射线照片得出的骨骼年龄与牙齿发育阶段之间的相关性,并确定牙齿发育评估是否可用于确定个体的生长阶段。材料和方法研究对象包括 362 名青少年,其中 180 名男孩年龄在 11.5-15.5 岁之间,182 名女孩年龄在 10.5-14.5 岁之间。采用 Demirjian 的分类方法评估 OPG 中的牙齿。我们评估了下颌的第 43、44、45 和 47 颗牙齿,以及上颌的第 13、14、15、17 和 18 颗牙齿。在评估手部和腕部的射线照片时,采用了比约克、格雷夫和布朗分类法。结果骨骼和牙齿年龄的相关性得到了证实。女孩和男孩下恒牙的相关性最高。手部 X 光片上的 S 阶段(最大生长突增之前的阶段)与下犬齿根平行壁的阶段(Demirjian 认为的 G 阶段)相对应。因此,如果下恒牙根的 OPG 显示根管的平行壁,则生长高峰的最大值出现在 0.5-1 年内。生长高峰的最大值(MP3cap 阶段)和随后的阶段与下犬齿顶闭合的情况(Demirjian 认为的 H 阶段)相对应。这有助于我们正确选择正畸治疗的时机。ORTODONCIE | ročník 33 | č.2/2024 ODBORNÉ PRÁCE / ORGINAL ARTIC文章 Recenzovaný časopis České ortodontické společnosti 14 结论:对牙齿(即下恒牙)发育阶段的评估可用于正畸治疗的规划,并可作为以下方面的参考
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引用次数: 0
Changes in the lower dental arch in patients treated with conventional brackets and self-ligating brackets – a comparison 使用传统托槽和自锁托槽治疗的患者下牙弓的变化--比较
Pub Date : 2024-05-02 DOI: 10.61110/50119
Aneta Hrubá, H. Tycová, J. Kučera
Aim: The aim was to assess the changes in the mandible in patients treated with conventional brackets compared to those treated with self-ligating brackets. In particular, we focused on the degree of transversal changes and the length of therapy. Material and method: The sample included 43 patients; 11 men and 32 women. The mean age was 22.2 years. The patients had complete permanent dentition, were treated without extractions, molars in Angle Class I. The subjects were divided into two groups – conventional brackets, self-ligating brackets. Measurements were performed in scans of cast models made prior to therapy (T1), after removal of fixed appliance (T2), the length of treatment was given in months. The changes in intercanine and intermolar distance were compared in teeth and in relevant points on WALA ridge of the mandible. ORTODONCIE | ročník 33 | č. 2/2024 ODBORNÉ PRÁCE / ORGINAL ARTICLES 29 www.ortodonciejournal.cz | e-mail: redakce@ortodonciejournal.cz, office@ortodonciejournal.cz Results: In lower first molars the change in intermolar width was significant in both groups both at T1 and T2. The change was significantly bigger in the group with self-ligating brackets. The change in intercanine width between T2 and T1 was statistically significant only in the group with self-ligating brackets when measured on canine tips. Measurements at FA points (the most prominent point in the middle of longitudinal axis of the clinical crown) did not prove significant change. At WALA the change between T2 and T1 was significant only in the group with self-ligating brackets and only in first lower molars (clinically the change was small). The change in the distance WALA-FA in first lower molars on the left and on the right between T2 and T1 was statistically significant in both groups, however, it was significantly bigger in the group with self-ligating brackets. The difference in the length of therapy was not statistically significant. Conclusion: In patients with self-ligating brackets there is a greater expansion in first molars and canines. We can also observe more prominent vestibular inclination of canines and first molars. In patien
目的:与使用自锁托槽治疗的患者相比,我们的目的是评估使用传统托槽治疗的患者下颌骨的变化情况。我们尤其关注横向变化的程度和治疗时间的长短。材料和方法:样本包括 43 名患者,其中男性 11 人,女性 32 人。平均年龄为 22.2 岁。受试者分为两组--传统托槽和自锁托槽。测量分别在治疗前(T1)和去除固定矫治器后(T2)对石膏模型进行扫描,治疗时间以月为单位。比较了牙齿和下颌 WALA 脊上相关点的齿间距离和磨间距离的变化。ORTODONCIE | ročník 33 | č.2/2024 ODBORNÉ PRÁCE / ORGINAL ARTICLES 29 www.ortodonciejournal.cz | e-mail: redakce@ortodonciejournal.cz, office@ortodonciejournal.cz 结果:在下第一磨牙中,两组的磨间宽度在T1和T2都有显著变化。自锁托槽组的变化明显更大。只有使用自锁托槽的组别在测量犬齿尖时,T2 和 T1 之间的齿间宽度变化才具有统计学意义。在FA点(临床牙冠纵轴中间最突出的点)进行的测量未证明有明显变化。在 WALA 点,T2 和 T1 之间的变化仅在使用自锁托槽的组别中显著,且仅在第一下磨牙中显著(临床上变化较小)。在 T2 和 T1 之间,左侧和右侧第一下磨牙的 WALA-FA 距离的变化在两组中均有统计学意义,但自锁托槽组的变化明显更大。治疗时间的长短差异无统计学意义。结论在使用自锁托槽的患者中,第一磨牙和犬齿的扩张程度更大。我们还可以观察到,犬齿和第一磨牙的前庭倾斜更加明显。患者
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引用次数: 0
Elastics in orthodontics 牙齿矫正中的橡皮筋
Pub Date : 2024-03-10 DOI: 10.61110/50093
Barbora Ličková, David Sluka, Klaudia Portašíková, Wanda Urbanová, Lucie Ptáčková, Iva Voborná, Ivana Dubovská
Aim: The work assesses force characteristics of one type and size of elastics, specifically 3/16“ medium elastics, of five different manufacturers. We compared initial forces, and particularly the relationship between their force degradation over aɸperiod of time. Material and method: 500 latex elastics 3/16“ medium from Dentaurum, American Orthodontics, 3M, Ortho Organizers and G & H Orthodontics (100 of each) were tested. Force was measured with dynamometer at time 0, 2, 8, 24 and 48 hours. Elastics were stretched to triple of their original diameter and they were placed onto the plate manufactured by us. The plate was produced with 3D printer. Then everything was put into an incubator at the temperature of 37 °C and constant humidity. Shapiro-Wilk normality tests, ANOVA and Bonferroni’sɸpost-hoc tests were used for statistical evaluation. Individual manufacturers were asked whether they know in which plants exactly the elastic tractions are produced. Unfortunately, they did not answer the question. Results: The average initial force was between 1.109 N and 1.550 N; elastics made by Dentaurum were closest to the declared force of 1.255 N. The force decreased most during the first two hours. Between the individual producers the decrease of elastic tractions during 24 hours oscillated between 20 and 33%. The greatest drop in force was recorded for American Orthodontics products. The smallest decrease was recorded between 2nd and 8th hour for 3M, and between 24th and 48th hour for OrthoOrganizers products. Conclusion: Intermaxillary elastics of 3/16“ medium measured in vitro differ both in the amount of their initial force and in force degradation. Orthodontists should know the basic parameters of elastic tractions. To secure maximum care aɸdoctor should measure initial force of elastic tractions with dynamometer intraorally.
目的:这项研究评估了五家不同制造商生产的一种类型和尺寸的橡皮筋(特别是 3/16 英寸中型橡皮筋)的受力特性。我们比较了初始力,特别是它们在一段时间内的力衰减关系。材料和方法测试了来自 Dentaurum、American Orthodontics、3M、Ortho Organizers 和 G & H Orthodontics 的 500 个 3/16" 中号乳胶矫治器(各 100 个)。在 0、2、8、24 和 48 小时时用测力计测量力量。将橡皮筋拉伸至其原始直径的三倍,然后将其放置在我们制造的板上。平板是用 3D 打印机制作的。然后将所有材料放入温度为 37 °C、湿度恒定的培养箱中。统计评估采用了 Shapiro-Wilk 正态性检验、方差分析和 Bonferroni'sɸpost-hoc 检验。个别制造商被问及是否知道弹性牵引力究竟是在哪个工厂生产的。遗憾的是,他们没有回答这个问题。测试结果平均初始力介于 1.109 牛顿和 1.550 牛顿之间;Dentaurum 生产的弹性体最接近 1.255 牛顿的申报力。不同生产商在 24 小时内的弹性拉力下降幅度在 20% 到 33% 之间。美国正畸公司产品的拉力下降幅度最大。3M 公司产品在第 2 至第 8 小时内的下降幅度最小,OrthoOrganizers 公司产品在第 24 至第 48 小时内的下降幅度最大。结论体外测量的 3/16 英寸中型颌间弹性体在初始力大小和力衰减方面都存在差异。正畸医生应该了解弹性牵引的基本参数。为了确保最大程度的护理,医生应在口腔内使用测力计测量弹性牵引的初始力。
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引用次数: 0
Stability of overjet, overbite and upper intermolar width following segmental osteotomy of the maxilla 上颌骨分段截骨术后过牙合、过咬合和上磨牙间宽度的稳定性
Pub Date : 2024-03-10 DOI: 10.61110/50101
Nina Žuffová, Hana Bohmová, Martin Kotas
Aim: The aim is to assess stability of overjet, overbite, and upper intermolar width after the orthodontic-surgical correction of orthodontic anomaly with segmental H-osteotomy of the maxilla. Material and method: The retrospective study works with 40 patients who underwent the segmental osteotomy of the maxilla. Each patient had aɸcomplete orthodontic documentation before the therapy (T1), prior to the surgery (T2), after aɸcompletion of an orthodontic treatment (T3) and approx. 25 months after aɸremoval of fixed appliance, minimum of 1 year after the completed orthodontic treatment and at least 1.5 years after the orthognathic surgery (T4). In every time interval, aɸdigital model of aɸdentition was made to measure the overjet, the overbite and the upper intermolar width. Results: During aɸ long-term check-up the value of the overjet showed aɸ clinically and statistically insignificant decrease by 0.1 ± 0.5 mm. The overbite also showed aɸclinically insignificant decrease by 0.1 ±0.5 mm; in none of the cases there was aɸclinically significant bite opening. The average value of the upper intermolar width was 38.9 ±3.1 mm before the beginning of therapy, prior to orthognathic surgery the value increased due to orthodontic treatment by 0.5 ±1.7 mm. After the active therapy completion, the value increased by 0.9 ±1.7 mm, i.e. by 1.4 ± 2.6 mm compared to the initial condition. In aɸlong-term check up, the average loss of uper intermolar width by 0.4 ±0.7 mm was recorded.
目的:旨在评估通过上颌节段性 H 型骨切除术进行正畸手术矫正后,过咬合、过咬合和上磨牙间宽度的稳定性。材料和方法:这项回顾性研究的对象是40名接受过上颌骨分段截骨术的患者。每位患者在治疗前(T1)、手术前(T2)、完成正畸治疗后(T3)、拆除固定矫治器后约25个月、完成正畸治疗后至少1年、正颌手术后至少1.5年(T4)都有ɸ完整的正畸记录。在每个时间间隔内,都要制作牙列的数字模型,以测量过咬合、过咬合和上磨牙间宽度。结果:在长期的检查中,过咬合值下降了 0.1 ± 0.5 毫米,在临床和统计上都不明显。过咬合值也出现了临床上不明显的下降,降幅为 0.1 ± 0.5 毫米;没有一个病例出现临床上明显的咬合张开。治疗开始前,上磨牙间宽度的平均值为(38.9 ± 3.1)毫米,正颌手术前,该值因正畸治疗而增加了(0.5 ± 1.7)毫米。积极治疗完成后,该值增加了 0.9 ± 1.7 毫米,即比初始状态增加了 1.4 ± 2.6 毫米。在ɸ长期检查中,记录到上磨牙间宽度平均减少了 0.4 ± 0.7 毫米。
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引用次数: 0
Position of impacted canines and lateral incisors, and factors associated with unerupted canines 阻生牙和侧切牙的位置,以及与未出牙相关的因素
Pub Date : 2023-11-10 DOI: 10.61110/50077
Markéta Kolaříková, Pavlína Černochová
Aim: The aim is to determine the impact of unerupted canine position on the position of adjacent teeth as well as the relationship of the severity of canine impaction and position, and associated factors of the impaction. Material and method: From CBCTs of the patients treated between 2015 and 2020 at the Department of Orthodontics of St.Anne’s University Hospital 39 scans with unilateral impacted upper canine were selected. There were 25 palatally impacted canines, 14 vestibularly impacted canines. The parameters measurements were carried out with Invivo6 software after setting of the reference planes. Results: Factors associated with canines impaction were proved, such as shift of the midline towards the affected side (by 0.56–0.68 mm), higher incidence of peg shaped lateral incisor (I2) in palatally impacted canines, narrower palate on the side of impacted canine (by 1 mm in palatally and 2 mm in vestibularly impacted canine). In vestibularly impacted canines lateral incisors (I2) were significantly more distally inclined (by 10.3°), in palatally impacted canines lateral incisors (I2) were distorotated by 14.1°and retruded by 7.2°. In vestibularly impacted canines the roots of I2 were shortened by almost 2 mm, in palatally impacted canines by 1 mm. On the side of impacted canines we found higher incidence of bent roots (51.3%) and hooks (12.8%); I2 bent roots were more frequent on the side of palatally impacted canines (32%). Conclusion: The study findings could help in early diagnostics – either clinical or radiological – of impacted upper permanent canines, and in adopting the best strategy of treatment. Disturbed development of impacted canines (shorter length, bent root) calls for early detection and timely orthodontic treatment of the impaction.
目的:确定未出牙位置对邻牙位置的影响,牙嵌塞的严重程度与位置的关系,以及牙嵌塞的相关因素。材料和方法:从2015年至2020年在圣安妮大学医院正畸科治疗的患者的cbct中选择39例单侧上犬阻生扫描。腭侧阻生犬25只,前庭侧阻生犬14只。设置好参考平面后,利用Invivo6软件进行参数测量。结果:证实了中线向患侧移位(偏移0.56 ~ 0.68 mm)、腭阻生犬侧栓形侧切牙(I2)发生率较高、腭阻生犬侧腭变窄(腭阻生犬侧腭变窄1 mm,前庭阻生犬侧腭变窄2 mm)等与牙嵌塞有关的因素。前庭阻生犬侧切牙(I2)明显偏向远端(10.3°),腭阻生犬侧切牙(I2)扭曲14.1°,后退7.2°。前庭阻生犬I2根缩短约2mm,腭阻生犬I2根缩短约1mm。在阻生牙侧,我们发现弯曲根(51.3%)和钩(12.8%)的发生率较高;2根弯曲多见于腭阻生犬侧(32%)。结论:本研究结果有助于上颌恒牙埋伏阻生的早期临床诊断和放射学诊断,并制定最佳治疗策略。阻生牙发育不正常(牙长较短,牙根弯曲),需要早期发现并及时进行正畸治疗。
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引用次数: 0
Etiology of impacted permanent maxillary canines. A review. 上颌恒牙阻生的病因学。复习一下。
Pub Date : 2023-11-10 DOI: 10.61110/50087
Dana Kloudová, Martin Horáček
The presented article presents a comprehensive survey of current knowledge on impacted maxillary canines with focus on palatal impaction. We worked with the relevant databases and eventually selected the 94 most important studies and monographies. In case of vestibular impaction the literature more or less agrees on that the main cause is the lack of space in the dental arch. However, in case of palatal impaction the situation is not so clear. In etiology of palatal impaction there prevail two opinions: genetic theory and guidance theory. Genetic theory sees genetics as the only cause, while guidance theory says impacted canine is the result of deviations in the shape of upper lateral incisor – agenesis, microdontia, peg shaped crown. Thus, lateral incisor cannot take on the role of guiding crest along which canine erupts into the oral cavity. Other potential causes include local obstruction, pathologies, traumas. However, they appear in only a minimum of cases.
这篇文章介绍了一个全面的调查,目前的知识对上颌牙齿的影响,重点是腭嵌塞。我们与相关数据库合作,最终选择了94项最重要的研究和专著。在前庭嵌塞的情况下,文献或多或少同意,主要原因是缺乏空间的牙弓。然而,如果是腭嵌塞,情况就不那么清楚了。在腭嵌塞的病因学上,主要有两种观点:遗传说和指导说。遗传理论认为遗传是唯一的原因,而指导理论认为影响犬只是上侧切牙形状偏差的结果-发育不全,小齿,钉状冠。因此,侧切牙不能承担引导牙冠的作用,沿牙冠犬齿向口腔内长出。其他可能的原因包括局部梗阻,病理,创伤。然而,它们只出现在极少数情况下。
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引用次数: 0
First and second upper premolar in the treatment of an orthodontic patient 第一和第二上前磨牙治疗正畸患者
Pub Date : 2023-01-01 DOI: 10.61110/50047
Abstract Aim: The study deals with differences in the size of anatomical crowns of first and second maxillary pemolars, and discusses the correlation between the crowns size and sex and skeletal classes of patients. Material and method: The non-randomized retrospective study worked with 152 plaster models of the maxilla. The models were scanned, and in these virtual models mesiodistal and buccolingual parameters of teeth anatomical crowns were measured. The models were divided into groups according to patients’ sex and skeletal class according to WITS. Results: Mesiodistal width was significantly bigger in first premolar (mean= 6.68 mm) than in the second one (mean = 6.43 mm). On the contrary, buccolingual dimension was statistically bigger in second premolars (mean value = 9.67 mm) that in the first one (mean value = 9.48 mm). Mean size of teeth was bigger in all parameters in males than females, i.e. mesiodistal dimension in first premolars (males = 6.75 mm; females = 6.61 mm) and in second premolars (males = 6.49 mm; females = 6.38 mm). The same holds true for buccolingual dimension in first premolars (males = 9,65 mm; females = 9.34 mm) and second premolars (males = 9,83 mm; females = 9.50 mm). In males with Class II the mesiodistal width of both first and second premolars is significantly smaller (mean value = 6.54 and 6.31 mm) than in males with Class I (mean value = 6.86 and 6.58 m) and with Class III (mean value = 6.85 and 6.56 mm). Conclusion: First upper premolar is bigger mesiodistally and smaller buccolingually than second upper premolar. Males’ teeth are bigger than females’. Men with Class II have statistically smaller mesiodistal width of first and second premolars than men with Class I and III.
摘要目的:研究上颌第一、第二pemolar解剖冠大小的差异,并探讨冠大小与患者性别、骨骼类别的关系。材料与方法:采用非随机回顾性研究方法对152个上颌石膏模型进行研究。对模型进行扫描,并在这些虚拟模型中测量牙齿解剖冠的中远端和颊舌参数。模型根据患者的性别和骨骼类别根据WITS进行分组。结果:第一前磨牙中远端宽度(平均6.68 mm)明显大于第二前磨牙(平均6.43 mm)。第二前磨牙颊舌尺寸(平均值为9.67 mm)大于第一前磨牙(平均值为9.48 mm)。在所有参数中,男性的平均牙齿尺寸均大于女性,即第一前磨牙的中远端尺寸(男性= 6.75 mm;女性= 6.61 mm)和第二前磨牙(男性= 6.49 mm;雌性= 6.38毫米)。第一前磨牙的颊舌尺寸也是如此(男性= 9,65 mm;女性= 9.34 mm)和第二前磨牙(男性= 9.83 mm;雌性= 9.50毫米)。II类男性第一和第二前磨牙的中远端宽度(平均值分别为6.54和6.31 mm)明显小于I类男性(平均值分别为6.86和6.58 m)和III类男性(平均值分别为6.85和6.56 mm)。结论:第一上前磨牙比第二上前磨牙中远端大,颊侧小。雄性的牙齿比雌性的大。II类患者第一和第二前磨牙的近远端宽度在统计学上小于I类和III类患者。
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引用次数: 0
Idiopathic (early) and secondary (late) tooth ankylosis in clinical practice and in experiment 临床和实验中特发性(早期)和继发性(晚期)牙齿强直
Pub Date : 2023-01-01 DOI: 10.61110/50069
Abstract Permanent tooth ankylosis is a multifactorial condition. Its origin on the molecular level is still rather unclear, and due to difficult diagnosis, the prevalence in the population is not known. ORTODONCIE | ro˃ník 32 | ˃. 3/2023 ODBORNÉ PRÁCE / ORGINAL ARTICLES Recenzovaný ˃asopis ˂eské ortodontické spole˃nosti 158 Úvod KoĜen zdravého zubu je ke kosti fixován pomocí periodontálních vláken, která tvoĜí pružný závÞs, což umožċuje zubIJm lépe odolávat žvýkacímu tlaku. Na základÞ patologického procesu (nejÐastÞji zánÞtu nebo traumatu) nebo také bez zĜejmé pĜíÐiny dochází v periodontální štÞrbinÞ ke koagulaci krve, poté k organizaci granulaÐní tkánÞ, která mIJže postupnÞ osifikovat. Tím dojde k vymizení periodontální štÞrbiny a ke spojení povrchu koĜene zubu a alveolární kosti, které nazýváme zubní ankylóza [1, 2] (Obr. 1). Etiologie a výskyt Ankylóza stálých zubIJ je považována za multifaktoriální onemocnÞní; vzhledem k obtížné diagnostice dosud není známa pĜesná pĜíÐina jejího vzniku ani její Ðetnost v populaci. K ankylotickému procesu dochází desetkrát ÐastÞji v doÐasné než ve stálé dentici (Obr. 2) a dvakrát ÐastÞji v mandibule než maxile, nejÐastÞji pĜitom postihuje doÐasné druhé dolní moláry. MIJže se však vyskytnout i ve stálém chrupu, pĜiÐemž není významný rozdíl v prevalenci jejího výskytu mezi muži a ženami. NejÐastÞji postiženým zubem bývá první stálý molár u dÞtí a adolescentIJ [3], což komplikuje ortodontickou léÐbu bÞhem dospívání. U dospÞlých je nejÐastÞji ankylóza pĜítomna u impaktovaných špiÐákIJ [4]. V souÐasnosti jsou ankylózy dÞleny na idiopatický (raný) typ a sekundární (pozdní) ankylózu. PĜíÐiny vzniku idiopatického raného typu nebyly dosud zcela objasnÞny. Uvažuje se o kongenitálních vlivech, které se podílejí na formování periodoncia a kosti, tomu by i napovídal zvýšený výskyt zubní ankylózy u pacientIJ se vzácnou formou CLCN–7 osteopetrózy. PĜi ní se jedná o poruchu H(+)-ATPasy na membránÞ osteoklastu, která umožċuje výmÞnu vodíkových a chloridových iontIJ pĜes membránu. I když osteoklasty jsou pĜítomny v dostateÐném poÐtu, nejsou schopny uvolnit vodíkové ionty, které snižují pH v extraIntroduction A healthy tooth root is fixed to the bone with periodontal fibres forming flexible anchorage enabling teeth to better resist pressure resulting from mastication. Pathological processes (e.g. inflammation or trauma) or even clearly identified causes may lead to blood coagulation in the periodontal fissure and subsequently to the formation of granulation tissue that can gradually ossify. In this way, the periodontal fissure is lost and the root surface fuses with the alveolar bone, i.e. ankylosis [1, 2] (Fig. 1). Etiology and incidence Permanent teeth ankylosis is a multifactorial condition; due to the difficult diagnosis, the precise cause and prevalence in the population remain unclear. The incidence of ankylosis is ten times higher in deciduous dentition than in permanent dentition (Fig. 2) and twice as common in the mandible as
摘要 恒牙强直是一种多因素疾病。它在分子水平上的起源仍相当不清楚,而且由于诊断困难,其在人群中的发病率也不清楚。ORTODONCIE | ro˃ník 32 | ˃.3/2023 ODBORNÉ PRÁCE / ORGINAL ARTICAL Articles Recenzovaný ˃asopis ˂eské ortodontické spole˃nosti 158 Úvod KoĜen zdravého zubu je ke kosti fixován pomocín periodontálních vláken、在牙周病的治疗过程中,牙周病患者的牙龈和牙周膜会受到损伤。在病理过程中(新的创伤和外伤),牙周病患者会出现牙龈肿胀、牙龈组织颗粒化,这些都是牙周病的后遗症。这种疾病会引起牙周病和牙龈肿胀,从而导致踝关节疼痛 [1, 2] (图 1)。病因与诊断 强直性脊柱炎是一种多病因的慢性疾病;在诊断过程中会出现一系列的症状。在牙釉质注射过程中,会对下颌骨和上颌骨(Obr. 2)进行快速咀嚼,然后再对下颌骨和上颌骨(Obr. 3)进行快速咀嚼。我们的研究显示,在儿童和青少年中的发病率很高。在儿童和青少年中,牙周病的发病率很高[3],而在儿童中,牙周病的发病率也很高。在婴幼儿口腔中,踝关节和髋关节的功能受到影响[4]。踝关节的类型有踝关节型(raný)和踝关节型(pozdní)。在这种情况下,您可能会选择将其放在 "惰性 "类型中,然后再将其放在 "非惰性 "类型中。通过对CLCN-7型骨质疏松症患者的骨骼健康状况进行监测和评估,可以发现患者的踝关节有明显的病变。在这种情况下,H(+)-ATPasy 会在骨膜上产生,并在骨膜上形成碘离子和氯离子。健康的牙根与牙槽骨固定在一起,牙周纤维形成灵活的锚,使牙齿能够更好地抵抗咀嚼时产生的压力。病理过程(如炎症或外伤)甚至是已明确的原因都可能导致牙周裂血液凝固,随后形成肉芽组织,并逐渐骨化。这样,牙周裂消失,牙根表面与牙槽骨融合,即强直[1, 2](图 1)。病因和发病率 恒牙强直是一种多因素疾病;由于诊断困难,其确切病因和在人群中的发病率仍不清楚。乳牙强直的发病率是恒牙的十倍(图 2),下颌的发病率是上颌的两倍。下第二乳磨牙是最常受影响的牙齿。不过,恒牙也可能发生强直。男性和女性的发病率没有明显差异。在儿童和青少年中,第一恒磨牙最常受到影响[3],这使得正畸治疗变得复杂。在成人中,受影响的犬齿最多[4]。强直目前分为特发性(早期)和继发性(晚期)强直。特发性强直的原因尚未得到令人满意的解释。参与牙周和骨骼形成的先天性因素被认为是原因之一,牙齿强直患者中一种罕见的 CLCN-7 骨化症的发病率增加也证明了这一点。这是由于允许氢离子和氯离子交换的破骨细胞膜上的 H(+)-ATP 酶发生了紊乱。即使破骨细胞的数量足够多,它们也无法释放氢离子来降低细胞外空间的 pH 值,因此,它们会导致牙齿强直。牙齿强直可分为病因不明的特发性(早期)和因外伤或牙根周围炎症引起的继发性(晚期)。一般来说,诊断的依据是患者的病史和临床表现,其特点是强直的牙齿活动度丧失,伴有明显的叩击声。放射学上可以使用计算机断层扫描(CT),但为了避免高辐射负荷,通常会用锥形束计算机断层扫描(CBCT)来代替。拔除强直的牙齿是最常见的解决方案。其他方法包括牙齿脱位(可能需要皮质切开术)或牙槽牵引配合正畸治疗。虽然使用了越来越多的先进成像方法,但
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