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1、高角和低角病例的诊断、临床特征及正畸治疗特点Highangleandlowanglecases,diagnosis,clinicalfeaturesandorthodontictreatment1由于以往的诊断是以安氏分类为主,正畸医生常常只注意到矢状向错牙合而忽略了垂直向不调。近年来,学者们逐渐认识到垂直面型在错畸形诊断和治疗中的重要性:它不仅为颅面复合体的生长方向提供了线索,而且直接影响治疗的成功与否。PreviousdiagnosiswasbasedonAngle'sclassificationsoorth
2、odontistsoftenonlynoticedthesagittalmalocclusionwhileignoringtheverticaldimension.Inrecentyears,scholarshavecometorealizetheimportanceoftheverticaldimensionsinthediagnosisandtreatmentofmalocclusionitnotonlyprovidescluestothedirectionofgrowthofthecraniofacialc
3、omplex,butalsodirectlyaffectsthesuccessoftreatment.2垂直向异常有高角和低角两种类型,在Ⅲ类安氏错牙合中约有50%左右的患者存在不同程度的垂直向异常。Verticalanomalyareoftwotypes of high-angleand low angle, about 50%of patientswithangleclassIIImalocclusionhave varyingdegreesofabnormal verticaldimensionhigh-a
4、ngle and low anglecases, diagnosis,clinicalfeatures, andorthodontictreatment3一、高角病例和低角病例的诊断和形成机制Highangleandlowanglecasesdiagnosisandform文献中用来描述垂直向异常的说法很多,常用的有开张面型(hyperdivergent)、向后旋转型(backwardrotation)、垂直生长型(verticaltype)、长面型(dolichocephalic)、高角型(high-angle
5、face),均指垂直向异常以发育过度(verticalexcessive)为主,而聚合面型(hypodivergent)、向前旋转型(forwardrotation)、水平生长型(horizontaltype)、短面型(brachypechalic)、低角型(low-angleface)则是指垂直发育不足(verticaldeficiency)。由于诊断标准和侧重点不同,从严格意义上讲,这些概念之间是有差异的,但在临床中描述垂直面型时经常通用。Diagnosticcriteriaandadifferentfocu
6、s,inthestrictsense,theseconceptsthereisadifference,butoftencommonintheclinicaldescriptionofverticaltype.4高角病例和低角病例的诊断和形成机制Highangleandlowanglecasesdiagnosisandform本文中统称为高角和低角,但不能误解为下颌平面角大者即为高角型、小者即为低角型,这是因为下颌角和下颌下缘在生长改建过程中变化较大,所以单纯以下颌平面角作为诊断标准可能掩盖了下颌真实的旋转方向,对
7、垂直面型的正确诊断还应结合其他指标。Referredtoarticleas high-angle andlow angle,shouldnotbeconfusewiththemandibular planeangle,ifitishigh,called highanglecase,andifsmallthanlowanglecase.Because themandibularangleandmandibularmarginchangeswithgrowth,sosimple mandibularplaneangl
8、e as the diagnosticcriteria maymaskthe true mandibular rotationanddirectionofthe vertical growth.Thecorrect diagnosis shouldbe combinedwith otherindicators5目前常用的诊断标准是:Thecommonlyuseddiagn