（参考课件）正畸治疗前的模型分析和投影测量分析.ppt

Orthodonticdiagnosis:ThedevelopmentofaProblemList,Operator:ZhouLingSupervisor:Prof.LiDate:2013.6.6,1,CompanyLogo,1,5,3,4,DevelopmentofaProblemList,TheProblem-Orientedapproach,ClinicalEvaluation,AnalysisofDiagnosticRecords,OrthodonticClassification,Chapteroutline,2,2,CompanyLogo,AnalysisofDiagnosticRecords,Cephalometricanalysisofdentofacialrelationships,Dentalcastanalysis,toevaluatespaceexcessordeficiencyandsymmetrywithinthedentalarches,3,CompanyLogo,SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis,Dentalcastanalysis,4,CompanyLogo,Symmetry,TransparentruledgridplacedoverdentalcastOrientedtothemidpalatalrapheSpotasymmetriesinarchform,andtoothposition,5,CompanyLogo,Lateraldriftofincisors(Crowding,Clost3blockedout),Symmetry,Driftofposteriorteeth（EarlylossofE),6,CompanyLogo,Pendulum,7,CompanyLogo,SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis,Dentalcastanalysis,8,CompanyLogo,Alignment(Crowding):SpaceAnalysis,9,CompanyLogo,Dentalcast,Computeralgorithm,SpaceAnalysis,10,CompanyLogo,Measuringarchperimeterfromthemesialofonefirstmolartotheother,overthecontactpointsofposteriorteethandincisaledgeofanteriors.,Stepone:Calculationofavailablespace,片段法,铜丝法,11,CompanyLogo,Steptwo:Calculationofrequiredspace,Measurethemesiodistalwidthofeacheruptedtoothfromcontactpointtocontactpoint.,12,CompanyLogo,SpaceAnalysis,13,CompanyLogo,01,Thespaceavailablewillnotchangebecauseofgrowth.,02,Alltheteetharenormalinsize,03,Correctanteroposteriorpositionofincisors,Threeassumptions,14,CompanyLogo,Interaction,Protrusion,Retrusion,Crowding,15,CompanyLogo,Crowdingandprotrusionaredifferentaspectsofthesamephenomenon.Ifthereisnotenoughroomtoproperlyaligntheteeth,theresultcanbecrowding,protrusion,or(mostlikely)somecombinationofthetwo.,16,CompanyLogo,17,CompanyLogo,18,CompanyLogo,19,CompanyLogo,01,Thespaceavailablewillnotchangebecauseofgrowth.,02,Alltheteetharenormalinsize,03,Correctanteroposteriorpositionofincisors,Threeassumptions,20,CompanyLogo,Inachildwithawell-proportionedface,thereislittleornotendencyforthedentitiontobedisplacedrelativetothejawduringgrowth.Buttheteethoftenshiftanteriorlyorposteriorlyinachildwithajawdiscrepancy.,21,CompanyLogo,22,CompanyLogo,01,Thespaceavailablewillnotchangebecauseofgrowth.,02,Alltheteetharenormalinsize,03,Correctanteroposteriorpositionofincisors,Threeassumptions,23,CompanyLogo,SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis,Dentalcastanalysis,24,CompanyLogo,MixDentitionEstimatingofUneruptedPermanentTeeth,25,CompanyLogo,EstimatingofUneruptedPermanentTeeth,26,CompanyLogo,Undistortedradiographicimage,Compensateforenlargement,Measurementoftheteethonradiographs,27,CompanyLogo,TruewidthofprimarymolarApparentwidthofprimarymolar,Measurementoftheteethonradiographs,TruewidthofuneruptedPremolarApparentwidthofuneruptedpremolar,=,28,CompanyLogo,Accuracyisfairtogooddependingonthequalityoftheradiographsandtheirpositioninthearch.Thetechniquecanbeusedinmaxillaryandmandibulararchesforallethnicgroups.,Measurementoftheteethonradiographs,29,CompanyLogo,EstimatingofUneruptedPermanentTeeth,30,CompanyLogo,Moyersprediction,Estimationfromproportionalitytables,Measuringthemesiodistalwidthofthelowerincisors,Predictionthesizeofboththelowerandupperuneruptedcaninesandpremolars,31,CompanyLogo,Estimationfromproportionalitytables,32,CompanyLogo,NorthernEuropeanwhitechildrenNoradiographsarerequired,usedfortheupperorlowerarch.,Estimationfromproportionalitytables,33,CompanyLogo,Estimationfromproportionalitytables,34,CompanyLogo,EstimatingofUneruptedPermanentTeeth,35,CompanyLogo,Combinationofradiographicandpredictiontable,Itdepends!,36,CompanyLogo,Comparison,Moyers,Takana&Johnston,NorthernEuropeanwhitechildrenNoradiographs,DependingonthequalityoftheradiographsandtheirpositioninthearchForallethnicgroups.,37,CompanyLogo,SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis,Dentalcastanalysis,38,CompanyLogo,Althoughthenaturalteethmatchverywellinmostindividuals,approximately5%ofthepopulationhavesomedegreeofdisproportionamongthesizesofindividualteeth.-ToothSizeDiscrepancy(TSD),ToothSizeAnalysis,39,CompanyLogo,ToothSizeAnalysis,40,CompanyLogo,BoltonRatio,ToothSizeAnalysis,(78.81.72)%(91.51.51)%,41,CompanyLogo,Aquickcheckfor.Anteriortoothsizediscrepancy:22Posteriortoothsizediscrepancy：5=5Atoothsizediscrepancyoflessthan1.5mmisrarelysignificant.,ToothSizeAnalysis,42,CompanyLogo,SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis,Dentalcastanalysis,43,CompanyLogo,AnalysisofDiagnosticRecords,Cephalometricanalysisofdentofacialrelationships,Dentalcastanalysis,toevaluatespaceexcessordeficiencyandsymmetrywithinthedentalarches,44,CompanyLogo,Theintroductionofradiographiccephalometricsisin1934byHofrathinGermanyandBroadbentinUSA.,Cephalometricanalysis,45,CompanyLogo,Function,OriginalpurposeEvaluatingdentofacialproportionsandclarifytheanatomicbasisforamalocclusionObservingpathologicchanges(Sometimes),Researchingongrowthpatternsinthecraniofacialcomplex.,46,CompanyLogo,Thispatienthasfusionofthe1stand2ndcervicalvertebrae,withtheodontoidprocessextendingintothemarginofforamen.,Function,47,CompanyLogo,Function,OriginalpurposeEvaluatingdentofacialproportionsandclarifytheanatomicbasisforamalocclusionObservingpathologicchanges(Sometimes)Recognizingandevaluatingchangesbroughtaboutbyorthodontictreatment.,Researchingongrowthpatternsinthecraniofacialcomplex.,48,CompanyLogo,Function,49,CompanyLogo,Thegoalofcephalometricanalysisistoevaluatetherelationships,bothhorizontallyandvertically,ofthefivemajorfunctionalcomponentsoftheface.,Cephalometricanalysis,50,CompanyLogo,Cephalometricanalysis,51,CompanyLogo,CranialBaseS，N，Po，Ba,BoMaxillaOr，Ptm，ANS，PNS，A，UIMandibularCo，Go，B，LI，Pog，Me，Gn,CephalometricLandmarks,52,CompanyLogo,S.sellaN.nasionPo.porionBa.basionBo,CephalometricLandmarks,53,CompanyLogo,Or.orbitalePtm.ANS.AnteriornasalspinePNSPosteriornasalspineA.subspinaleUI.UpperIncisor,CephalometricLandmarks,54,CompanyLogo,Co.condylionGo.gonionPog.pogonionMe.mentonGn.gnathionB.supramentalLI.lowerincisor,CephalometricLandmarks,55,CompanyLogo,56,CompanyLogo,Cephalometricanalysis,57,CompanyLogo,Contemporarymeasurementapproach,ChoiceofaHorizontal(Cranial)ReferenceLine.SteinerAnalysisSassouniAnalysisWitsAnalysis,58,CompanyLogo,ChoiceofaHorizontalReferenceLine,AninternationalcongresswasheldinFrankfort,Germanyin1882.withthechoiceofahorizontalreferencelinefororientationofskulls,59,CompanyLogo,“Machineporion:TheuppersurfaceoftheearrodofthecephalometricAnatomicporion”:Theuppersurfaceoftheshadowoftheauditorycanal.,ChoiceofaHorizontalReferenceLine,60,CompanyLogo,61,CompanyLogo,NHP(naturalheadposition):Relaxedindividualslookatadistantobiectorintotheirowneyesinamirrorandinclinetheirheadsupanddowninincreasinglysmallermovementsuntiltheyfeelcomfortablypositioned.,ChoiceofaHorizontalReferenceLine,62,CompanyLogo,ChoiceofaHorizontal(Cranial)ReferenceLine.SteinerAnalysisSassouniAnalysisWitsAnalysis,Contemporarymeasurementapproach,63,CompanyLogo,SteinerAnalysis,SNA:Maxillatothecranialbase822SNB：MandibletotheCB782ANB:skeletaljawdiscrepancy.SN-MP(mandiblarplane):Verticalpositionofthemandible.,64,CompanyLogo,ANBangleisinfluencedbytwofactors:Verticalheightoftheface.Anteroposteriorpositionofnasion.,SteinerAnalysis,65,CompanyLogo,66,CompanyLogo,SteinerAnalysis,U1-NA（mm)U1-NAL1-NB（mm)L1-NB,67,CompanyLogo,HoldawayRatio:,Thebalancebetweentheprominenceofthechinandtheprominenceofthelowerincisor:themoreprominentthechin,themoreprominenttheincisorcanbe。,SteinerAnalysis,68,CompanyLogo,SteinerAnalysis,69,CompanyLogo,70,CompanyLogo,SteinerAnalysis,71,CompanyLogo,ChoiceofaHorizontal(Cranial)ReferenceLine.SteinerAnalysisSassouniAnalysisWitsAnalysis,Contemporarymeasurementapproach,72,CompanyLogo,skeletalopenbite,SNFHPPOPMP,SassouniAnalysis,73,CompanyLogo,74,CompanyLogo,ChoiceofaHorizontal(Cr