高角和低角病例的诊断临床特征及正畸治疗特点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。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。Verticalanomalyareoftwotypesofhigh-angleandlowangle,about50%ofpatientswithangleclassIIImalocclusionhavevaryingdegreesofabnormalverticaldimensionhigh-angleandlowanglecases,diagnosis,clinicalfeatures,andorthodontictreatment一、高角病例和低角病例的诊断和形成机制Highangleandlowanglecasesdiagnosisandform高角病例和低角病例的诊断和形成机制Highangleandlowanglecasesdiagnosisandform目前常用的诊断标准是:Thecommonlyuseddiagnosticcriteriaare:高角病例或低角病例的形成主要与前后面部高度的生长发育失调有关。high-angleorlowanglecaseswithahighlevelofgrowthanddevelopmentbeforeandafterfacialdisorders后面部高度生长不足(升支短小、关节窝靠前靠上)和/或前面部高度生长过度(髁突向后生长、上颌骨垂直发育过度、后牙垂直萌出过度)形成了高角型。Lackofposteriorfacialgrowth(ascendingbranchoftheglenoidfossasmall)and/oranteriorfacialheightovergrowth(condylarbackwardgrowth,excessiveeruptionofthemaxillaryposteriorteeth)isresponsibleforahigh-anglecase.后面部高度生长过度(升支较长、关节窝靠后靠下)和/或前面部高度生长不足(髁突向上向前生长、上颌骨垂直发育不足、后牙萌出不足)形成了低角型。posteriorheightovergrowth(theascendingbranchofaglenoidfossalong)and/orinlackofposteriorfacialgrowth(upwardandforwardrotationofcondyle,lackoferuptionofmaxillaryposteriorteeth)isresposibleforlow-anglecase.二、高角病例和低角病例的临床特征Thecaseofhigh-angleandlowangleoftheclinicalfeatures9侧面观Lateralview:高角病例呈开张面型,面下1/3长,凹面型多见,上唇较厚,颏部和颏唇沟均不明显,头位略前伸;Highanglecases,lengthofthelower1/3ofthefaceislong,theconcavetypeprofilemorecommon,thickupperlip,chinandchinlipgroovearenotprominent.低角病例呈聚合面型,面下1/3段短,凸面型多见,上唇较薄,颏部和颏唇沟明显。low-anglecasesthelower1/3ofthefacegenerallyshorterconvexfacialprofile,thinupperlip,chinandchinlipgrooveareprominent.二、高角病例和低角病例的临床特征Thecaseofhigh-angleandlowangleoftheclinicalfeaturesclinicalfeaturesofhigh-angleandlowanglecases牙弓狭窄、腭盖高拱二、高角病例和低角病例的临床特征Thecaseofhigh-angleandlowangleoftheclinicalfeatures低角病例腭平面、牙合平面和下颌平面接近平行,下颌角呈直角,下颌下缘平缓,下颌管弯曲,前牙直立,上下中切牙角较大thepalatalplane,occlusalplaneandmandibularplanenearlyparalleltotheangleofmandibularperpendiculartothef