|
所在平台: Udemy |
课程主页: https://www.udemy.com/course/early-diagnosis-and-management-of-class-iii-malocclusion/
课程评论：没有评论
Coursera 课程：III 类错颌的早期诊断与管理 本课程旨在为牙医提供诊断和治疗 III 类错颌所需知识和技能，以满足日益增长的患者对美观的需求。III 类错颌在亚洲人群中发病率较高 (4%-14%)，其病因可能涉及遗传、环境、习惯和种族等多种因素，主要表现为骨性（下颌前突、上颌后缩）或牙槽性（下颌切牙后倾、上颌切牙前倾）因素，或两者兼有。 课程将区分真性 III 类错颌和假性 III 类/功能性 III 类错颌。诊断依据包括：关系位、家族史、切牙关系以及头影测量学分析。真性 III 类常有家族史，头影测量学显示 SNB 角增大、SNA 角减小或正常、下颌切牙后倾等；假性 III 类常无家族史，头影测量学显示 SNA 正常、SNB 略增大、上颌切牙后倾、下颌切牙正常，并可能存在功能性移位。 III 类错颌特征常在 3-5 岁出现，若不及时治疗，可能加重并最终需要正颌手术。因此，在生长发育期早期诊断并进行干预至关重要，这不仅能改善面部美观，提升孩子的心理社会发展，还能避免错颌发展为永久性问题。 课程将介绍多种治疗方案，包括： 1. 功能性矫治器（如反向 twin block、Frankel 矫治器 mandibular retractor） 2. 骨矫治器（如下颌头帽、面弓） 3. 错颌矫治器（如上颌扩弓器、固定矫治器） 最终选择何种治疗方案，将根据患者的上颌发育受限程度、下颌平面角、软组织侧貌及年龄等因素综合决定。
Due to increasing awareness regarding malocclusion and more concern about esthetic in the general population in present days, it is necessary for a dentist to have immense knowledge and skills about the diagnosis and treatment planning of the malocclusion to meet patient's expectations. Nowadays, the patient reports to a clinician at very early age for the correction of malocclusion. The prevalence rate of Class III malocclusion varies according to different racial categories. The mean incidence rate in Caucasians is 1%-4%,[1] with higher being found in Asians (4%-14%). The etiology of Class III malocclusion is multifactorial. However, hereditary is the main etiological factor. Other factors include environment, habits, and race. Class III malocclusion is mainly due to skeletal component, dentoalveolar component, and combination of both. Prognathic mandible, retrognathic maxilla, or combinations of both are the features of skeletal Class III malocclusion. Dentoalveolar component presents with retruded mandibular incisors and protruded maxillary incisors for dentoalveolar compensation.Class III malocclusion is of two types: (1) True Class III malocclusion and (2) Pseudoclass III/functional Class III malocclusion. PseudoClass III malocclusion may be due to high points while occluding teeth or functional shift. The diagnosis and treatment planning can be done considering the following: (a) centric relation (CR), (b) family history, (c) interincisal relationship, and (d) cephalometric findings.[4] True Class III malocclusion mostly has a positive family history. Cephalometric findings may present with increased Sella-Nasion-B point (SNB) angle and small or decreased Sella-Nasion-A Point (SNA) angle, retroclination of lower incisors, and less incisor mandibular plane (MP) angle. Cephalometric findings of pseudo/functional Class III malocclusions show normal SNA, slight increase in SNB angle, retroclined maxillary incisors, and normal lower incisors. Family history is usually absent. The functional shift can be seen.The characteristic features of Class III malocclusion are present at an early age, usually between 3 and 5 years of age. If left untreated, the Class III malocclusion or severe anterior crossbite may worsen, with the majority of these patients ultimately requiring orthognathic surgery as adults. The treatment in all developing Class III cases should be undertaken as soon as the abnormality is diagnosed to prevent it from becoming permanent and resulting in a full-blown Class III malocclusion. It provides more pleasing facial esthetics (the lip posture and facial appearance), thus improving the psychosocial development of a child. Various treatment options available for the management of developing Class III malocclusion are as follows: (1) functional appliances such as reverse twin block, Frankel appliance, and the removable mandibular retractor; (2) orthopedic appliances such as chin cap and face mask; and (3) orthodontic appliances, namely removable maxillary expansion plate or fixed orthodontic appliance with expanded upper arch wire. A treatment plan may be chosen depending on the amount of maxillary growth restriction, mandibular plane angle, the soft-tissue profile, and the age of the patient.
