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早在1860年Angle就提出可以通过打开腭中缝来扩大上颌骨。1961年Hass提出对于处在生长发育高峰期的青少年来说,可以通过上颌螺旋扩大器来打开腭中缝,扩大上颌骨;不同于上颌腭中缝的扩展,下颌正中联合的软骨在出生后1-1.5岁就与骨组织融合成一体,至青春发育期下颌已无法像腭中缝一样水平向展开,下颌非手术扩弓饱受争议。借鉴Bihelix、Schwarz、Crozat等下颌活动扩弓器的优缺点,改良制作了固定式钢网结构的下颌螺旋扩大器,将上颌Hyrax螺旋扩大器和改良的下颌螺旋扩大器同时应用于安氏各类错(牙合)畸形病例,均取得了令人满意的疗效。将螺旋扩大器应用于安氏Ⅰ类错(牙合)的主要目的是开辟间隙,解除中、重度拥挤;应用于安氏Ⅱ类错的主要目的是扩大上颌牙弓,解除上颌对下颌的阻挡,以利于下颌前移,纠正下颌后缩,上颌所开间隙用于直立唇倾的上前牙,以达到内收上前牙的效果,而下颌所开的间隙用于纠正下颌拥挤和整平过陡的Spee曲线;应用于安氏Ⅲ类错(牙合)的主要目的是快速扩大上颌腭中缝,配合面具前方牵引,刺激上颌基骨发育,纠正因前颌骨发育不足产生的前牙拥挤,扩大下颌牙弓,使上下牙弓宽度相匹配,纠正过陡的Spee曲线、同时内收下前牙。应用体会:1.在生长发育阶段,螺旋扩弓器可以有效地扩展上下颌牙弓,减少拔牙矫治。2.螺旋扩弓器主要用于非拔牙矫治,也适用于一些牙弓狭窄伴重度拥挤和牙槽前突需要拔牙的患者,可采取先扩弓后拔牙的方案。3.年龄和骨龄直接影响扩弓矫治的效果,同样年龄对男性患者可适当放宽适应症,而女性患者则需谨慎把握。4.将螺旋扩弓器与固定矫治联合使用,可获得所需支抗控制,取得更好的矫治效果。5.上下颌联合应用螺旋扩大器更有利于拥挤的解除和Spee曲线的整平,也有利于牙弓狭窄的解决。6.纠正不良习惯、适当延长矫治时间使肌肉充分适应增宽的牙槽骨从而获得良好的改建是保持扩弓效果稳定的基础,所追踪的完成后三到七年的病例,效果是稳定的。其后期的稳定性将在临床上继续观察。
As early as 1860 Angle proposed that the maxillary bone could be enlarged by opening the palatal midline. In 1961, Hass proposed that for adolescents in the peak period of growth and development, the maxillary spiral expansion can be used to open the palatal midsection and enlarge the maxilla. Unlike the expansion of the maxillary palate midline, Year old and bone tissue integration into one, to the puberty mandibular can not be as horizontal as the palatal incision, mandibular non-surgical expansion is controversial. Learn from Bihelix, Schwarz, Crozat jaw and other advantages and disadvantages of mandibular active devices, improved production of fixed steel mesh mandibular spiral amplifier, the maxillary Hyrax spiral amplifier and modified mandibular spiral amplifier applied to all types of Angle Wrong (occlusal) deformity cases, have achieved satisfactory results. The main purpose of applying spiral expander to Class Ⅰ malocclusion is to open up the gap and relieve the moderate and severe crowding. The main purpose of Class Ⅱ malocclusion is to enlarge the maxillary arch and relieve maxillary to mandibular Blocking, in order to facilitate the mandibular advancement, correction of mandibular retrusion, maxillary opening gap for vertical lip tilt of the anterior teeth, in order to achieve the effect of adduction of the anterior teeth, and mandibular open gap is used to correct the crowded crowded and the whole Flat over steep Spee curve; applied to Class III malocclusion main purpose is to rapidly expand the maxillary palatal incision, with the mask in front of traction, stimulation of maxillary basement bone development, to correct the anterior teeth due to underdevelopment of the anterior maxilla Crowded, expanding the mandibular arch, so that the upper and lower arch width to match, correct the steep Spee curve, at the same time accept the front teeth. Application experience: 1. In the growth and development stage, spiral expansion device can effectively expand the maxillary and maxillary dental arch, reducing extraction teeth treatment. 2. Spiral expansion device is mainly used for non-extraction treatment, but also for some dental arch stricture with severe congestion and alveolar process in patients with tooth extraction can be taken after the expansion of the program after the extraction. Age and bone age directly affect the effect of augmentation correction, the same age may be appropriate for men to relax indications, while women need to be cautious. 4. The spiral expansion device with fixed joint treatment, access to the required support control, to achieve a better correction effect. 5. Combined application of the upper and lower jaw spiral amplifier is more conducive to relieve congestion and Spee curve leveling, but also conducive to the solution to the stenosis. 6 to correct bad habits, and appropriately extend the treatment time to make the muscles fully adapt to the widening of the alveolar bone to obtain a good reconstruction is to maintain the stability of the expansion effect of the expansion, the tracked completion of three to seven years after the case, the effect is stable . The latter part of the stability will continue to be observed clinically.