第二双尖牙先天缺失14例治疗体会

Treatment experience of 14 cases of congenitally missing second premolar

目的探讨第二双尖牙先天缺失时合适的治疗方法。方法分析总结2000—2008年治疗的14例第二双尖牙先天缺失患者的临床资料,并结合国内外相关文献,寻找第二双尖牙先天缺失病例合适的治疗方法。结果14例患者中13例选择正畸关闭牙间隙矫治,完成时间为18～36个月,平均27个月,矫治后上下牙列排列整齐,前牙覆、覆盖正常,尖牙中性关系。1例选择集中间隙镶牙的治疗方法,矫治时间10个月。矫治后曲面断层片显示牙根平行,缺牙区牙槽骨无缺损、吸收。结论第二双尖牙的先天缺失应及早发现,并给予适当的治疗,如果患者选择正畸关闭牙间隙的矫治方法,要注意前牙支抗的严格控制,以防破坏侧貌的丰满度。

Objective To explore proper clinical options of congenitally missing second premolar,hoping to give some reference for other orthodontist in treating such patients.Methods Collect 14 patients treated by author from 2000 to 2008,analyze the methods and results of treatment,summarize clinical experience and correlative literature,and look for right options of treatment for congenitally missing second premolar.Results Orthodontic treatment was chosen for 13 patients to close the space;treatment time ranged from 18 to 36 months,with average 27 months.After treatment,upper and lower tooth was in alignment and even,overjet and overbite was normal and canine was neutral.Only 1 patient was performed orthodontic treatment combined with prosthetic restoration;treatment time was 10 months.After therapy the root was parallel in Panoramic and there was no alveolar bone defect or resorption in tooth losing area.Conclusion Congenitally missing second premolar should be found as early as possible with correct treatment.When the patient asks for closing the space,severely control the anterior anchorage to prevent flattening facial fullness.