上颌侧切牙先天缺失的矫治

ORTHODONTIC TREATMENT OF CONGENITAL UPPER LATERAL INCISOR MISSING

目的:探讨上颌侧切牙先天缺失的矫治设计及特点。方法:选择已矫治完成伴上颌侧切牙先天缺失的错畸形患者23例,根据上颌侧切牙先天缺失的数目、错类型、矫治方法及效果进行统计分析评价,对其中两组拔牙设计模式进行重点探讨。第一组:7例,缺1颗上颌侧切牙,下颌拔除两颗第一双尖牙和上颌非缺牙侧拔除1颗第一双尖牙;第二组:6例,缺2颗上颌侧切牙,下颌拔除两颗第一双尖牙或两颗第二双尖牙。将两组患者的模型进行Bolton指数测量分析,计算时将上颌侧切牙缺失侧的第一双尖牙纳入前牙量范畴,全牙比按减去先天缺牙和拔牙后的牙量计算,将两组模式的测量数据进行统计学检验。结果:两组全牙比为﹙87.68±1.0～87.41±1.01﹚%,前牙比为﹙76.6±2.24～75.24±0.87﹚%,前牙不调量在0.7±0.66～1.3±0.56mm之间。两组Bolton指数比较均无统计学差异(P>0.05)。结论:先天缺1颗上颌侧切牙若上下颌均需拔牙者,拔除上颌非缺牙侧的第一双尖牙或侧切牙对Bolton指数影响均不大;上颌侧切牙变异时选择拔除变异的上颌侧切牙保留同侧的第一双尖牙,避免Bolton指数不调的影响。

Objective： To explore the treatment planning and methods in patients with congenital upper lateral incisor missing . Methods ： Twenty-three patients with congenital upper lateral incisor missing with treatment finished were included in the investigation . According to quantity of algenesis, treatment method and outcome ,this article emphasizes to explore two patterns of extraction by statistical method .The first group consisted of seven patients with congenital missing of one upper lateral incisor who treated by extracting two lower first premolars and one upper first premolar at non-missing side; the second group consisted of six cases with congenital missing of two upper lateral incisors who treated by extracting two lower first or second premolars .The Bolton Index of models of the two group patients was analyzed when calculating, when analyzing anterior ratio , congenital missing upper lateral incisor （s） was taken place by first premolar （s）.The over all ratio was analyzed after extracting tooth . According to analysis of variance , the Bolton Index of samples in two groups was analyzed. Results ： Overall ratio in two groups were from 87.68%±1.0% to 87.41±1.01%, anterior ratio were from 76.6%± 2.24%to 75.24%±0.87%,anterior tooth-size discrepancy were between 0.7±0.66 to 1.3±0.56mm. No statistical significance was found on Bolton Index in two groups（P〉0.05 ）. Conclusion ： To patients with congenital missing of one upper lateral incisor who need extraction both in upper and lower jaws ,it was less inflnential in on Bolton Index that extracting one first premolar or lateral incisor at non-missing side. If upper lateral incisor is a malformed teeth,we shoul choose to extract the malformed lateral incisor and retain the first premolar on the same side in order to decrease influence on Bolton Index.