安氏Ⅰ类拥挤伴融合牙的矫治设计

Treatment planning of Class Ⅰ patients with crowding and mandibular fused teeth

目的结合临床病例探讨安氏Ⅰ类拥挤伴下颌融合牙的临床处理,以期获得比较有效的处理下颌融合牙病例的常用治疗方法。方法收集本科近三年来临床上安氏Ⅰ类拥挤拌下颌前牙有融合牙者12例(男5例,女7例),根据牙弓的拥挤程度,面型突度、患者主观要求等,决定是采用拔牙或非拔牙的矫治方案,再通过计算 Bolton 指数的前牙比和全牙比,确定如何拔牙以及如何邻面去釉。结果根据不同的适应证,分别采用不同的矫治设计方法:非拔牙矫治患者,主要采用上颌邻面去釉的方法,磨去的量主要以Bolton 指数来指导;拔牙病例中,多采用上下颌非对称拔牙(上颌两颗,下颌一颗),再通过计算 Bolton 指数来适当行下颌下齿的领面去釉。最后所有患者均获得满意的临床矫治效果。结论对于安氏Ⅰ数拥挤伴下颌融合牙患者,根据其临床条件可选择拔牙或非拔牙的矫治方案,两者均可取得健康,美观的临床疗效。

Objective To discuss the treatment of class Ⅰ patients with crowding and mandibular fused teet, and to get the suitable methods of dealing with those patients. Methods Twelve Class Ⅰ cases （5 males, 7 females） with mandibular fused teeth and crowding were collected. Extraction and non-extraction therapies were selected based on arch crowding, profile, patient＇s chief complaint and so on. Under the guidance of Bolton index extraction and interproximal stripping were determined.. Results In non-extaction patients, interproximal stipping of the upper arch was the main solution In extaction patients, asymmetric extaction （two teeth in the upper arch and one in the lower arch） was mainly adopted and mandibular interproximal ename stripping was also used. The results were satisfactory in all patients. Conclusion In Class Ⅰ patients with crowding and mandibular fused teeth, extraction or non-extraction treatment planning could get healthy and esthetical results.