上颌埋伏尖牙非手术助萌的正畸治疗

Orthodontic treatment of non-surgical eruption of impacted maxillary canines

目的探讨上颌埋伏尖牙非手术助萌正畸治疗的适应证及其临床效果。方法选取10～15岁上颌埋伏尖牙患者20例,应用螺旋CT三维重建技术对其进行诊断,明确埋伏尖牙颌骨内位置、方向及牙根发育情况,选取适合病例12例通过正畸手段为埋伏尖牙开辟间隙,等待其自行萌出;8例采用外科翻瓣导萌术牵引导萌。结果 12例非手术助萌患者,正畸拓展足够间隙后经3～10个月上颌埋伏尖牙均自行萌出至正常位置,牙周附着健康;8例外科手术导萌患者,上颌埋伏尖牙正畸牵引到位后均有不同程度的牙周附着丧失,影响龈缘美观。结论采用螺旋CT三维重建技术可以立体直观的提供埋伏尖牙的信息,为临床医师明确诊断及制定治疗方案提供依据,减少手术适应证,使用非手术助萌的方法可使上颌埋伏尖牙自行萌出,避免手术创伤痛苦,萌出后牙周附着好。

Objective To invesigate the indications of orthodontic treatment of non-surgical eruption of impacted maxillary canines and observe the clinical effect.Methods 20 patients（10~15 year-old）with impacted maxillary canines diagnosed by three-dimensional spiral computed tomography（CT） reconstructions were selected and the location,orientation in the maxilla and root development of the impacted tooth were identified.12 appropriate cases were treated by non-surgical orthodontic methods to expand space for the impacted teeth.Wait for its own eruption.8 cases were treated by flap surgery traction.Results Maxillary canines in the non-surgery eruption group erupted to the normal position with normal periodontal attachment in 3-10 months after enough space was expanded.Maxillary canines in proper positions of the 8 surgery eruption cases showed various degree of periodontal attachment loss,affecting gingival appearance.Conclusions Three-dimensional spiral CT technology can provide intuitive information of impacted tooth for clinicians to develop a clear diagnosis and treatment options,reducing surgical indications.Non-surgical methods can help the impacted maxillary canines erupt themselves,avoiding surgical trauma.