第1磨牙缺失的正畸治疗分析

Treatment analysis of first molar orthodontic

目的分析第1磨牙缺失患者正畸治疗的临床疗效,探讨拔除第1磨牙进行正畸治疗的可行性。方法通过临床完成的15例由于第1磨牙缺失或因病变需要拔出第1磨牙的患者的矫正结果的临床分析。患者平均22.5岁,均存在1颗或多颗第1磨牙早失或严重病损。矫治设计拔出病损侧的第1磨牙而保留健康的双尖牙,已早失磨牙一侧不再减数,健康侧常规拔出第1前磨牙,所有病例均采用方丝弓矫治器。结果 15例患者平均疗程(24.5±4.5)月。矫治后前牙覆、覆盖关系正常,上下牙列中线对齐,尖牙均为中性关系。拔牙间隙关闭,第2磨牙牙根与第2前磨牙牙根平行,牙齿尖窝关系良好。结论对于第1恒磨牙存在严重龋坏或过早缺失的患者非常规拔除第1磨牙,进过仔细的支抗设计和精心的临床操作,可以获得较满意的临床治疗效果。

Objective To analyze the clinical curative effect of orthodontic treatment on the first molar missing and explore the feasibility of orthodontic treatment. Methods The clinical data of 15 cases whose first molar needed to be pulled out and corrected due to the first molar missing or due to a lesion need were analyzed. Patients had an average age of 22.5 years. They had one or a plurality of first molar early loss or severe lesions. It was designed to pull out the lesion side of the first molar while sparing healthy premolar. No more teeth on the molar side with early loss were re- duced and the first premolar was pulled out on the healthy side. All cases were treated with edgewise appliance. Results The mean treatment duration of 15 patients was （22.5 ± 4.5） months. Molar tooth space was completely closed. After treatment, a good relationship was established between the second molar teeth and bicuspid. Conclusion Careful anchorage design and clinical operation can ensure curative effect on the regular extraction of the first molar for patients who had severe caries or premature loss.