埋伏弯根上颌中切牙序列矫治的研究

Sequence orthodontic treatment of impacted dilacerated maxillary central incisors

目的探讨埋伏弯根上颌中切牙有效的正畸牵引治疗方法。方法选择11例患者共12颗埋伏弯根上颌中切牙为研究对象,常规拍摄定位X线片,配合口内检查、模型分析等,确定埋伏牙的位置及其与邻牙的相互关系,采用封闭式导萌、选择性根管治疗及根尖切除术、修复治疗等方法进行矫治。结果 12颗埋伏牙通过治疗后顺利进入正常牙列,未见牙根吸收粘连,建立了良好的咬合关系。9例唇侧埋伏弯根上颌中切牙患者的临床牙冠唇倾角度较大,4例根尖位于唇侧黏膜下,进行了根管治疗加根尖切除术,其中1例行烤瓷冠改形修复;其余5例未做根管治疗,暂行观察。2例腭侧埋伏弯根上颌中切牙的疗效稳定。结论埋伏弯根上颌中切牙采用序列矫治可以取得良好的美观和功能效果。

Objective To explore an effective orthodontic method for treating impacted dilacerated maxillary cen-tral incisors.Methods 12 impacted teeth of 11 cases were chosen.The position of the impacted teeth and the rela-tions with neighbour tissues were assessed by X-ray images,oral examination and plaster model,etc.The impacted teeth were induced to erupt with the closed-eruption technique and fixed orthodontic appliances,root canal therapy,apicoectomy and prosthetic treatment.Results 12 impacted teeth were moved into arches,and the occlusal relation-ship was normal.There were no root resorption or conglutination in those impacted teeth.The labial impacted teeth of nine cases had bigger labial crown torsion.The root apexes of four impacted teeth were palpable under mucosa of the labial sulcus and operated by root canal therapy and apicoectomy.One of them received prosthetic treatment.Others（five cases） hadn＇t accepted root canal therapy,and were observed temporarily.The effects of two palatal impacted teeth was stable.Conclusion It was a good method to expand indication with sequence orthodontic treatment.The impacted dilacerated maxillary central incisors could be aligned with good esthetical and functional effect.