减数第一恒磨牙正畸治疗的临床分析

Analysis of orthodentics treatment with first molar extraction

目的探讨减数第一恒磨牙正畸治疗的临床效果和相关问题。方法回顾性分析2003—2010年收治的第一恒磨牙严重龋坏无法保留的错牙合畸形病例,采用滑动直丝弓矫正技术,拔除龋坏第一恒磨牙,将第二恒磨牙近中移动代替第一恒磨牙,关闭拔牙间隙。结果 39例患者经过18～28个月的固定正畸治疗,磨牙间隙关闭,中线对齐,牙列排齐,覆牙合覆盖正常,磨牙关系良好,术后曲面断层X线片显示第二恒磨牙与前磨牙牙根平行,牙根及牙槽骨无明显吸收。结论减数第一恒磨牙错牙合畸形的正畸治疗,经过合理的支抗设计和控制,恰当的临床操作,可以获得满意的临床效果并可以替代传统的修复治疗。

Objective To analyse the clinical effect of orthodentics treatment with first molar extraction and explore relative problems. Methods 39 cases whose first molar in severe caries needed to be pulled out and corrected. They were treated with straightwire appliance. The first molar space was closed by means of mesio - translation of second molar. Results All of them were treated with fixed appliance in 18 - 28 months, an average of 22 months. Succesful results were acquired after treatment together with normal overbite, overjet and right occlusion relationship. Molar space was completely closed. From orthopantomographic, the roots of second premolar and second molar were paralleling after treatment. There were no evidence that second molar had remarkable root resorption and alveolar crest resorption. Conelusions Patients could be successfully cured with first molar extraction as long as careful anchorage design and correct operation. Technology of the first molar extraction with orthodentics could replace traditional prosthodentics.