14例正畸减数第一恒磨牙病例临床疗效分析及相关问题初探

Effects of orthodontic treatment with first molar extraction of 14 cases

目的 评价正畸减数第一磨牙的临床疗效,并就减数第一磨牙的相关矫治原则、间隙关闭情况及第三磨牙的建（牙合）等问题进行初步探讨.方法 选取我科近10年完成的14例减数第一磨牙矫治病例进行分析.通过对矫治前后模型的PAR指数和头颅侧位片,对矫治后磨牙间隙关闭、咬合关系及软组织侧貌进行评价;并通过曲面断层片,初步评价第二磨牙的牙根吸收和牙槽骨的改建以及第二磨牙和前磨牙的牙根平行状况.结果 14例患者平均疗程（29.5±4.3）个月,PAR疗效分析显示治疗后变差或无改变0例,改善5例,明显改善9例,提示拔牙间隙关闭满意,牙（牙合）关系良好;软组织侧貌协调,面型满意;曲面断层片显示第二前磨牙与第二磨牙牙根平行状况良好,第二磨牙牙根及牙槽骨无明显吸收.结论 减数第一磨牙病例只要严格把握适应证,合理的支抗设计和严谨的临床操作,可以获得满意的临床矫治效果.

Objective To evaluate the effects of the orthodontic treatment with first molar extraction and to investigate the relative treatment principles,space closure and third molar occlusion results.Methods 14 patients with the first molar extraction treatment in the past ten years were analyzed.Model PAR index and cephalograms were used to evaluate space closure,occlusal relationship,and soft tissue lateral profile after treatment.Panoramic films were used to evaluate root resorption,alveolar crest height and root paralleling of second molars.Results The average treatment time was （29.5±4.3） months.9 cases（64.3%）were evaluated as greatly improved,5 cases （35.7%） as improved,and none were evaluated as worse or no difference.Extraction spaces of first molars were closed; good occlusalrelationships and soft tissue profiles were achieved in all cases.The roots of second premolar,second molars and third molars were paralleled.The root and alveolar crest height of the second molars showed no significant difference after treatmen.Conclusions The first molar extraction cases could receive satisfactory results under strict plan,appropriate anchorage control and careful clinical operation.