上颌腭侧阻生尖牙非手术与手术助萌的比较研究

Comparative study between non-surgical and surgical eruption of maxillary palatally impacted canines

目的探讨上颌腭侧阻生尖牙通过正畸开辟间隙等非手术助萌的适应证、矫治时间及其临床效果。方法选取9例患者的12颗上颌腭侧阻生尖牙为研究对象,通过曲面全景及头颅侧位片判断阻生尖牙在颌骨内的位置、牙齿的发育阶段及患者骨成熟阶段,通过正畸治疗配合头帽口外弓为阻生尖牙开辟间隙,定期拍摄曲面全景片观察阻生尖牙的萌出潜力。结果 7颗阻生尖牙自动萌出,3颗阻生尖牙采取外科开窗联合正畸牵引治疗,2颗阻生尖牙选择外科拔除。结论正畸开辟间隙后阻生尖牙成功萌出的主要因素可以概括为:萌出路径无干扰、骨成熟早期,根尖孔未闭合,而骨发育阶段比牙发育阶段更有指导意义。

Objective This study was designed to investigate the indication and treatment time of non-surgical eruption of maxillary palatally impacted canines and its clinical effect. Methods Nine patients with 12 maxillary palatally impacted canines were enrolled based on skeletal maturity as well as the position and dental maturity of the impacted canine diagnosed using panoramic and scephalometric radiographs. All patients underwent orthodontic treatment with headgear, followed by extraction of the deciduous canines. In addition, panoramic radiographs of the patients were taken every six months to observe the eruption of the impacted canine. Results Seven palatally impacted canines erupted spontaneously, three palatally impacted canines received surgery eruption, and two canines were extracted. Conclusion The influencing factors for non-surgical eruption of maxillary palatally impacted canines included the absence of obstruction in the erupted path, early stages of skeletal maturity, and open root apices. Eventually, skeletal maturity is more instructive than dental maturity.