减数下颌切牙正畸治疗的效果评价

Orthodontic treatment of patients with mandibular incisor extraction

目的 探讨拔除下颌切牙进行正畸治疗的适应证、治疗特点及临床效果.方法 选择拔除单颗下颌切牙或还需配合拔除其他牙齿进行矫治的成人患者23例,男9例、女14例,开始治疗年龄17～39岁,平均（23.2±5.4）岁.单纯拔除1颗下切牙者17例,同时拔除1颗下切牙和2颗上颌前磨牙者6例.对矫治前后X线头影测量、模型测量和临床疗效进行分析.结果 固定矫治疗程13～23个月,所有病例治疗后牙齿排列整齐,前牙覆（牙合）覆盖关系正常,拔牙间隙完全关闭,拔牙区相邻牙齿牙冠无倾斜,全部患者对治疗结果满意.X线头影测量矫治前后无显著变化,模型测量矫治后下颌尖牙间宽度比矫治前减小[（26.89±2.89） mm比（23.92±1.54）mm,（P＜0.05）].结论 拔除下颌切牙矫治下尖牙间宽度明显减小,治疗中应密切注意.临床矫治应谨慎选择病例,在治疗过程中要注重相应技术和方法的应用,以取得满意的矫治效果.

Objective To evaluate the indications and effectiveness of lower incisor extraction in orthodontics.Methods Twenty-three adult patients with lower incisor extraction were included in the study.The cases consisted of 14 female and 9 male patients with an average age of 23.2 years at the start.One single lower incisor was extracted in 17 patients and the other tow upper premolars were extracted in 6 patients.Cephalometric and casts analyses were carried out.Results Total treatment time was 13-23 months.All extraction space was closed after the treatment.All patients achieved satisfactory treatment results,with normal overbite and overjet and stable occlusal relationship.There were no significant changes before and after treatment on cephalometric analysis.The intercanine width was reduced by from pretreatment to posttreatment [（26.89--2.89） mm vs （23.92-t-1.54） mm （P＜0.05）].Conclusions The intercanine width is reduced after lower incisor extraction.In order to achieve satisfactory clinical effect,we should carefully select cases and pay attention to the corresponding techniques and methods.