微种植体支抗钉结合改良滑动杆近中移动上颌前磨牙的临床应用

Clinical application of modified miniscrew-supported sliding jig in maxillary premolars mesialization

目的探讨微种植体支抗钉结合改良滑动杆近中移动上颌前磨牙关闭缺牙间隙的可行性及有效性。方法选取上颌侧切牙或尖牙缺失的患者5例(男2例,女3例),年龄14~25岁。缺失侧磨牙关系均为安氏Ⅱ类。在上颌第二前磨牙及第一磨牙间植入微种植体支抗钉,结合改良滑动杆近中移动前磨牙。前磨牙移动到位后更换支抗钉位置,利用支抗钉拉磨牙近中移动,关闭剩余间隙。前磨牙移动疗程6~10个月。通过矫治前后石膏模型测量前磨牙近中移动有效性。结果5例患者均得到有效治疗,上颌前磨牙及磨牙近中移动,缺牙间隙关闭,缺牙侧磨牙关系完全远中,治疗效果均令人满意。上颌前磨牙近中平均移动4.1 mm,平均移动速度0.96 mm/月。结论对于上颌侧切牙或尖牙缺失的患者,微种植体支抗钉结合改良滑动杆可简单高效实现前磨牙近中移动,并最终关闭缺牙间隙,临床上可作为一种备选治疗方案。

Objective To evaluate the clinical application of a modified miniscrew-supported sliding jig in maxillary premolars mesialization.Methods 5 patients(3 females and 2 males)with Class II subdivision malocclusion and missing upper lateral incisors or canines were selected,aged from 14 to 25 years old.All the patients were treated by mesializing the premolars with a modified miniscrew-supported sliding jig.The miniscrew was embedded in buccal alveolar bone between maxillary second premolar and first molar.After the premolars were moved to the right position,the miniscrew was repositioned to pull molars mesially and close the remaining gap.The duration of premolar movement was from 6 to 10 months The effectiveness of the mesial movement of premolar was determined by measuring the pre-and-post treatmentchanges in velocity,distance and position of the maxillary premolar through gypsum casts.Results All the 5 cases were treated effectively.The maxillary premolars and molars moved in the right position and the edentulous gaps were closed.The maxillary premolars moved mesially by 4.1 mm at 0.96 mm/M.Conclusion A modified miniscrew-supported sliding jig was an effective method to achieve maxillary premolars mesialization,which could be used as an alternative treatment for patients with missing maxillary lateral incisors or canines.