可调式活动牵引器治疗上颌唇侧倒置阻生中切牙效果评价

Clinical study of a adjustable movable retractor for maxillary labially inverted impacted central incisor

目的:评价一种新型可调式活动牵引器治疗上颌唇侧倒置阻生中切牙的临床效果。方法:选择年龄7~10岁上颌唇侧倒置阻生中切牙患者10例(10颗患牙),使用一种新型可调式活动牵引器(专利证书号:11012293),联合外科助萌进行牵引治疗。术前和术后即刻拍摄CBCT,术后对阻生中切牙(治疗组)及对侧同名牙(对照组)进行牙髓电活力测试及牙周探诊,评价治疗效果。采用SPSS 23.0软件包对数据进行统计学分析。结果:10例患者牵引成功率为100%,平均治疗时间(8.60±1.26)个月。术后治疗组无松动、无牙龈红肿、牙髓坏死及牙周袋出现,但唇侧牙龈略有退缩,其唇侧牙龈高度[(10.58±0.45)mm]显著高于对照组[(9.47±0.31)mm](P<0.01)。治疗组生长发育水平高于对照组:其根长及根尖孔变化量[(2.80±1.09)mm、(1.79±0.59)mm]高于对照组[(1.84±0.97)mm、(0.96±0.40)mm]。术前治疗组牙根发育迟缓,其根长[(7.28±1.03)mm]与对照组[(9.80±1.46)mm]相比较短,根尖孔宽度[(2.18±0.63)mm]也比对照组[(1.26±0.40)mm]大;治疗结束时,治疗组根长[(10.08±0.63)mm]仍短于对照组[(11.75±0.90)mm]。唇腭侧牙槽骨水平[(1.77±0.37)mm、(1.23±0.21)mm]高于对照组[(1.25±0.26)mm、(1.05±0.15)mm]。治疗组唇侧牙槽骨厚度[(1.49±0.31)mm]与对照组[(1.80±0.11)mm]相比也更薄。结论:该新型可调式活动牵引器治疗上颌唇侧倒置阻生中切牙效果可靠,牵引治疗能促进牙根进一步发育,且牙周牙髓状况良好。

PURPOSE:To evaluate the orthodontic treatment outcome of a new adjustable movable retractor for patients with maxillary labially inverted impacted central incisors.METHODS:Ten patients,aged 7 to 10 years,who had a maxillary labially inverted impacted central incisor,were treated using a new adjustable movable retractor.Cone-beam CT(CBCT)was taken before treatment and after treatment immediately.Pulp electrical activity test and periodontal probing were performed after treatment.The parameters of the treated incisors and contralateral ones served as controls were compared.SPSS 23.0 software package was used for data analysis.RESULTS:The success rate of treatment in 10 patients was 100%.The mean duration of treatment was(8.60±1.26)months.There were no loosening,gingival swelling and redness,periodontal pockets,and pulp necrosis in the treatment group.However,the labial gingival height of the treatment group was(10.58±0.45)mm,significantly higher than that of the control group[(9.47±0.31)mm].The growth and development level of the treatment group was higher than that of the control group during traction.The root length[(2.80±1.09)mm]and apical foramen[(1.79±0.59)mm]of the treatment group were higher than those of the control group[(1.84±0.97)mm and(0.96±0.40)mm].Before treatment,the root growth of the treatment group was retarded.The root length of the treatment group[(7.28±1.03)mm]was shorter than that of the control group[(9.80±1.46)mm];meanwhile,the apical foramen width of the treatment group[(2.18±0.63)mm]was larger than that of the control group[(1.26±0.40)mm].After treatment,the root length[(10.08±0.63)mm]of the treatment group was still shorter than that of the control group[(11.75±0.90)mm].The labial alveolar bone level of the treatment group[(1.77±0.37)mm]was higher than that of control group[(1.25±0.26)mm].The palatal alveolar bone level of treatment group[(1.23±0.21)mm]was also slight higher than that of the control group[(1.05±0.15)mm].The thickness of the alveolar bone in the treatment group[(1.49±0.31)mm]was thinner than that in the control group[(1.80±0.11)mm].CONCLUSIONS:The effect of the new adjustable movable retractor for maxillary labially inverted impacted central incisor is reliable.Traction therapy can promote root development,and the periodontal and endodontic condition is well after treatment.