水平阻生上颌中切牙的临床治疗1例及文献复习

Horizontally impacted maxillary central incisor:1 case report and literature review

目的探讨1例水平阻生上颌中切牙的病因、诊断及治疗过程并文献复习,以期为临床医生治疗提供参考。方法对此患者的口腔锥形束CT的检查资料、面相及口内照片和模型等数据、方案制定及治疗过程进行回顾性分析,并在中国知网(CNKI)、维普、万方、PubMed数据库进行文献检索并文献复习。结果水平阻生上颌中切牙主要表现为替牙前中期上颌前牙区有中切牙缺失或乳牙滞留、缺牙间隙缩小、邻牙向缺失处倾斜,口腔锥形束CT检查示牙冠唇向生长,牙根处于发育期,根尖孔未闭合,牙根短且向上弯曲,与牙冠约呈65°。通过治疗,水平阻生上颌中切牙进入牙弓并排齐,未见牙根吸收,无叩痛、松动及温度刺激痛。结论采用扩弓矫治器牵引配合局部固定法排齐水平阻生中切牙是治疗水平阻生埋伏中切牙的有效治疗方式,可提高患牙保存率。

Objective To investigate the etiology,diagnosis and treatment of a case of horizontally impacted maxillary central incisor and review relevant literature,so as to provide reference for the clinical treatment of such disease.Methods The data of cone beam computer tomography(CBCT),facial and intraoral photographs of the patient were retrospectively analyzed.Relevant literature in CNKI,VIP,Wanfang and PubMed databases were reviewed.Results The main manifestation included unerupted permanent central incisor,deciduous tooth retention,space loss,and inclination of adjacent teeth in mixed dentition.CBCT revealed crown labial growth,immature roots,curved roots with an approximate angle of 65°to the crown.After treatment,the impacted incisor moved into alignment,without external root resorption,sensitivity to percussion,mobility,or sensitivity to thermal stimuli.Conclusion It is an effective way to fix horizontally impacted maxillary central incisor with removable orthodontic appliances and sectional fixed orthodontic appliances,which can improve the preservation rate of affected teeth.