上颌前牙区多个埋伏牙伴发囊肿17例治疗体会

Treatment of 17 cases of multiple ambushed teeth with cysts in the maxillary anterior region

目的:探讨上颌前牙区多个埋伏牙伴发囊肿的治疗方法。方法:选择上颌前牙区多个埋伏牙伴发囊肿的患者17例(男8例,女9例),年龄7.5~16.0岁。进行锥形束CT定位,观察囊肿的大小、囊肿与埋伏牙的位置关系。手术开窗,剪除部分囊壁,引流囊液,在埋伏牙上同期或二期粘接正畸附件。术后3个月再次拍摄锥形束CT,观察囊肿消失情况,牵引埋伏牙。埋伏牙萌出后,利用MBT直丝弓矫治器排齐牙列,并精细调整。结果与结论:治疗3~12个月后,15例患者囊肿完全消失,见骨质形成,2例患者骨质形成欠佳伴牙龈轻度退缩。术中关键点是精确判断囊肿与埋伏牙的关系、多个埋伏牙之间的位置关系及与周围邻牙的关系,以及适时调整牵引方向和牵引力源,以便较顺利地将埋伏牙牵拉至正常位置。

Aim:To investigate the treatment of multiple ambushed teeth with cysts in the maxillary anterior region.Methods:A total of 17 cases(8 males and 9 females)of multiple ambushed teeth with cysts in the maxillary anterior region were selected,aged 7.5-16.0 years.CBCT was performed to observe the size of the cyst and the relationship between the cyst and the ambushed teeth.The fenestration was performed after tooth extracting,part of the cyst wall was cut off,the cyst fluid was drained,and the orthodontic attachment was bonded to the ambushed teeth at the same or second stage.CBCT was taken again 3 months after operation to observe whether the cyst disappeared or not and the ambushed teeth were tracted.After the eruption of the ambushed teeth,the MBT straight wire appliance was used to line up and fine-adjust the teeth.Results and conclusion:After 3 to 12 months treatment,the cysts disappeared completely and bone formation was observed in 15 cases,and the remaining 2 cases had poor bone formation with mild gingival retreat.The key points in the operation are to accurately judge the relationship between the cyst and the ambushed teeth,the position relationship between multiple ambushed teeth and the relationship with the surrounding teeth,and timely adjust the traction direction and traction source,so as to smoothly pull the ambushed teeth to the normal position.