拔除上颌第二磨牙后推第一磨牙远移矫治上牙列中度拥挤的研究

Clinical treatment of moderately crowded upper dentition by distalization of first upper molars following extraction of second molars

目的 探讨拔除上颌第二磨牙促进第一磨牙远移 ,矫治上牙列中度拥挤的临床疗效。方法 临床选择面型较好的安氏Ⅱ类错 ,上牙列中度拥挤的患者 16例。拔除上颌第二磨牙后 ,推第一磨牙远移 ,同时促使第三磨牙自行向近中迁移代替第二磨牙 ,采用方丝弓固定矫治技术进行治疗。结果 牙列拥挤全部解除 ,推第一磨牙向远中顺利。治疗结束时 7例年龄较大的患者第三磨牙已萌出 ,9例第三磨牙未萌出 ,但位置已明显向近中迁移。治疗结束 3年后观察 ,16例患者上颌第三磨牙均从第二磨牙的位置萌出并建。结论 选择合适的适应证 ,拔除上颌第二磨牙后 ,能顺利地通过推磨牙远移矫治牙列拥挤 ,也能促进第三磨牙的近移和萌出 。

Objective To evaluate the clinical effects of first upper molar distalization following second molar extraction for treatment of moderately crowded upper teeth.Methods Sixteen patients with class Ⅱ malocclusion of upper dentition with harmony profile and moderately crowded teeth were selected(7 males,and 9 females),with a mean age of 16 years and 5 months(ranging from 15 years and 6 months to 17 years and 8 months).The patients were treated by edgewise technique including distalization of first upper molars and mesial drift of third molars following extraction of second upper molars.Results Crowded teeth were completely corrected.The distalization of first upper molars and mesial movement of third molars succeeded smoothly.At the end of treatment,third molars erupted in 7 cases,not in 9 cases,but a significant mesial movement ensued.Conclusions With proper indication,distalization of first upper molars following extraction of second molars can treat moderately crowded upper dentition and make third molars drift mesially and erupt,thus taking the place of second molars.