中切牙外伤拔除的正畸治疗  

The orthodontic extraction of upper incisor tooth trauma

作　　者：武霞 袁东辉[2] 李仲影 李娜[3] 

机构地区：[1]河北武警河北总队医院口腔科,050081 [2]河北白求恩国际和平医院口腔科 [3]河北白求恩军医学院图书馆

出　　处：《中华口腔正畸学杂志》2014年第2期82-86,共5页Chinese Journal of Orthodontics

摘　　要：目的 探讨正畸拔除上颌单侧中切牙矫治模式的可行性及临床治疗的要点.方法 从40例切牙外伤正畸病例中,选出患者19例.其中安氏Ⅰ类错（牙合）10例,安氏Ⅱ类错（牙合）7例,安氏Ⅲ类错（牙合）2例;男16例,女3例,平均年龄14.5岁,均存在牙量与骨量不调需拔牙矫治病例.所有患者采取拔除外伤中切牙及其它三个象限第一前磨牙模式进行矫治.矫治后对临床资料做回顾性的研究,并进行临床疗效评价.结果 19例患者均取得较好的治疗效果,矫治后拔牙间隙关闭,前牙覆（牙合）覆盖正常,中线基本正中,侧貌得到改善.采用治疗前后配对t检验方法,发现牙性指标4项：U1-NA（27.5°至23.3°）、L1-NB（36.4°至32.5°）、L1-MP（97.2°至93.5°）角度减少,表示上下中切牙的倾斜度减小,U1-L1（11.83°至124.4°）角度增加,表示上下中切牙的凸度减少;软组织指标2项：上唇凸点-E线距（Ls-E）从3.5mm减小到1.2mm、下唇凸点-E线距（Li-E）从4.1mm减少到1.5mm,差异均有统计学意义（P＜0.05）.结论 遵循个体化原则,用Bolton指数指导设计和有效支抗控制,非常规拔牙模式矫治,能够达到预期目的.Objective To explore the feasibility and key treatment points of orthodontic extraction of unilateral traumatized maxillary central incisors.Methods 19 patients （mean age 14.5 years old,16 males and 3 females） from 40 central incisor trauma cases were selected.10 of them were Angle Class Ⅰ malocclusion,7 were Class Ⅱ,and the other 2 were Angle Class Ⅱ malocclusion.All patients were treated by extraction of the traumatized central incisor and the first premolars in the other three quadrants.Pre and Post treatment analysis and comparisons were done.Results All 19 cases achieved satisfied outcomes.Extraction spaces were closed,the overject and overbite were normal,midlines were almost on,and the profiles were improved.Paired t test showed statistically significantdifferences in 4 dental indices.U1-NA° （from 27.5 to 23.3）L1-NB° （from 36.4 to 32.5） and L1-MP° （from 97.2 to 93.5） decreased,indicating a decrease of central incisor angulation,while U1-L1° （from 11.83 to 124.4） increased,indicating a decrease in incisor protrusion.For 2 soft tissue indices,statistically significant differences were also found.Ls-E （from 3.5 to 1.2 mm） and Li-E （from 4.1 to 1.5 mm） both decreased.Conclusions Individual treatment plan based on Bolton index analysis and effective anchorage control,the unconventional extraction plan could receive desired treatment outcome.

关 键 词：上中切牙 牙外伤 正畸治疗 拔牙模式 

分 类 号：R783.5[医药卫生—口腔医学]