第一磨牙缺失后以第二磨牙前移替代的正畸治疗  

Orthodontic clinical study about substituting second molars for missing first molars

作　　者：韩俊[1] 陈莉莉[1] 胡莉[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院口腔医学中心,湖北武汉430022

出　　处：《临床口腔医学杂志》2014年第7期424-426,共3页Journal of Clinical Stomatology

基　　金：湖北省自然科学基金资助项目(2013CKB014)

摘　　要：目的：探讨第一磨牙缺失后应用正畸方法前移第二磨牙关闭间隙的矫治方法。方法：选择第一磨牙早失或因病变需要拔除的正畸矫治病例26例。所有病例均为上颌或／双颌前突、牙列拥挤、需拔牙矫治病例，拔除因严重龋坏的第一磨牙或第一磨牙早失进行矫治，对矫治结果进行分析。结果：26例患者平均疗程20～38个月。矫治后前牙覆（牙合）、覆盖正常，上下牙列中线对齐，尖牙均为中性关系。拔牙间隙关闭，牙齿尖窝关系良好，第二磨牙与第二前磨牙牙根平行。结论：对于第一磨牙严重龋坏需拔除或过早缺失的患者，经过严格的支抗设计和精心的临床操作，可以重建完整健康的牙列，达到功能、美观及稳定的目标。Objective：To analyze the cases with missing first molar and to study the treatment characteristics after or-thodontic space closure. Method：26 patients,who have extracted or need extraction of one or more first molars due to seri-ous caries or periapical disease,were selected from the Department of Orthodontics for the present study. Among these 26 patients,9 were males while 17 were females with the mean age of 23.3 years old. On clinical examination,the dentitions of 9 cases were mildly crowded while 15 cases were crowded along with protrusive arch whereas the teeth of the other 2 cases were normally aligned. Extraction of the contralateral healthy premolar was performed only in those patients with severe crowding and protrusive arch. All the cases were treated with straight wire appliance and loop mechanics and segmental archwire were incorporated during the closure of the first molar extraction space. Depending upon the cases ,different anchor-age reinforcement was planned. After the completion of the treatment,the pre-treatment and the post-treatment models were compared and analyzed. Result：In the 26 cases,the duration of treatment ranged from 20 to 38 months. At the end of the treatment,normal overjet and overbite were achieved,the upper and lower dental midlines were aligned, class I canine rela-tionship was achieved,all extraction spaces were closed and excellent functional occlusion was restored. Conclusion：In pa-tients who need extraction of first molar, which is unrestorably damaged or in those who have previously extracted first molar and present with extraction space,excellent occlusal relationships can be restored to achieve the goal of function,esthetics and stability by orthodontic treatments with proper anchorage planning and use of appropriate treatment mechanics.

关 键 词：第一磨牙 第二磨牙 支抗 覆(牙合)覆盖 

分 类 号：R783.5[医药卫生—口腔医学]