上颌腭侧埋伏阻生尖牙CBCT导引下的牵引治疗  

Surgical and orthodontic management of maxillary palatal impacted canines guided by cone-beam computed tomography

作　　者：于剑南[1,2] 王林[1,2] 王震东[1,2] 邵胜[1,2] 李媛[1,2] 赵春洋[1,2] 

机构地区：[1]南京医科大学口腔医学研究所 [2]南京医科大学附属口腔医院正畸科,210029

出　　处：《实用口腔医学杂志》2015年第1期36-40,共5页Journal of Practical Stomatology

基　　金：国家自然基金面上项目(编号:81230022);教育部博士学士点基金(编号:20113234110003);江苏省高校优势学科建设工程项目(编号:201437)

摘　　要：目的:探讨锥形束CT(CBCT)三维(3D)重建在上颌腭侧埋伏阻生尖牙牵引治疗中的指导作用。方法:对22例上颌尖牙(共26颗)腭侧埋伏阻生的青少年患者行CBCT检查。CBCT三维重建观察尖牙形态、腭侧埋伏状况,测量分析与邻近组织的位置关系及相邻切牙牙根吸收情况。结果:CBCT能够真实再现颌骨内埋伏的上颌尖牙。埋伏尖牙均近中倾斜,与平面平均成角61.1°±18.1°,近中异位分别为Ⅰ类埋伏尖牙8颗、Ⅱ类5颗、Ⅲ类3颗、Ⅳ类10颗。3颗相邻侧切牙及2颗中切牙因严重牙根吸收而拔除;26颗上颌腭侧埋伏尖牙均成功牵引至平面排入牙弓并建立正常咬合。结论:CBCT能立体再现上颌尖牙腭侧埋伏阻生特征及与邻近牙的关系等,对治疗方案的制定、开窗牵引具有指导作用,可提高疗效。Objective：To assess the guidance of 3D reconstruction in the surgical and orthodontic management of maxillary palatal impacted canines with cone-beam computed tomography （CBCT）.Methods：22 adolescent patients with 26 impacted maxillary conines were examined by CBCT.CBCT 3D reconstruction was used to observe the impaction of the canines.Measurements were taken to evaluate spatial relationship between the canine and adjacent structures and resorption of neighboring incisor roots.Results：CBCT was effective to localize the impacted canines.All of the maxillary palatal impacted canines inclinated mesially,angles of impacted ca-nines to occlusal plane were 61.1＆#176;＆#177;18.1＆#176;,there were 8,5,3 and 10 impacted canines found in classⅠ,Ⅱ,Ⅲ and Ⅳ mesial mal-position respectively.3 adjacent lateral incisors and 2 central incisors were extracted because of severely root resorption.Normal occlu-sion was achieved for 26 impacted canines by the traction of the canines into dental arch and reaching the occlusal plane.Conclusion：CBCT can spatially show the palatal impaction of maxillary canines and the relationship to adjacent tooth,can guide the treatment plan and traction direction,therefore increase therapeutic effect.

关 键 词：上颌尖牙 腭侧埋伏阻生 指引 生物力学 CBCT 

分 类 号：R783.5[医药卫生—口腔医学]