正畸治疗中阻生牙助萌术1例  

Management of impacted tooth during orthodontic treatment:a case report

作　　者：李天元 朱彤欣 陈金东[3] 陈斌[1] 闫福华[1] Tianyuan Li;TongxinZhu;Jindong Chen;Bin Chen;Fuhua Yan(Department of Periodontics,Nanjing Stomatological Hospita,Medical School of Nanjing University,Nanjing,P.R.China;No.904 Hospital of PLA,Changzhou,P.R.China;Department of Oral Anesthesiology,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing,P.R.China)

机构地区：[1]南京大学医学院附属口腔医院牙周病科 [2]联勤保障部队第九〇四医院常州医疗区 [3]南京大学医学院附属口腔医院口腔正畸科

出　　处：《中国口腔医学继续教育杂志》2023年第1期39-44,52,共7页Chinese Journal of Stomatologial Continuing Education

基　　金：南京市卫生科技发展项目(ZKX22054);江苏省自然科学基金项目(BK20220199);南京口腔疾病临床医学研究中心项目(2019060009)。

摘　　要：目的以正畸治疗中阻生牙助萌术为例,探讨正畸患者的牙周手术设计中应注意的问题。诊治过程:25岁男性患者,牙龈呈炎症表现,牙列不齐,右上颌侧切牙阻生。前牙深覆牙合,双侧第一磨牙及尖牙远中关系,右上颌中切牙和尖牙间存在间隙。前期通过正畸治疗排齐牙列,并开辟右上颌侧切牙处的间隙。在完成牙周基础治疗的前提下,设计偏腭侧切口,在有效暴露阻生牙的前提下尽可能保存所有软组织,同时根据正畸牙移动的目标位置行骨增量和软组织增量,术后牵引并排齐右上颌侧切牙。结果通过合理的牙周手术设计,本病例在正畸过程中保持了牙周软硬组织的健康。结论正畸患者的牙周手术设计应同时关注正畸需求和牙周健康。Objective:The purpose of this study is to discuss the problems that should be paid attention to in the periodontal surgery for orthodontic patients,taking a surgery on an impacted tooth as an example.Diagnosis and treatment:A 25-year-old male patient presented with gingivitis,malocclusion,and an impacted upper right lateral incisor.The malocclusion included overbite of anterior teeth,distal relationship of bilateral first molars and canines,and there was a gap between the central incisor and canine of right maxillary.First,the teeth were aligned and the gap was widen through orthodontic treatment.Next,non-surgical periodontal therapy was completed.Then,a surgery eruption was carried out,in which a modified incision was designed on the palatal side to preserve all soft tissues as much as possible on the premise of effectively exposing the impacted tooth.At the same time,bone and soft tissue augmentation were performed according to the target position of orthodontic teeth movement.Finally,the right maxillary lateral incisor was aligned after the surgery.Results:The soft and hard tissues of the periodontal complex were kept healthy during orthodontic treatment after rational design of the periodontal surgery.Conclusions:Both orthodontic and periodontic factors should be taken into consideration when designing a periodontal surgery for patients in orthodontic practice.

关 键 词：牙周-正畸联合治疗 阻生牙 手术助萌 正畸治疗 牙周手术 

分 类 号：R78[医药卫生—口腔医学]