儿童正中多生牙拔除时机对恒牙萌出异常矫治时长的影响  

Effect of extraction timing of mesiodens on orthodontic treatment duration for abnormal eruption of perma⁃nent teeth in children

作　　者：郭小科 刘建锋 赵吉宏[3] 满其文 丁洁 GUO Xiaoke;LIU Jianfeng;ZHAO Jihong;MAN Qiwen;DING Jie(Department of Erqi outpatient,School&Hospital of Stomatology,Wuhan University,Wuhan 430000,China;Department of Gener-al Dentistry,School&Hospital of Stomatology,WuHan University,WuHan 430000,China;Department of Oral and Maxillofacial Surgery,School&Hospital of Stomatology,Wuhan University,Wuhan 430000,China)

机构地区：[1]武汉大学口腔医学院,武汉大学口腔医院二七门诊部,湖北武汉430000 [2]武汉大学口腔医学院,武汉大学口腔医院综合科,湖北武汉430000 [3]武汉大学口腔医学院,武汉大学口腔医院口腔颌面外科,湖北武汉430000

出　　处：《口腔疾病防治》2023年第8期567-572,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(82001066)。

摘　　要：目的探讨儿童正中多生牙拔除时机与恒牙萌出异常矫治时长的关系,为临床治疗提供依据。方法将187例儿童正中多生牙分为Ⅰ型萌出型、Ⅱ型冠部埋伏型、Ⅲ型牙间埋伏型、Ⅳ型根部埋伏型。按拔除时机分别将Ⅰ型、Ⅲ型、Ⅳ型多生牙分为:毗邻中切牙萌出前拔除组(A),毗邻中切牙萌出后拔除组(B);将Ⅱ型多生牙分为:对侧中切牙萌出前拔除组(A),对侧中切牙萌出后拔除组(B)。统计正中多生牙所致的错(牙合)畸形表现及多生牙拔除后恒前牙萌出异常的矫治时长。结果正中多生牙引起后继恒前牙萌出异常表现为:唇侧异位萌出106例,恒牙阻萌28例,牙扭转27例,个别牙反26例。Ⅰ型A组、Ⅱ型A组、Ⅲ型A组平均矫治时长分别为(7.07±2.45)个月、(6.57±1.12)个月、(6.95±2.52)个月,低于Ⅰ型B组(9.67±3.04)个月、Ⅱ型B组(10.25±1.29)个月、Ⅲ型B组(9.33±3.26)个月,差异均具有统计学意义(P<0.01);Ⅳ型A组平均矫治时长(6.00±0.94)个月,与B组(6.33±0.80)个月之间差异无统计学意义(P>0.05)。结论儿童正中多生牙在邻近中切牙萌出前拔除,在大多数情况下可减低后期恒前牙萌出异常的矫治时长。Objective To discuss the correlation between the extraction timing of mesiodens and the orthodontic treatment duration of its eruption⁃related complications in children to provide a reference for the clinic.Methods The mesiodentes of 187 children were classified as eruption type(typeⅠ),dental crown impacted type(typeⅡ),interdental impacted type(typeⅢ),and dental root impacted type(typeⅣ).According to the timing of extraction,mesiodentes in typeⅠ,typeⅢ,and typeⅣwere divided into Groups A:before the eruption of the adjacent central incisor and B:after the eruption of the adjacent central incisor.Mesiodentes in typeⅡwere divided into Group A:before the eruption of the contralateral central incisor and B:after the eruption of the contralateral central incisor.Eruption⁃related complica⁃tions and orthodontic treatment durations caused by mesiodens were statistically analyzed.Results There were 106 cases of displacement,28 cases of failed eruption,27 cases of tooth rotation,and 26 cases of individual cross⁃bite among the eruption⁃related complications caused by mesiodens.The mean orthodontic treatment cycle in Group A of typeⅠ(7.07±2.45 month),Group A of typeⅡ(6.57±1.12 month),and Group A of typeⅢ(6.95±2.52 month)were low⁃er than that in Group B of typeⅠ(9.67±3.04 month),Group B of typeⅡ(10.25±1.29 month),and Group B of typeⅢ(9.33±3.26 month),and the differences were statistically significant(P<0.01).Meanwhile,there was no significant difference in the mean orthodontic treatment duration between Groups A(6.00±0.94 month)and B(6.33±0.80 month)of typeⅣ(P>0.05).Conclusion In most cases,the mesiodens are removed before the eruption of the adjacent cen⁃tral incisor,which can reduce the duration of orthodontic treatment for eruption⁃related complications in children.

关 键 词：正中多生牙 错(牙合)畸形 拔牙时机 萌出异常 矫治时长 早期矫治 儿童 

分 类 号：R78[医药卫生—口腔医学]