發(fā)布時(shí)間：2018-01-31 00:13

  本文關(guān)鍵詞： 埋伏上頜尖牙 正畸-外科聯(lián)合治療 助萌　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：研究臨床中正畸外科聯(lián)合助萌埋伏尖牙，探討埋伏尖牙的特征及矯治效果。 方法：選取大連醫(yī)科大學(xué)附屬第二醫(yī)院2011年7月收治的上頜埋伏尖牙患者一例，男性，14歲，恒牙牙合，雙側(cè)磨牙中性關(guān)系。左側(cè)尖牙先天缺失，右側(cè)尖牙埋伏阻生。前牙覆牙合4.5mm，覆蓋2mm，上下頜中線對(duì)正，Spee曲線正常。正面觀，面部左右對(duì)稱，比例協(xié)調(diào)。側(cè)面觀為直面型，面下1/3正常。根據(jù)頭顱側(cè)位、曲面斷層X(jué)線片以及記存模型的測(cè)量分析，制定正畸聯(lián)合外科助萌埋伏尖牙的治療方案。采用非拔牙矯治,排齊整平牙列，調(diào)整上下頜牙軸傾斜度。集中間隙，保留滯留乳牙，待正畸治療后行修復(fù)治療。 結(jié)果：正畸治療共33個(gè)月。矯治前后的各項(xiàng)測(cè)量數(shù)據(jù)對(duì)比顯示：（1）治療前后骨性的改變：患者埋伏牙周圍骨質(zhì)良好，鄰近牙齒牙槽骨正常，達(dá)到理想效果。本患者治療前，骨骼發(fā)育基本正常，因此，矯治后骨性數(shù)值測(cè)量結(jié)果無(wú)較大改變。SNB角治療后較治療前增加2°，表明在外力刺激和生長(zhǎng)潛力的作用下，下頜骨向前生長(zhǎng)； ANB角減小了1.5°；FMA治療前后無(wú)變化，面下1/3高度ANS-Me的距離治療后略有增加，這與其生長(zhǎng)發(fā)育有關(guān)。（2）治療前后牙齒位置的變化：患者的埋伏牙已經(jīng)納入牙列，牙位，牙軸都已達(dá)到預(yù)期效果。治療前，其他牙軸基本正常，因此在治療過(guò)程中針對(duì)個(gè)別牙齒精細(xì)調(diào)整，治療前后數(shù)值測(cè)量變化不大。上中切牙的唇傾得到了改善。L1-NB角、L1-NB距在治療前后無(wú)明顯變化，F(xiàn)MIA治療后增加了1°，IMPA°減少了1°，表明下中切牙長(zhǎng)軸得到調(diào)整，與眶耳平面的交角更加合理。（3）治療前后軟組織的變化：埋伏牙及周圍牙齒牙齦形態(tài)、顏色良好，軟組織正常。本病例矯治前軟組織側(cè)貌尚可，只有輕微的下頜不足。完成后測(cè)量結(jié)果發(fā)現(xiàn)軟組織頦前點(diǎn)Pos得到改善，達(dá)到理想的Ｅ審美線，上下唇突度正常，鼻唇角為83°，面凸角為7.5°，治療后軟組織側(cè)貌協(xié)調(diào)。 結(jié)論：通過(guò)正確診斷埋伏牙的位置及生長(zhǎng)情況，合理設(shè)計(jì)治療方案。聯(lián)合外科開(kāi)窗，采用正畸手段，合理選擇支抗，施以合適大小的牽引力，可以有效地將埋伏阻生的尖牙納入牙列。并且治療后觀察，牙髓活力正常，牙周情況良好，，牙齦形態(tài)美觀，未見(jiàn)牙齒變色和牙根吸收。牙列整齊，牙弓形態(tài)良好，咬合關(guān)系正常，治療效果滿意。
[Abstract]:Objective: to study the clinical features and curative effect of orthodontic surgery combined with assisted implantation of canine teeth. Methods: a case of maxillary impacted canine was treated in the second affiliated Hospital of Dalian Medical University in July 2011. The male was 14 years old, the permanent teeth were occlusal, the bilateral molar was neutral, and the left canine was congenital missing. The anterior overbite was 4.5mm, covering 2 mm. The front and mandibular midline had normal Spee curve. The front view was symmetrical, the face was symmetrical and the proportion was in harmony. The lateral view was straight. 1/3 cases were normal under the face. According to the measurement and analysis of lateral cranial position, curved surface X-ray film and recording model, the treatment scheme of orthodontic combined surgery assisted burying canine teeth was established. Adjust the inclination of the upper and lower teeth. Concentrate the space and retain the remaining deciduous teeth. After orthodontic treatment, repair the teeth. Results: the orthodontic treatment lasted 33 months. The comparison of the measured data before and after orthodontic treatment showed that the osseous changes of the patients before and after the treatment were as follows: the bone around the ambushed teeth was good and the alveolar bone of the adjacent teeth was normal. Before the treatment, the bone development of the patients was basically normal, therefore, the bone value measurement results after orthodontic treatment showed no significant change. SNB angle after treatment increased by 2 擄compared with before treatment. The results showed that the mandible grew forward under the action of external force stimulation and growth potential. The ANB angle was reduced by 1. 5 擄. There was no change in FMA before and after treatment, and the distance of 1/3 ANS-Me in the face increased slightly after treatment. This is related to its growth and development. 2) the changes of tooth position before and after treatment: the embedded teeth have been included in the dentition, tooth position, tooth axis have achieved the desired results. Before treatment, the other tooth axis is basically normal. Therefore in the course of treatment for individual teeth fine adjustment before and after treatment no significant change in numerical measurement. The upper central incisor labial tilt improved. L1-NB angle and L1-NB distance before and after treatment did not change significantly. After FMIA treatment, the increase of 1 擄and the decrease of 1 擄showed that the long axis of the lower central incisor was adjusted. The change of soft tissue before and after treatment: the gingival shape of the embedded teeth and the surrounding teeth is good, the soft tissue is normal. Only slight mandibular deficiency was found. The results showed that the Pos of the anterior mental point of soft tissue was improved and reached the ideal E aesthetic line. The upper and lower lip protrusions were normal, the nasolabial angle was 83 擄, and the facial projection angle was 7.5 擄. After treatment, soft tissue side appearance was harmonious. Conclusion: through the correct diagnosis of the location and growth of the impacted teeth, the reasonable design of the treatment plan, combined surgical fenestration, orthodontic means, reasonable selection of Anchorage, apply the appropriate size of traction. After treatment, dental pulp activity was normal, periodontal condition was good, gingival appearance was beautiful, tooth discoloration and root absorption were not seen. The dental arch shape is good, the occlusal relation is normal, and the curative effect is satisfactory.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.5

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