本文選題：易位埋伏　切入點：尖牙　出處：《大連醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:運用正畸固定矯治聯(lián)合外科牙周翻瓣術(shù)將易位埋伏的上頜尖牙牽引至牙列內(nèi)正常位置,探討易位埋伏上頜尖牙的治療方法。方法:選取2例沈陽市口腔醫(yī)院正畸科收治的錯牙合畸形患者為研究對象,所選病例均為恒牙牙合期,患者的依從性好,能主動接受并配合外科牙周翻瓣手術(shù)。經(jīng)臨床檢查和影像學(xué)分析診斷為上頜阻生尖牙易位埋伏于同側(cè)上頜中切牙與上頜側(cè)切牙之間,牙冠向近中并與中切牙牙長軸約成45°角,埋伏牙牙根鄰近上頜竇底,牙根已基本發(fā)育完成,根尖孔基本閉合,萌出動力不足,長期不能自行萌出�？陀^分析易位埋伏尖牙的阻生原因,掌握其埋伏位置,埋伏牙及鄰牙周圍牙周組織狀況,采用正畸固定矯治聯(lián)合外科牙周翻瓣術(shù),開拓間隙,合理選擇支抗,彈性橡皮鏈60g輕力牽引,將易位埋伏尖牙牽引至牙列正常位置。分別在術(shù)前術(shù)后收集患者面、牙合像,拍攝曲面斷層片觀察易位埋伏上頜尖牙的變化及牙周狀況,拍攝頭顱側(cè)位片,分析上下頜頜骨變化、上下頜前牙的唇傾程度以及軟組織側(cè)貌的改變情況。結(jié)果:本文所選2例患者都獲得了令人滿意的的療效。2例患者矯治所用時間平均為29個月。正畸固定矯治聯(lián)合外科牙周翻瓣術(shù)成功地將易位埋伏的上頜尖牙牽引到牙列正常位置并與鄰牙接觸良好,無前伸牙合及側(cè)方牙合干擾,牙髓活力無異常。典型病例矯治前后骨性變化:未發(fā)現(xiàn)較明顯的骨質(zhì)異常,兩側(cè)髁突形態(tài)基本不變。SNA角增加1.0°,NA-PA角增加3.5°,MP-FH角增加4.0°,ANS-Me/N-ME增加0.6%,Wits值增加2.1mm,SNB角減少0.5°,APDI角減少7.5°,NP-FH角減少9.0°;典型病例治療前后牙齒位置的變化:患者的13、34均已納入牙弓至正常位置,13、34牙根根尖1/3遠中彎曲,22、23牙根略微向遠中傾斜,其余牙牙根互相平行,無明顯的根吸收。U1-SN角增加3.5°,U1-NA角增加9.0°,L1-NB角增加8.4°,L1-MP角增加6.0°;典型病例治療前后軟組織的變化:矯治后部分齦乳頭輕微紅腫,13腭側(cè)牙齦無明顯退縮,其余未見異常。術(shù)后測量結(jié)果顯示FCA、ULP距、LLP距、EPUL距、EPLL距均有所增大,NLA減小,Z角從79°減小到正常值73°,上下唇突度正常,鼻、唇、頦三者比例協(xié)調(diào),側(cè)貌美觀。結(jié)論:運用正畸固定矯治聯(lián)合外科牙周翻瓣術(shù),能有效地將易位埋伏上頜尖牙排列到牙列正常位置。典型病例治療后易位埋伏尖牙與鄰牙接觸良好,牙髓活力正常,未見明顯骨質(zhì)吸收及根吸收�；颊呱舷骂M牙弓寬度及矢狀向關(guān)系更為協(xié)調(diào),改善了軟硬組織側(cè)貌,患者對治療效果滿意;通過正確診斷易位埋伏上頜尖牙的位置,生長情況,靈活掌握牽引時機與牽引方向,利用直絲弓矯治器有效控制轉(zhuǎn)矩,全面考慮支抗問題,輕力加以牽引,采用正畸固定矯治聯(lián)合外科牙周翻瓣術(shù)助萌易位埋伏上頜尖牙,可以有效地將其牽引至牙列正常位置,達到美觀、平衡、穩(wěn)定的矯治目標。
[Abstract]:Objective: to apply orthodontic fixation combined with orthodontic orthodontic orthodontic surgery to pull the transposed maxillary canine teeth to the normal position in the dentition. Methods: two patients with malocclusion were selected from orthodontic department of Shenyang Stomatology Hospital. The maxillary impacted canine translocation was found to be located between the ipsilateral maxillary central incisor and the maxillary lateral incisor, with the crown approaching the center and at an angle of about 45 擄with the long axis of the central incisor. The root of the ambushed tooth is near the floor of the maxillary sinus, the root has basically developed, the apical foramen is basically closed, the eruption power is insufficient, and can not erupt on its own for a long time. The periodontal tissue around the buried teeth and adjacent teeth was treated by orthodontic fixation combined with surgical periodontal flap surgery to open up the gap and select Anchorage reasonably. The elastic rubber chain was drawn by 60 g light force. The transposition canine teeth were towed to the normal position of dentition. The patients' faces and occlusal images were collected before and after operation. The changes and periodontal status of the transposition maxillary canine teeth were observed on curved surface tomograms, and the lateral cephalic films were taken. The changes of maxillary and maxillary bone were analyzed. Results: satisfactory results were obtained in 2 cases of maxillary and mandibular anterior teeth. The average time for correction was 29 months. The orthodontic fixation was combined with orthodontic fixation. The orthopedic periodontal flap successfully towed the transposed maxillary canines to the normal position of the dentition and had good contact with the adjacent teeth. There was no disturbance of anterior and lateral occlusal, no abnormal pulp activity. The bone changes of typical cases before and after orthodontic treatment: no obvious bone abnormality was found. The condylar shape of bilateral condyle is almost unchanged. The angle of SNA increases by 1.0 擄and NA-PA angle increases by 3.5 擄and the angle of MP-FH increases by 4.0 擄ANS-MeP / N-ME increases by 0.6 mm SNB angle decreases by 0.5 擄and APDI angle decreases by 7.5 擄and NP-FH angle decreases by 9.0 擄. Changes of tooth position before and after treatment in typical cases: 1334 of the patients were included in the dental arch to positive. The root tip 1/3 distal to the root tip was slightly tilted to the distal end of the tooth, and the root of the tooth was slightly tilted to the distance. The roots of the other teeth were parallel to each other, the root resorption. U1-SN angle increased by 3.5 擄and U1-NA angle increased by 9.0 擄and L1-NB angle increased by 8.4 擄and the angle of L1-MP increased by 6.0 擄. The results of postoperative measurement showed that the distance between ULP and EPUL / EPLL increased and the angle of NLA decreased from 79 擄to 73 擄, and the upper and lower lip protrusions were normal, and the ratio of nose, lip and chin was in harmony. Conclusion: orthodontic orthodontic fixation combined with surgical periodontal valvulation can effectively arrange the transposition maxillary canine teeth to the normal position of dentition. After treatment, the transposition canine teeth are in good contact with the adjacent teeth, and the pulp activity is normal. There was no apparent bone absorption and root resorption. The width and sagittal relationship of maxillary and mandibular arch were more harmonious, the soft and hard tissue profile was improved, the patients were satisfied with the therapeutic effect, and the position and growth of the maxillary canine teeth were ambushed by correct diagnosis. Using straight wire appliance to control torque, fully consider the problem of Anchorage, apply light force to traction, and apply orthodontic fixation and orthodontic orthodontic orthodontics combined with periodontal flap surgery to help the maxillary canine teeth to be ambushed. It can be effectively towed to the normal position of dentition to achieve aesthetic, balanced, stable correction goal.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R783.5

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