【摘要】：在臨床正畸診療工作中，埋伏阻生牙是一種常見(jiàn)的錯(cuò)牙合畸形，嚴(yán)重影響頜面發(fā)育，口腔健康及功能，破壞牙列完整性和容貌外觀。阻生牙是指在乳牙脫落或拔除后，超過(guò)正常恒牙萌出時(shí)間，恒牙牙冠或部分牙冠已經(jīng)基本形成但長(zhǎng)期埋伏在牙槽骨內(nèi)不能自然萌出的牙齒。主要發(fā)病原因?yàn)楹阊烂瘸鲩g隙不足或是萌出位置異常等所導(dǎo)致的恒牙埋伏阻生。 除智齒以外的阻生牙多發(fā)生于上頜前牙區(qū)，尤其以上頜尖牙多見(jiàn)。這些發(fā)生在上頜中切牙、側(cè)切牙、尖牙的異位牙、倒萌牙、扭轉(zhuǎn)牙、低位、斜位等阻生牙在正畸治療過(guò)程中及時(shí)配合外科手術(shù)方式去除阻力，將牙冠暴露出來(lái)的方法稱為開(kāi)窗助萌術(shù)，將暴露的“窗口”處的牙面上粘結(jié)掛鉤（托槽），利用正畸方法加力牽引阻生牙，使這些處于非正常位置的牙齒慢慢恢復(fù)至正常牙弓內(nèi)，恢復(fù)牙列功能和牙齒美觀。 在治療由埋伏阻生牙引起的錯(cuò)牙合畸形時(shí)配合開(kāi)窗助萌術(shù)后，改善了以往只能拔除埋伏牙，在缺損處做固定或活動(dòng)義齒進(jìn)行修復(fù)的缺陷，使得大部分埋伏牙都能夠得到保留并可減少在正畸治療過(guò)程中的拔牙數(shù)量,開(kāi)窗助萌術(shù)配合正畸治療阻生牙效果顯著，所以在臨床上以推廣應(yīng)用。 本研究將就2013年2月—2014年3月實(shí)行的13例開(kāi)窗助萌術(shù)，進(jìn)行適應(yīng)癥、禁忌癥、手術(shù)方法及開(kāi)窗助萌術(shù)臨床治療效果方面的介紹。 方法：選取正畸治療牽引阻生牙過(guò)程中需要外科手術(shù)開(kāi)窗助萌的患者13例，其中男性7例，女性6例。阻生牙位：上頜中切牙6例，上頜側(cè)切牙1例（因松動(dòng)度較大，無(wú)法承受正畸治療而在術(shù)中拔除），，上頜尖牙7例。開(kāi)放式助萌法8例，閉合式助萌法5例。 結(jié)果：全部病例(13例)中，除一例患者在術(shù)后一周內(nèi)因正畸附件脫落而行二次手術(shù)外，其他（12例）均一次順利完成手術(shù)，且術(shù)后觀察組織恢復(fù)良好，得到患者的滿意至今順利進(jìn)行正畸治療。 結(jié)論：除第三恒磨牙以外發(fā)生的阻生牙，在非拔牙指征的前提下，通過(guò)開(kāi)窗助萌術(shù)方法輔助正畸牽引治療可以有效地縮短埋伏阻生牙齒的萌出時(shí)間。
[Abstract]:In clinical orthodontic diagnosis and treatment, impacted tooth is a common malocclusion, which seriously affects maxillofacial development, oral health and function, and destroys dentition integrity and appearance. An impacted tooth is a tooth that after the deciduous tooth has been removed or removed, the permanent tooth crown or part of the permanent tooth crown has been basically formed but cannot erupt naturally in the alveolar bone for a long time after the eruption time of the normal permanent tooth. The main causes are the absence of eruption space or the abnormal eruption position of permanent teeth. Most of the impacted teeth except wisdom teeth occur in the maxillary anterior teeth, especially in the maxillary canines. These occur in the ectopic teeth of the maxillary central incisors, lateral incisors, canines, inverted teeth, torsion, lower, oblique, and other impacted teeth in the process of orthodontic treatment in a timely manner in conjunction with surgical procedures to remove resistance. The method of exposing the crown is called fenestration, which binds the tooth surface at the exposed window (bracket), and uses orthodontic method to pull the impacted tooth with extra force. Make these abnormal teeth slowly return to normal arch, restore dentition function and tooth beauty. In the treatment of malocclusion caused by ambushed impacted teeth, combined with fenestration and sprouting, the defect which could only be removed and fixed or repaired by movable dentures in the past can be improved. Most of the impacted teeth can be preserved and the number of extraction can be reduced during orthodontic treatment. The effect of fenestration combined with orthodontic treatment on impacted teeth is remarkable, so it is widely used in clinic. This study will introduce 13 cases of fenestration from February 2013 to March 2014, including indications, contraindications, surgical methods and clinical therapeutic effects of fenestration. Methods: 13 patients (7 males and 6 females) who needed surgical fenestration during orthodontic treatment of impacted teeth were selected. Impacted tooth position: maxillary central incisor 6 cases, maxillary lateral incisor 1 case (because of greater mobility, unable to withstand orthodontic treatment, extraction), maxillary canine 7 cases. There were 8 cases with open method and 5 cases with closed method. Results: in all the cases (13 cases), except for one patient who underwent the second operation due to the abscission of the orthodontic appendages within one week, all the other cases (12 cases) completed the operation successfully once, and the observed tissues recovered well after the operation. The patients were satisfied with orthodontic treatment so far. Conclusion: in addition to the third permanent molar, under the condition of non-extraction indication, assisted orthodontic traction with fenestration can effectively shorten the eruption time of impacted teeth.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 陳松齡,林爾堅(jiān),冉煒,匡代軍,黎熾彬;螺旋CT牙體表面成像對(duì)骨內(nèi)埋伏牙的定位及臨床應(yīng)用[J];華西口腔醫(yī)學(xué)雜志;2000年04期

2 祁德強(qiáng);;青少年上頜前牙埋伏阻生的正畸治療[J];口腔醫(yī)學(xué);2008年08期

3 邵菊萍;馬立歐;白雪芹;;上頜阻生尖牙閉合式助萌與開(kāi)窗式助萌后牙周指數(shù)差異分析[J];口腔醫(yī)學(xué)研究;2012年05期

4 李筱;;上頜埋伏尖牙的手術(shù)導(dǎo)萌和正畸治療[J];臨床口腔醫(yī)學(xué)雜志;2006年11期

5 王兵，竇偉;103例上恒切牙阻生原因分析及治療[J];寧夏醫(yī)學(xué)院學(xué)報(bào);1995年02期

6 王鵬;;上頜前牙埋伏阻生32例固定正畸矯治效果分析[J];基層醫(yī)學(xué)論壇;2009年10期

7 翟仁義;常莉;;青少年上頜埋伏前牙的外科正畸治療[J];中國(guó)婦幼保健;2007年35期

本文編號(hào)：2298569