上颌埋伏尖牙的正畸—外科联合治疗

发布时间：2018-01-31 00:13

本文关键词： 埋伏上颌尖牙正畸-外科联合治疗助萌　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：研究临床中正畸外科联合助萌埋伏尖牙，探讨埋伏尖牙的特征及矫治效果。方法：选取大连医科大学附属第二医院2011年7月收治的上颌埋伏尖牙患者一例，男性，14岁，恒牙牙合，双侧磨牙中性关系。左侧尖牙先天缺失，右侧尖牙埋伏阻生。前牙覆牙合4.5mm，覆盖2mm，上下颌中线对正，Spee曲线正常。正面观，面部左右对称，比例协调。侧面观为直面型，面下1/3正常。根据头颅侧位、曲面断层X线片以及记存模型的测量分析，制定正畸联合外科助萌埋伏尖牙的治疗方案。采用非拔牙矫治,排齐整平牙列，调整上下颌牙轴倾斜度。集中间隙，保留滞留乳牙，待正畸治疗后行修复治疗。结果：正畸治疗共33个月。矫治前后的各项测量数据对比显示：（1）治疗前后骨性的改变：患者埋伏牙周围骨质良好，邻近牙齿牙槽骨正常，达到理想效果。本患者治疗前，骨骼发育基本正常，因此，矫治后骨性数值测量结果无较大改变。SNB角治疗后较治疗前增加2°，表明在外力刺激和生长潜力的作用下，下颌骨向前生长； ANB角减小了1.5°；FMA治疗前后无变化，面下1/3高度ANS-Me的距离治疗后略有增加，这与其生长发育有关。（2）治疗前后牙齿位置的变化：患者的埋伏牙已经纳入牙列，牙位，牙轴都已达到预期效果。治疗前，其他牙轴基本正常，因此在治疗过程中针对个别牙齿精细调整，治疗前后数值测量变化不大。上中切牙的唇倾得到了改善。L1-NB角、L1-NB距在治疗前后无明显变化，FMIA治疗后增加了1°，IMPA°减少了1°，表明下中切牙长轴得到调整，与眶耳平面的交角更加合理。（3）治疗前后软组织的变化：埋伏牙及周围牙齿牙龈形态、颜色良好，软组织正常。本病例矫治前软组织侧貌尚可，只有轻微的下颌不足。完成后测量结果发现软组织颏前点Pos得到改善，达到理想的Ｅ审美线，上下唇突度正常，鼻唇角为83°，面凸角为7.5°，治疗后软组织侧貌协调。结论：通过正确诊断埋伏牙的位置及生长情况，合理设计治疗方案。联合外科开窗，采用正畸手段，合理选择支抗，施以合适大小的牵引力，可以有效地将埋伏阻生的尖牙纳入牙列。并且治疗后观察，牙髓活力正常，牙周情况良好，，牙龈形态美观，未见牙齿变色和牙根吸收。牙列整齐，牙弓形态良好，咬合关系正常，治疗效果满意。
[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 掳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 掳. 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 掳and the decrease of 1 掳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 掳, and the facial projection angle was 7.5 掳. 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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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