开窗助萌术治疗埋伏阻生牙的临床相关研究

发布时间：2018-10-29 19:19

【摘要】：在临床正畸诊疗工作中，埋伏阻生牙是一种常见的错牙合畸形，严重影响颌面发育，口腔健康及功能，破坏牙列完整性和容貌外观。阻生牙是指在乳牙脱落或拔除后，超过正常恒牙萌出时间，恒牙牙冠或部分牙冠已经基本形成但长期埋伏在牙槽骨内不能自然萌出的牙齿。主要发病原因为恒牙萌出间隙不足或是萌出位置异常等所导致的恒牙埋伏阻生。除智齿以外的阻生牙多发生于上颌前牙区，尤其以上颌尖牙多见。这些发生在上颌中切牙、侧切牙、尖牙的异位牙、倒萌牙、扭转牙、低位、斜位等阻生牙在正畸治疗过程中及时配合外科手术方式去除阻力，将牙冠暴露出来的方法称为开窗助萌术，将暴露的“窗口”处的牙面上粘结挂钩（托槽），利用正畸方法加力牵引阻生牙，使这些处于非正常位置的牙齿慢慢恢复至正常牙弓内，恢复牙列功能和牙齿美观。在治疗由埋伏阻生牙引起的错牙合畸形时配合开窗助萌术后，改善了以往只能拔除埋伏牙，在缺损处做固定或活动义齿进行修复的缺陷，使得大部分埋伏牙都能够得到保留并可减少在正畸治疗过程中的拔牙数量,开窗助萌术配合正畸治疗阻生牙效果显著，所以在临床上以推广应用。本研究将就2013年2月—2014年3月实行的13例开窗助萌术，进行适应症、禁忌症、手术方法及开窗助萌术临床治疗效果方面的介绍。方法：选取正畸治疗牵引阻生牙过程中需要外科手术开窗助萌的患者13例，其中男性7例，女性6例。阻生牙位：上颌中切牙6例，上颌侧切牙1例（因松动度较大，无法承受正畸治疗而在术中拔除），，上颌尖牙7例。开放式助萌法8例，闭合式助萌法5例。结果：全部病例(13例)中，除一例患者在术后一周内因正畸附件脱落而行二次手术外，其他（12例）均一次顺利完成手术，且术后观察组织恢复良好，得到患者的满意至今顺利进行正畸治疗。结论：除第三恒磨牙以外发生的阻生牙，在非拔牙指征的前提下，通过开窗助萌术方法辅助正畸牵引治疗可以有效地缩短埋伏阻生牙齿的萌出时间。
[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.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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