改良式正畸固定矫治装置在替牙期埋伏上颌中切牙中的应用研究

摘要

Objective To explore the application effect of modified orthodontic fixed appliance in patients with maxillary labial inverted impacted incisor in mixed dentition.Methods 58 patients with maxillary labial inverted impacted incisor in mixed dentition admitted to department of stomatology of our hospital from December 2009 to December 2011 were divided into two groups according to treatment method.30 patients in control group were given edgewise appliance,while 28 patients in observation group were given modified Nance arch appliance.The course of treatment,reexamination frequency,success rate,complications,root length and alveolar bones surroundings situation were compared between two groups.Results The average orthodontic treatment time and reexamination times of control group were (14.7 ± 3.6)months and (18.5 ± 5.3) respectively,and those of observation group were (7.2±1.8) months and (10.1 ± 1.2)respectively,with statistically significant differences (t=35.79,P=0.000; t=13.57,P=0.003).The successful rate of observation group was significantly higher than that of control group (85.71％ vs.46.67％; x 2=9.774,P=0.002),while complication rate of observation group was significantly lower than that of control group (10.71％ vs.43.33％; x 2=7.714,P=0.006).After treatment,labial and lingual length of diseased incisor from alveolar panoramic crest to cemento-enamel junction (CEJ) increased compared with homonym incisor teeth in control group,root length,labial and lingual length ratio of impacted roots surrounded by alveolar bone to the total root length decreased compared with homonym incisor teeth,with statistically significant differences (P＜0.05); while there were no statistically significant differences in above indicators between diseased incisor and homonym incisor teeth in observation group (P＞0.05).Conclusion Modified orthodontic fixed appliance can effectively correct offending teeth in patients with maxillary labial inverted impacted incisor in mixed dentition,with few adverse reactions,worthy of clinical application.%目的 探讨改良式正畸固定矫治装置在替牙期埋伏上颌中切牙中的应用效果.方法 选取本院口腔科2009年12月至2011年12月接收的58例替牙期上颌唇侧倒置埋伏中切牙患者为研究对象,根据治疗方法的不同分为两组.对照组30例采用标准方丝弓技术进行矫治,观察组28例采用改良式正畸固定矫治装置进行正畸牵引矫治.比较两组患者疗程、复查次数、治疗成功率、并发症发生率以及治疗后牙根长度及牙槽骨状况.结果 对照组平均矫治时间为(14.7±3.6)个月,平均复查次数为(18.5±5.3)次;观察组平均矫治时间为(7.2±1.8)个月,平均复查次数为(10.1±1.2)次;差异均有统计学意义(t=35.79,P=0.000;t=13.57,P=0.003).观察组患者矫治成功率显著高于对照组(85.71％vs.46.67％; x2=9.774,P=0.002),并发症发生率显著低于对照组(10.71％vs.43.33％; x2=7.714,P=0.006).治疗后,对照组患牙唇、牙槽峭顶到CEJ长度均较同名牙长,牙根长度,牙根唇、舌侧被牙槽骨包绕长度占总根长的比例均较同名牙低,差异均有统计学意义(P＜0.05);观察组患牙唇、牙槽峭顶到CEJ长度,牙根长度,牙根唇、舌侧被牙槽骨包绕长度占总根长的比例与同名牙比较,差异均无统计学意义(P＞0.05).结论 对于替牙期埋伏上颌中切牙患者,改良Nance弓治疗能够有效对患牙进行矫正,不良反应小,值得临床上推广应用.