Chaushu S, Brin I, Ben-Bassat Y, Zilberman Y, Becker A
Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
Eur J Orthod. 2003 Dec;25(6):579-84. doi: 10.1093/ejo/25.6.579.
Several factors may affect the outcome of the orthodontic/surgical modality for the resolution of impacted central incisors, but particularly the manner in which the impacted tooth is exposed. The present study aimed to evaluate the post-retention clinical appearance and periodontal status of impacted maxillary central incisors which were exposed and aligned with an open-eruption surgical-orthodontic technique. Twelve subjects (four males, eight females), aged 22 years (range 15-38 years), previously treated for a unilateral impacted central incisor (ICI), were examined 10 years (range 3-25 years) post-retention. A split-mouth method was used for the comparison with the unaffected side. One treated central incisor exfoliated 10 years post-retention, thus the results were based on the remaining 11 patients. Statistically significant differences were found between the affected and control incisors in most of the periodontal parameters measured, although some were small and of minimal clinical importance. The increase in the mesio-labial pocket depth was associated with a highly significant 10 per cent reduction in bone level at this site (P = 0.007). A highly statistically significant increase in crown length (P < 0.001) and a reduction in the width of the attached gingiva (P = 0.005) were seen in these previously impacted teeth. An abnormal gingival contour was present in eight treated incisors and positional relapse in five cases. It is concluded that the convenience of the open-eruption technique must be weighed against the long-term negative aesthetic and periodontal effects on the treated tooth, although the findings of this study should be viewed with caution due to the limited sample size.
有几个因素可能会影响正畸/手术方式治疗埋伏正中切牙的效果，尤其是埋伏牙的暴露方式。本研究旨在评估采用开窗萌出外科正畸技术暴露并排列的上颌埋伏正中切牙在保持后的临床外观和牙周状况。对12名曾因单侧埋伏正中切牙（ICI）接受治疗的受试者（4名男性，8名女性）进行了检查，他们的年龄为22岁（范围15 - 38岁），在保持后10年（范围3 - 25年）。采用自身对照的方法与未受影响的一侧进行比较。一颗经过治疗的正中切牙在保持10年后脱落，因此结果基于其余11名患者。在大多数测量的牙周参数中，患牙与对照牙之间存在统计学上的显著差异，尽管有些差异较小且临床意义不大。近中唇侧袋深度的增加与该部位骨水平显著降低10%相关（P = 0.007）。在这些曾经埋伏的牙齿中，观察到冠长有高度统计学意义的增加（P < 0.001）以及附着龈宽度减小（P = 0.005）。8颗经过治疗的切牙存在牙龈轮廓异常，5例出现位置复发。结论是，尽管由于样本量有限，本研究结果应谨慎看待，但开窗萌出技术的便利性必须与对治疗牙齿的长期负面美学和牙周影响相权衡。
