Fukunaga Tomohiro, Kuroda Shingo, Kurosaka Hiroshi, Takano-Yamamoto Teruko
Department of Orthodontics and Dentofacial Orthopedics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Angle Orthod. 2006 Jan;76(1):148-55. doi: 10.1043/0003-3219(2006)076[0148:SAFOCO]2.0.CO;2.
Because the number of adult patients seeking orthodontic treatment is increasing, orthodontists are becoming more likely to encounter patients with adult periodontitis. However, it is sometimes difficult to establish anchorage because of poor periodontal tissues in patients with adult periodontitis. This article reports the successful use of skeletal anchorage to treat a maxillary protrusion case complicated by severe adult periodontitis. A female patient aged 50 years seven months showed a skeletal Class II jaw base relationship. A spacing of five mm in the upper anterior teeth with an overjet of 7.5 mm and overbite of four mm was observed. She had generalized horizontal bone loss in both arches, with vertical bone loss in the posterior segment. After periodontal treatment, miniplates were placed in the zygomatic process, and retraction and intrusion of the maxillary incisors were performed. After active treatment for 21 months, the upper incisors had been inclined 9.5 degrees lingually, intruded two mm at the apex, and good anterior occlusion was achieved. Acceptable occlusion and periodontal tissue were maintained after a retention period of two years. Our results suggest that skeletal anchorage is useful for retraction and intrusion of upper incisors in cases of maxillary protrusion with severe adult periodontitis.
由于寻求正畸治疗的成年患者数量不断增加，正畸医生越来越有可能遇到患有成人牙周炎的患者。然而，由于成人牙周炎患者的牙周组织状况不佳，有时难以建立支抗。本文报道了成功使用骨支抗治疗一例合并严重成人牙周炎的上颌前突病例。一名50岁7个月的女性患者表现为骨性II类颌骨关系。观察到上前牙有5毫米的间隙，覆盖7.5毫米，覆合4毫米。她双侧牙弓均有广泛性水平骨吸收，后段有垂直骨吸收。牙周治疗后，在颧骨处植入微型钛板，并对上颌切牙进行内收和压低。经过21个月的积极治疗，上颌切牙舌倾9.5度，根尖压低2毫米，实现了良好的前牙咬合。在两年的保持期后，维持了可接受的咬合和牙周组织。我们的结果表明，骨支抗对上颌前突合并严重成人牙周炎病例的上颌切牙内收和压低是有用的。
