Huck Lothar, Korbmacher Heike, Niemeyer Karsten, Kahl-Nieke Bärbel
Department of Orthodontics, Center of Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Orofac Orthop. 2006 Jul;67(4):297-307. doi: 10.1007/s00056-006-0614-9.
Conventional therapeutic approaches to correct ankylosed anterior teeth in infraposition require compromises involving esthetics and function. The combined approach of distraction and early orthodontic fine adjustment, not yet established as a routine, promises better results concerning the bone conditions and gingival development.
Both female patients had suffered a trauma to the front teeth during early mixed dentition resulting in ankylosed central incisors in infraposition. At the ages of 14 years and 2 months and 15 years and 2 months, respectively, we carried out segment distraction by means of a bone-supported internal distractor followed by orthodontic fine adjustment after having shortened the consolidation phase. Both ankylosed front teeth could be successfully aligned, leading to an increase in bone and harmonization of the gingival margin in the dental arch. At ten and 14 months after the conclusion of treatment, we observed only few deviations in the dental situation compared to posttherapeutic findings.
From a functional and esthetic point of view, therapy involving combined orthodontics and surgery is superior to conventional therapy. Orthodontic fine adjustment should be considered as a continuation of the distraction procedure.
传统的矫正低位强直前牙的治疗方法需要在美学和功能方面做出妥协。牵引与早期正畸精细调整相结合的方法尚未成为常规方法，但有望在骨条件和牙龈发育方面取得更好的效果。
两名女性患者在乳牙混合早期均遭受前牙外伤，导致低位中央切牙强直。我们分别在患者14岁2个月和15岁2个月时，通过骨支持式内置牵引器进行节段性牵引，在缩短巩固期后进行正畸精细调整。两颗强直前牙均成功对齐，使牙弓内的骨量增加且牙龈边缘协调一致。在治疗结束后10个月和14个月时，与治疗后的结果相比，我们观察到牙齿情况仅有少量偏差。
从功能和美学角度来看，正畸与手术相结合的治疗方法优于传统治疗方法。正畸精细调整应被视为牵引程序的延续。
