Ling Kwok K, Ho Christopher T C, Kravchuk Olena, Olive Richard J
School of Dentistry, University of Queensland and Specialist Practice, Brisbane, Australia.
Aust Orthod J. 2007 May;23(1):8-15.
Palatally impacted maxillary canines may appear unsightly after treatment because of changes in position and colour.
To determine if palatally impacted canines treated either by surgical exposure and orthodontic repositioning or by creation of space in the arch and unassisted eruption have different aesthetic outcomes.
Twenty eight subjects with unilateral palatally impacted canines who had completed orthodontic treatment at least 6 months previously were recruited from three specialist practices. In 14 subjects the canines had been treated by surgical exposure, orthodontic extrusion and repositioning in the arch (SE group) and in the remainder the deciduous canines were extracted and excess space created in the arch for the canines to erupt naturally (OT group). The contralateral canines were used as controls. The mean pretreatment ages of the subjects in the SE and OT groups were 13.5 (SD:1.6) years and 13.5 (SD:1.3) years respectively. The position and colour of the canines were assessed on post-treatment study models and 35 mm slides using the American Board of Orthodontics Objective Grading System (ABO OGS) and subjective appraisal by two orthodontists. Each subject used a semantic scale to rate the aesthetic outcome of treatment.
Sixty four per cent of the treated canines in the SE group were significantly more 'intruded' than the treated canines in the OT group (p = 0.004) and the control canines (p = 0.004). The ABO OGS grades of the canines in the SE and OT groups were similar (p = 0.173). While the assessors detected a lack of labial root torque and gingival margin changes in the canines in the SE group, the subjects in both groups were satisfied with the appearance of the canines post-treatment.
Palatally impacted canines treated by surgical exposure, extrusion and orthodontic treatment were more likely to be displaced vertically ('intruded') after treatment than palatally impacted canines treated by extraction of the overlying deciduous canines and creation of excess space in the arch. Small occlusal and aesthetic changes detected by the orthodontists, but not the ABO OGS, did not appear to detract from the satisfaction of the subjects with the results of orthodontic treatment.
由于位置和颜色的变化，腭侧埋伏阻生上颌尖牙在治疗后可能会显得不美观。
确定通过手术暴露和正畸重新定位治疗的腭侧埋伏阻生尖牙与通过在牙弓中开辟间隙并自然萌出治疗的腭侧埋伏阻生尖牙是否有不同的美学效果。
从三家专科诊所招募了28名单侧腭侧埋伏阻生尖牙且至少在6个月前已完成正畸治疗的受试者。在14名受试者中，尖牙通过手术暴露、正畸牵引并重新定位到牙弓中进行治疗（SE组），其余受试者拔除乳尖牙并在牙弓中开辟额外间隙让尖牙自然萌出（OT组）。对侧尖牙用作对照。SE组和OT组受试者的平均治疗前年龄分别为13.5（标准差：1.6）岁和13.5（标准差：1.3）岁。使用美国正畸委员会客观评分系统（ABO OGS）以及两名正畸医生的主观评估，在治疗后的研究模型和35毫米幻灯片上评估尖牙的位置和颜色。每位受试者使用语义量表对治疗的美学效果进行评分。
SE组中64%的治疗后尖牙比OT组中治疗后的尖牙（p = 0.004）以及对照尖牙（p = 0.004）明显更“内倾”。SE组和OT组尖牙的ABO OGS评分相似（p = 0.173）。虽然评估者发现SE组尖牙缺乏唇向牙根转矩且牙龈边缘有变化，但两组受试者对治疗后尖牙的外观均感到满意。
与通过拔除上方乳尖牙并在牙弓中开辟额外间隙治疗的腭侧埋伏阻生尖牙相比，通过手术暴露、牵引和正畸治疗的腭侧埋伏阻生尖牙在治疗后更有可能垂直移位（“内倾”）。正畸医生检测到的微小咬合和美学变化（但ABO OGS未检测到）似乎并未降低受试者对正畸治疗结果的满意度。
