Kocsis András, Seres László, Kocsis-Savanya Gábor, Kovács Adám
Gyermekfogászati es Fogszabályozási Tanszék, Szeged.
Fogorv Sz. 2010 Mar;103(1):3-9.
Impaction of maxillary canines is a frequently encountered clinical problem. Patients' refusal to a long orthodontic treatment or ankylosis of the impacted tooth results in various treatment difficulties. The aim of this study was to evaluate the possible role of miniscrews in the management of impacted upper canines. In a series of 28 consecutive patients with a total of 31 impacted maxillary canines (12 men and 16 women aged from 14 to 63 years, mean 24 years), each impacted tooth was surgically exposed and an attachment was bonded. An intraosseous screw (1.5 mm in diameter and 8-10 mm long) with an endosseous body and intraoral neck section was inserted into the premolar-molar interradicular space. Following soft tissue healing, orthodontic traction was initiated. After correction of the angulation of the canine, the mini-screw was removed and traditional orthodontic therapy was completed. Twenty-seven canines were extruded successfully (87%), the duration of the orthodontic treatment with fixed appliances was decreased. In the 3 cases that failed due to ankylosis, the skeletal anchorage spared the patients and the clinicans the disappointment of a long-term unsuccessful traditional orthodontic treatment. In one patient, the mini-screw was removed because of inflammation and pain before the beginning of the orthodontic traction. This study shows that mini screw anchorage should be taken into consideration when extrusion of an impacted canine is planned.
上颌尖牙阻生是临床上常见的问题。患者拒绝接受长时间的正畸治疗或阻生牙的牙根粘连会导致各种治疗困难。本研究的目的是评估微型螺钉在上颌阻生尖牙治疗中的潜在作用。在连续的28例患者中,共有31颗上颌阻生尖牙(12名男性和16名女性,年龄14至63岁,平均24岁),每颗阻生牙均通过手术暴露并粘结附件。将具有骨内体和口内颈部的骨内螺钉(直径1.5毫米,长8至10毫米)插入前磨牙-磨牙根间间隙。软组织愈合后,开始正畸牵引。在矫正尖牙的角度后,取出微型螺钉并完成传统的正畸治疗。27颗尖牙成功萌出(87%),固定矫治器正畸治疗的时间缩短。在3例因牙根粘连而失败的病例中,骨锚固避免了患者和临床医生因长期传统正畸治疗失败而产生的失望。在1例患者中,微型螺钉在正畸牵引开始前因炎症和疼痛而被取出。本研究表明,在计划萌出阻生尖牙时应考虑微型螺钉锚固。