Kocsis Andras, Seres Laszlo
Private Orthodontic Practice; Szeged, Hungary.
J Orofac Orthop. 2012 Jan;73(1):19-27. doi: 10.1007/s00056-011-0057-9. Epub 2012 Jan 12.
The impaction of maxillary canines is a frequently encountered clinical problem in orthodontic practice. Patients' refusal to participate in long-term treatment or ankylosis of the impacted tooth result in various treatment difficulties. The aim of this study was to evaluate the possible role of mini-screws in the management of unerupted upper canines.
In a series of 63 consecutive patients (27 males and 36 females, age range 14-49 years, mean 22.7 years) with a total of 69 impacted maxillary canines, each impacted tooth was surgically exposed and an attachment bonded. An intraosseous screw 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 canine angulation, the mini-screw was removed and conventional orthodontic therapy completed.
Of the 69 canines, 61 (88.41%) were extruded successfully. In the 7 cases that failed, skeletal anchorage spared both patients and clinicians the disappointment of customary long-term, unsuccessful orthodontic therapy. In one patient, the mini-screw was removed because of inflammation and pain before initiating orthodontic traction.
Our results demonstrate that mini-screw anchorage should be taken into consideration when extrusion of an impacted canine is planned.
上颌尖牙阻生是正畸临床中常见的问题。患者拒绝接受长期治疗或阻生牙发生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未萌出上颌尖牙治疗中的可能作用。
连续纳入63例患者(男27例,女36例,年龄14 - 49岁,平均22.7岁),共有69颗上颌阻生尖牙。每颗阻生牙均通过手术暴露并粘结附件。将带有骨内体和口内颈部的骨内螺钉植入前磨牙与磨牙的根分叉间隙。软组织愈合后,开始正畸牵引。在矫正尖牙角度后,取出微型螺钉并完成常规正畸治疗。
69颗尖牙中,61颗(88.41%)成功萌出。在7例失败病例中,骨支抗避免了患者和临床医生因常规长期正畸治疗失败而产生的失望。1例患者在开始正畸牵引前因炎症和疼痛取出了微型螺钉。
我们的结果表明,在计划牵引阻生尖牙时应考虑微型螺钉支抗。