Ayers E, Kennedy D, Wiebe C
Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada,
Eur Arch Paediatr Dent. 2014 Dec;15(6):421-8. doi: 10.1007/s40368-014-0132-1. Epub 2014 Jul 4.
Un-erupted maxillary incisors may result secondary to supernumerary teeth. Despite the removal of such mesiodentes, orthodontic traction of a permanent un-erupted maxillary incisor may be required.
The literature regarding the impacted maxillary central incisor(s) was reviewed and all pertinent publications on the subject assessed. The review specifically relative to mesiodentes, surgical exposure and orthodontic management was interpreted together with the clinical experience of a number of the authors' cases. From this analysis a set of recommendations was developed.
(1) A sufficient arch space has to be ensured or orthodontically created for permanent maxillary central incisor(s). (2) Early surgical extraction of a mesiodens or mesiodentes (ideally before 7 years of age), with simultaneous closed surgical exposure of the permanent impacted maxillary incisor with bonding of an attachment with gold chain. (3) Re-evaluation after 2-3 months to assess for any natural eruption of the maxillary central incisor. (4) Application of orthodontic traction in the event of non-eruption.
Early diagnosis of the presence of mesiodentes is imperative. Appropriate surgical and/or orthodontic traction is often indicated with regular post-surgical follow-up assessments.
上颌未萌出的切牙可能继发于多生牙。尽管已拔除此类正中牙，但可能仍需要对永久性未萌出的上颌切牙进行正畸牵引。
对有关上颌中切牙阻生的文献进行了综述，并对该主题的所有相关出版物进行了评估。与一些作者病例的临床经验一起解读了特别与正中牙、手术暴露和正畸治疗相关的综述。通过该分析制定了一套建议。
（1）必须确保或通过正畸方法为永久性上颌中切牙创造足够的牙弓间隙。（2）早期手术拔除正中牙（理想情况是在7岁之前），同时对上颌永久性阻生切牙进行闭合性手术暴露，并粘结带有金链的附着体。（3）2 - 3个月后重新评估，以评估上颌中切牙是否有自然萌出。（4）如果未萌出，则应用正畸牵引。
早期诊断正中牙的存在至关重要。通常需要进行适当的手术和/或正畸牵引，并进行定期的术后随访评估。
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