Dave Heemanshu R, Samrit Vilas D, Kharbanda Om Prakash
Aust Orthod J. 2015 May;31(1):107-15.
The extraction of an upper lateral incisor for orthodontic purposes is rare and must be adequately justified.
The present case report describes the management of a skeletal Class II crowded malocclusion that was facilitated by the extraction of upper lateral incisors and lower first premolars.
A 14-year-old male patient presented with a skeletal Class II crowded malocclusion with associated speech and chewing difficulties. Phase I of treatment involved the extraction of the upper lateral incisors and functional appliance therapy. Phase II included the extraction of lower first premolars and mechanotherapy using full fixed appliances.
An improvement in aesthetics and sagittal relations was achieved during phase I therapy as the mandible was advanced over a period of eight months. Mandibular skeletal change was 6.5 mm observed at pogonion. During phase II therapy, the maxillary canines were substituted for lateral incisors and a functional occlusion was achieved. The skeletal correction and occlusion were stable one year after debonding.
The present case indicated that the timely extraction of palatally-placed maxillary lateral incisors facilitated functional appliance therapy in the management of a skeletal Class II problem. The crowding of the lower anterior teeth was relieved and alignment of the upper arch was achieved with full fixed appliance therapy, resulting in improved aesthetics and a stable occlusion at one year review.
因正畸目的拔除上颌侧切牙的情况罕见，必须有充分的理由。
本病例报告描述了通过拔除上颌侧切牙和下颌第一前磨牙来治疗骨性II类拥挤错牙合畸形的情况。
一名14岁男性患者，表现为骨性II类拥挤错牙合畸形，伴有言语和咀嚼困难。治疗的第一阶段包括拔除上颌侧切牙和功能性矫治器治疗。第二阶段包括拔除下颌第一前磨牙和使用全固定矫治器进行机械治疗。
在第一阶段治疗期间，随着下颌在八个月的时间里向前移动，美观和矢状关系得到改善。在下颌点观察到下颌骨骨骼变化为6.5毫米。在第二阶段治疗中，上颌尖牙替代了侧切牙，实现了功能性咬合。拆除矫治器一年后，骨骼矫正和咬合稳定。
本病例表明，及时拔除腭侧位的上颌侧切牙有助于在治疗骨性II类问题时进行功能性矫治器治疗。通过全固定矫治器治疗缓解了下前牙拥挤，实现了上颌牙弓排齐，在一年复查时美观得到改善，咬合稳定。
