Mucedero M, Pezzuto C, Rozzi M, Ricchiuti M R, Cozza P
Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy.
Oral Implantol (Rome). 2016 Nov 13;9(1):17-26. doi: 10.11138/orl/2016.9.1.017. eCollection 2016 Jan-Mar.
Young adult patient treated for impaction of two maxillary canines.
C.S., 15 years, female. Diagnostic evaluation by clinical and radiographic examinations shows permanent dentition with persistence of 5.3 and 6.3, impaction of 1.3 and 2.3, dento-skeletal Cl I malocclusion, normodivergence of bone bases. Analysis of TC dentalscan confirms the palatal impaction of 1.3 and 2.3. The treatment plan provided an orthodontic-surgical approach for adequate space management in dental arch, evaluation of eruption movements, choice of anchorage device, surgical exposure and application of the brackets.
Deciduous canines have been extracted and an edgewise appliance with rigid rectangular full thickness archwires has been used to align the arches and to obtain maximum anchorage during the forced traction. The surgical phase, for exposure of 1.3 and 2.3 respectively, performed an open technique by excisional uncovering and a close technique by a repositioned flap. The case has been finalized for the achievement of the right occlusal keys.
The possibility to choose the surgical technique depending on the intraosseous position of impacted teeth in association to the edgewise therapy with full thickness arches allows to realize an effectiveness surgical-orthodontic approach for the forced traction of impacted teeth in a favourable position.
对一名接受两颗上颌尖牙阻生治疗的年轻成年患者进行研究。
患者C.S.，15岁，女性。通过临床和影像学检查进行诊断评估，结果显示恒牙列，5.3和6.3恒牙持续存在，1.3和2.3恒牙阻生，牙颌面安氏I类错牙合，骨基正常散开。牙科TC扫描分析证实1.3和2.3恒牙腭侧阻生。治疗方案采用正畸-外科联合方法，以充分管理牙弓间隙，评估萌出移动，选择支抗装置，进行手术暴露并粘贴托槽。
已拔除乳牙，并使用带有刚性矩形全厚弓丝的方丝弓矫治器排齐牙弓，并在强制牵引过程中获得最大支抗。手术阶段，分别对1.3和2.3恒牙进行暴露，采用切除暴露的开放技术和翻瓣复位的闭合技术。该病例已完成，实现了正确的咬合关系。
根据阻生牙的骨内位置选择手术技术，并结合全厚弓丝的方丝弓治疗，能够实现一种有效的外科正畸方法，将阻生牙牵引至有利位置。
