Felicita A Sumathi
Department of Orthodontics, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India.
Saudi Dent J. 2017 Oct;29(4):185-193. doi: 10.1016/j.sdentj.2017.04.001. Epub 2017 Jun 14.
To align a dilacerated maxillary central incisor and partially impacted canine with unilateral extraction in a young patient with skeletal deep bite.
A 14 year old male patient reported to the hospital with skeletal deep bite (basal plane angle-17°), severe horizontal pattern of growth (Go-Gn to Sn -22°), upright maxillary incisors (U1 to NA -26°) and retroclined lower incisors (L1 to NB -11°). The maxillary left central incisor was dilacerated, and the maxillary left canine was partially impacted. Unilateral extraction of the left maxillary premolar and left mandibular central incisor was done. A canine disimpaction spring was used to align the impacted canine. An anterior bite plane was given to open the bite.
Superimposition of lateral cephalogram (T1, T2) revealed bite opening, normal overjet and overbite. There was backward rotation of the mandible and increase in lower anterior facial height. There was no evidence of root resorption or loss of vitality in the dilacerated tooth. Clinically the canine was well aligned in the arch.
Orthodontic management of a dilacerated incisor can be done without root resorption or loss of vitality. The partially impacted canine was well aligned in the arch. Unilateral extraction can produce good treatment results.
在一名患有骨性深覆合的年轻患者中，通过单侧拔牙使上颌中切牙牙根弯曲和部分埋伏阻生的尖牙排齐。
一名14岁男性患者前来医院就诊，其患有骨性深覆合（基底平面角为17°）、严重的水平生长型（下颌平面角至鼻根点连线与鼻根点至下牙槽座点连线夹角为22°）、上颌切牙直立（上中切牙长轴与鼻根点至下牙槽座点连线夹角为26°）以及下颌切牙舌倾（下中切牙长轴与下颌平面夹角为11°）。上颌左侧中切牙牙根弯曲，上颌左侧尖牙部分埋伏阻生。拔除上颌左侧第一前磨牙和下颌左侧中切牙。使用尖牙开窗弹簧使埋伏阻生的尖牙排齐。给予前牙咬合平面打开咬合。
头颅侧位片叠加分析（T1、T2）显示咬合打开、覆盖和覆合正常。下颌发生向后旋转，下颌前部面部高度增加。弯曲牙根的牙齿未见牙根吸收或活力丧失的迹象。临床检查发现尖牙在牙弓中排列整齐。
正畸治疗弯曲牙根的切牙可避免牙根吸收或活力丧失。部分埋伏阻生的尖牙在牙弓中排列整齐。单侧拔牙可取得良好的治疗效果。
