Meros Gladistone C, Shoji Aline, Suzuki Selly, Paranhos Luiz R, Manfroi Rodrigo, Claus Jonathas, Garcez Aguinaldo
Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil, Phone: +554699117799 e-mail:
Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil.
J Contemp Dent Pract. 2017 Dec 1;18(12):1198-1205. doi: 10.5005/jp-journals-10024-2200.
This case report aimed to present an orthodontic mechanic alternative for space opening in a patient missing maxillary lateral incisors, using miniplates as anchorage, associated with self-ligating brackets.
Dental agenesis affects the population causing esthetic and functional damages. The prevalence of missing maxillary lateral incisors should be considered for its significant rate and negative impact on smile esthetics.
This treatment was chosen based on the presence of balanced facial pattern, large canine anatomy, the need to improve dental occlusion to prevent further wear, and patient's esthetic complaint. To obtain the results, upper third molars were extracted, and two miniplates were installed to distalize the upper arch with no need for patient compliance or auxiliary devices. Self-ligating brackets were used to reduce friction on posterior teeth, thus facilitating movement with light force application. At the end of 19 months, the patient presented with class I good overbite and overjet, and adequate space for implant and prosthetics; also, good facial esthetic was maintained.
When indicated, space opening may provide excellent esthetics and functional results, and even more predictable results when skeletal anchorage miniplates are used to distalize all posterior teeth.
Considering the high level of esthetic and functional compromise caused by dental agenesis, the technique hereby described represents a viable mechanic alternative within orthodontic possibilities.
本病例报告旨在介绍一种正畸力学方法，用于上颌侧切牙缺失患者的间隙开辟，使用微型钛板作为支抗，并结合自锁托槽。
牙发育不全影响人群，造成美观和功能损害。上颌侧切牙缺失的患病率因其高发生率和对微笑美观的负面影响而应予以考虑。
选择该治疗方案是基于面部形态平衡、尖牙解剖形态较大、需要改善牙合关系以防止进一步磨损以及患者的美观诉求。为获得治疗效果，拔除上颌第三磨牙，并安装两个微型钛板使上颌牙弓远中移动，无需患者配合或辅助装置。使用自锁托槽减少后牙摩擦力，从而在施加轻力时便于移动。19个月结束时，患者呈现I类磨牙关系、良好的覆牙合覆盖，并有足够的种植和修复空间；同时，保持了良好的面部美观。
在有适应证时，间隙开辟可提供优异的美观和功能效果，当使用骨支抗微型钛板使所有后牙远中移动时，效果甚至更可预测。
考虑到牙发育不全导致的高度美观和功能损害，本文所述技术是正畸可行的力学替代方法。
