Renger Stéphane, Gremeret Mélanie, Gebeile-Chauty Sarah
13 rue du Temple, 68300 Saint-Louis, France.
Département d'orthodontie, Faculté d'odontologie, rue Guillaume Paradin, 69372 Lyon cedex 08, France.
Orthod Fr. 2018 Mar;89(1):111-121. doi: 10.1051/orthodfr/2018008. Epub 2018 Apr 20.
The main causes of failures in canine traction are anchorage defects, incorrect direction of force, uncontrolled forces. An adolescent female (10 years, 9 months) presents with two included canines on the maxillary arch, in a palatal position and her lateral incisors (12 and 22) are microdontic. Two mini-screws are inserted on the palate, in a mesial position to 16 and 26 to secure the traction of 13 and 23; in general, braces are bonded after this first step. After debonding, mini-screws remain to help stabilize the palatal plate during the retention period and to avoid unaesthetic metallic wires and hooks which sometimes cause occlusal interferences.
The alternatives are discussed: Ballista spring, mini-screw inserted in the palatal suture, Nance appliance… Conclusion: The multi-use of temporary anchorage devices during traction of palatally impacted canine(s) (especially in the case of bilateral inclusions) offer new alternatives by securing the canine displacement, eliminating almost all of the patient's compliance (no loss of sagittal anchorage). This type of small appliance increases the patient's comfort and decreases the complexity of activations. The global duration of treatment with braces can be decreased if no braces are needed during the first steps, and then retention can be more effective and more aesthetic, especially during smiling.
犬齿牵引失败的主要原因是锚固缺陷、力的方向不正确、力不受控制。一名青春期女性（10岁9个月）上颌牙弓有两颗埋伏犬齿，位于腭侧位置，其侧切牙（12和22）过小。在腭部16和26近中位置植入两颗微型螺钉，以固定13和23的牵引；一般来说，在这第一步之后再粘结矫治器。拆除矫治器后，微型螺钉保留下来，以在保持期帮助稳定腭板，并避免有时会导致咬合干扰的不美观的金属丝和挂钩。
讨论了其他替代方法：弩弹簧、植入腭中缝的微型螺钉、南斯矫治器……结论：在腭侧埋伏犬齿牵引过程中（尤其是双侧埋伏的情况）多次使用临时锚固装置，通过确保犬齿移位，消除几乎所有患者的依从性问题（矢状向锚固无损失），提供了新的选择。这种小型矫治器增加了患者的舒适度，降低了激活的复杂性。如果在第一步不需要矫治器，那么矫治器治疗的总体时间可以缩短，然后保持可以更有效、更美观，尤其是在微笑时。
