Department of Orthodontics, National and Kapodistrian University of Athens, Athens, Greece; Clinic for Orthodontics and Paediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Center for Advanced Dental Education, Department of Orthodontics, Saint Louis University, Saint Louis, Mo.
Am J Orthod Dentofacial Orthop. 2018 Dec;154(6):835-847. doi: 10.1016/j.ajodo.2018.08.009.
Spacing between the maxillary anterior teeth is a common concern for young patients and their parents. Patients often consider a diastema to be an annoying but minor problem; they might consult their general dentists for help, or try to address the issue themselves by applying elastic "gap bands." Moreover, parents, without any informed consent, sometimes accept this erroneous method as an easy and inexpensive treatment approach. A 9-year-old boy had severe acute periodontitis involving the maxillary central incisors caused by the placement of an elastic band and its apical migration. Despite periodontal and surgical interventions, the maxillary central incisors were finally extracted, and the patient started orthodontic treatment. The orthodontic treatment plan included maxillary lateral incisor substitution to replace the lost central incisors and mesialization of the maxillary posterior dentition. An interdisciplinary approach with excellent cooperation among the orthodontist, general dentist, and other dental specialists obtained an esthetically pleasing and optimized functional result. Treating the diastema between the anterior teeth with elastic gap bands and without fixed orthodontic appliances should be avoided. Patients should seek proper orthodontic advice for even small-scale orthodontic problems to prevent catastrophic outcomes, as exhibited in this case report.
上颌前牙之间的间隙是年轻患者及其家长普遍关注的问题。患者通常认为牙缝是一个恼人的小问题,但他们可能会咨询他们的普通牙医寻求帮助,或者试图通过应用弹性“间隙带”来自己解决这个问题。此外,未经任何知情同意,家长有时会接受这种错误的方法作为一种简单且廉价的治疗方法。一位 9 岁男孩因弹性带的放置及其根尖迁移而患有严重的急性牙周炎,累及上颌中切牙。尽管进行了牙周和手术干预,但上颌中切牙最终还是被拔除了,患者开始接受正畸治疗。正畸治疗计划包括上颌侧切牙替代缺失的中切牙,以及上颌后牙的近中移动。正畸医生、普通牙医和其他牙科专家之间的跨学科合作取得了美观且优化的功能效果。用弹性间隙带治疗前牙间隙而不使用固定正畸器械应该避免。对于即使是小规模的正畸问题,患者也应寻求适当的正畸建议,以防止像本病例报告中那样出现灾难性的后果。