Department of Sense Organs, "Sapienza" University, Rome, Italy.
Department of Medicosurgical Sciences and Biotechnologies, "Sapienza" University, Rome, Italy.
Am J Orthod Dentofacial Orthop. 2019 Sep;156(3):355-364. doi: 10.1016/j.ajodo.2018.09.020.
The aim of this work was to analyze data of patients with failed or delayed eruption of first and second permanent molars, to assess the effectiveness of the treatment methods used.
Epidemiologic and clinical data of 125 patients (mean age 14.08 ± 4.04 years) with 197 affected molars (30 first and 167 second molars) were retrospectively analyzed. The treatment outcome was known in 161 molars after patient drop-out (20 patients with 36 molars). The cases were categorized into 8 groups according to the choice of treatment: orthodontic uprighting, surgical-orthodontic uprighting, surgical uprighting, surgical repositioning, surgical exposure, first or second molar extraction, third molar extraction, or removal of pathologic conditions.
The overall treatment outcome was positive in 141 molars (87.6%). It was positive in all cases treated with orthodontic uprighting (7 molars), surgical exposure (10 molars), surgical uprighting (38 molars), and surgical repositioning (8 molars), but it was significantly lower for surgical-orthodontic uprighting (34/48 molars, 70.8%). The positive outcome was significantly lower for inclusion (52/68 molars, 76.5%) than for early-diagnosed condition (11/11 molars, 100%) and retention (78/82 molars, 95.1%), and for total bone crown coverage (21/28 molars, 75.0%) than for osteomucosal or mucosal crown coverage (120/133 molars, 90.2%).
This study demonstrates that an early diagnosis results in a better outcome regardless of the treatment used, with the number of cases with a positive outcome being higher in younger patients.
本研究旨在分析第一和第二恒磨牙萌出失败或延迟患者的数据,评估所采用治疗方法的有效性。
回顾性分析了 125 名患者(平均年龄 14.08 ± 4.04 岁)197 颗受影响磨牙(30 颗第一恒磨牙和 167 颗第二恒磨牙)的流行病学和临床数据。161 颗磨牙在患者脱落(20 名患者,36 颗磨牙)后已知治疗效果。根据治疗选择将病例分为 8 组:正畸直立、正畸-手术直立、手术直立、手术复位、手术暴露、第一或第二磨牙拔除、第三磨牙拔除或去除病理状况。
141 颗磨牙(87.6%)的总体治疗效果为阳性。正畸直立(7 颗磨牙)、手术暴露(10 颗磨牙)、手术直立(38 颗磨牙)和手术复位(8 颗磨牙)治疗的所有病例均为阳性,但正畸-手术直立(34/48 颗磨牙,70.8%)的阳性率明显较低。纳入的阳性结果(52/68 颗磨牙,76.5%)明显低于早期诊断(11/11 颗磨牙,100%)和保留(78/82 颗磨牙,95.1%),总牙冠骨覆盖(21/28 颗磨牙,75.0%)明显低于骨黏膜或黏膜牙冠覆盖(133 颗磨牙中的 120 颗,90.2%)。
本研究表明,无论采用何种治疗方法,早期诊断都能获得更好的结果,且年轻患者的阳性结果病例数更高。