Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
Department of Orthodontics, School of Dentistry, University of Michigan, Ann Arbor, Mich.
Am J Orthod Dentofacial Orthop. 2020 Jul;158(1):102-113. doi: 10.1016/j.ajodo.2019.03.032.
Treatment for a patient with a dental anomaly pattern is challenging and complex. This article presents a rare case with an association of multiple ectopic eruptions treated in 2 phases. An 8-year-old boy in the early mixed dentition showed a Class II, Division 2 malocclusion, and an ectopic eruption of the mandibular right lateral incisor. The treatment plan included extractions of the deciduous mandibular right lateral incisor and canine, followed by partial mandibular fixed appliances and a lingual arch. In the late mixed dentition, the panoramic radiograph showed bilateral ectopic eruptions of the maxillary canines. The deciduous maxillary canines were extracted, and a cervical headgear was installed. Within 12 months, both permanent maxillary canines spontaneously erupted. Comprehensive orthodontic treatment was initiated when the patient was aged 13 years to level the curve of Spee and reduce the overbite. Phase 2 lasted 15 months. In patients with dental anomaly patterns, longitudinal follow-up during the mixed dentition is highly important and might contribute to simplifying comprehensive orthodontic treatment and reducing complications and adverse effects.
治疗具有牙齿异常模式的患者具有挑战性且复杂。本文介绍了一个罕见的病例，涉及多颗异位萌出的病例，分两个阶段进行治疗。一名 8 岁男孩处于混合牙列早期，表现为 II 类，2 分类错颌，下颌右侧侧切牙异位萌出。治疗计划包括拔除下颌右侧乳侧切牙和乳尖牙，然后使用部分下颌固定矫治器和舌弓。在混合牙列晚期，全景片显示上颌尖牙双侧异位萌出。拔除上颌乳尖牙，并安装颈带。12 个月内，两颗上颌恒尖牙均自行萌出。当患者 13 岁时，开始进行全面的正畸治疗，以整平 Spee 曲线并减少覆颌。第二阶段持续了 15 个月。对于具有牙齿异常模式的患者，混合牙列期间的纵向随访非常重要，这可能有助于简化全面的正畸治疗，减少并发症和不良影响。
