Yasumura Toshihiko, Kashiwagi Yumi, Katada Hidenori, Nishii Yasushi
Department of Orthodontics, Tokyo Dental College.
Bull Tokyo Dent Coll. 2020 Dec 16;61(4):255-264. doi: 10.2209/tdcpublication.2020-0016. Epub 2020 Nov 10.
This case report describes the unusual choice of extraction of maxillary incisors with short roots as part of an orthodontic treatment plan. The patient was a 20-year-old woman referred to our department in whom the diagnosis was maxillary protrusion and open bite. Both of the maxillary central incisors had short roots. Two treatment options were considered. The first involved extraction of the 4 first premolars with the aim of improving dentoalveolar protrusion and crowding. If preservation of the central incisors subsequently became difficult due to root resorption, prosthetic options were to be considered. The second treatment option involved extraction of the maxillary central incisors with short roots and the mandibular first premolars. The second treatment option was selected as survival of the central incisors following orthodontic movement was uncertain and the patient also wanted to minimize the risk of future extractions and the use of prosthetics. Active treatment was performed over a span of 31 months, and circumferential type retainers were used on both arches for retention. For such treatment to be successful, careful diagnosis and orthodontic treatment planning must be taken to ensure the anterior dental esthetics are properly restored.
本病例报告描述了作为正畸治疗计划一部分的拔除短根上颌切牙这一不寻常的选择。患者为一名20岁女性,转诊至我科,诊断为上颌前突和开牙合。两颗上颌中切牙牙根较短。考虑了两种治疗方案。第一种方案是拔除4颗第一前磨牙,目的是改善牙牙槽前突和拥挤。如果随后由于牙根吸收而难以保留中切牙,则应考虑修复方案。第二种治疗方案是拔除牙根较短的上颌中切牙和下颌第一前磨牙。选择第二种治疗方案是因为正畸移动后中切牙的存留情况不确定,且患者也希望将未来拔牙和使用修复体的风险降至最低。积极治疗持续了31个月,并在上下牙弓均使用了环绕式保持器进行保持。为使此类治疗成功,必须进行仔细的诊断和正畸治疗计划,以确保正确恢复前牙美观。