Li Chenshuang, Jiang Wenlu, Chen Shih-Chin, Borenstein Krisena, Tanna Nipul, Chung Chun-Hsi, Moon Won
Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Department of Orthodontics, School of Dentistry, University of California, Los Angeles, CA 90095, USA.
Diagnostics (Basel). 2022 Apr 22;12(5):1055. doi: 10.3390/diagnostics12051055.
Molar distalization has been a validated method to correct dental sagittal relationships and create space to relieve mild to moderate crowding. In the current case report, an adult female patient had a mild skeletal Class III relationship and dental Class III molar relationship. Four premolars and one lower incisor were extracted during the previous two rounds of orthodontic treatments, and the maxillary anterior teeth were left with severe proclination and root resorption. Limited by the available teeth, extraction was not an option for her. Thus, molar distalization with TADs was the best option used in the treatment to address her chief complaint. In addition, a proper bite opening was performed to eliminate occlusion trauma. Utilizing the mid-palatal TADs, the maxillary central incisors were retracted 7.9 mm and retroclined 33 degrees, and the molar distalization was achieved as much as 8 mm. The cross-section slices of CBCT images confirmed the proper retraction of maxillary incisors and well-positioned roots in the alveolar bone. Moreover, the root resorption was not worsened from the treatment. Clinically, the maxillary anterior teeth were preserved esthetically and functionally. This case report illustrates that with proper diagnosis and treatment mechanics, significant tooth movement can be achieved even on extremely proclined maxillary incisors with severe root resorption.
磨牙远移是一种已被验证的用于矫正牙齿矢状关系并创造间隙以缓解轻至中度牙列拥挤的方法。在本病例报告中，一名成年女性患者存在轻度骨性III类关系和牙性III类磨牙关系。在前两轮正畸治疗中拔除了四颗前磨牙和一颗下切牙，上颌前牙仍严重前倾且有牙根吸收。由于可用牙齿数量有限，拔牙对她来说不是一个选择。因此，使用微型种植体支抗进行磨牙远移是治疗中用于解决其主要诉求的最佳选择。此外，进行了适当的打开咬合操作以消除咬合创伤。利用腭中微型种植体支抗，上颌中切牙后移了7.9毫米并向后倾斜了33度，磨牙远移达到了8毫米。CBCT图像的横断面切片证实了上颌切牙的适当后移以及牙根在牙槽骨中的良好定位。此外，治疗后牙根吸收并未加重。临床上，上颌前牙在美观和功能上均得以保留。本病例报告表明，通过适当的诊断和治疗力学方法，即使是对上颌极度前倾且有严重牙根吸收的牙齿，也能实现显著的牙齿移动。
