Li Kun, Sun Peng, Sun Jing, Wang Tiejun
Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China.
Wolong Division, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China.
Dent Traumatol. 2023 Oct;39(5):495-508. doi: 10.1111/edt.12859. Epub 2023 Jun 7.
Symmetric extraction of premolars is a frequently used orthodontic treatment for dental crowding and protrusion. However, when a patient has incisors with ankylosis, the establishment of a treatment protocol often plagues orthodontists. An adolescent patient with a history of incisor trauma sought treatment for dental protrusion and crowding. Upon percussion of his infrapositioned maxillary central incisors, characteristic dull metallic sounds were noted, and a lack of normal mobility of these teeth under the application of external forces was detected. Follow-up radiographs after the trauma showed replacement root resorption of the maxillary central incisors. Based on clinical and radiological findings, ankylosis of the maxillary central incisors was tentatively diagnosed. A combination of orthodontic and prosthodontic treatment options involving extraction of the maxillary central incisors and mandibular first premolars was chosen to resolve the functional and esthetic problems. After treatment, well-aligned dentition, improved smile esthetics, and a more harmonious facial profile were achieved, and these outcomes remained stable during the follow-up period. This case report illustrates a viable treatment strategy for tackling predicaments caused by ankylosed incisors, which is unusual in the literature.
对称拔除前磨牙是治疗牙列拥挤和前突常用的正畸治疗方法。然而，当患者存在切牙粘连时，治疗方案的制定常常困扰正畸医生。一名有切牙外伤史的青少年患者因牙列前突和拥挤前来寻求治疗。叩诊其低位上颌中切牙时，可闻及典型的沉闷金属音，且在外力作用下这些牙齿缺乏正常的动度。外伤后的随访X线片显示上颌中切牙出现替代性牙根吸收。根据临床和影像学检查结果，初步诊断为上颌中切牙粘连。选择正畸和修复联合治疗方案，拔除上颌中切牙和下颌第一前磨牙，以解决功能和美观问题。治疗后，牙列排列整齐，微笑美观度提高，面部轮廓更加协调，且这些结果在随访期间保持稳定。本病例报告阐述了一种应对切牙粘连所致困境的可行治疗策略，这在文献中并不常见。
