Department of Orthodontics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Palackeho 700/12, 779 00, Olomouc, Czech Republic.
STOMMA Dental Clinic, Tř. 1. máje 3414/11A, 690 02, Břeclav, Czech Republic.
Prog Orthod. 2023 Jun 26;24(1):17. doi: 10.1186/s40510-023-00470-7.
Central incisor impaction is a rare condition with potentially severe clinical and psychological implications for the patient. Treatment techniques vary according to the pretreatment situation and individual factors. The aim of this study was to compare the esthetic outcomes and treatment times between two different approaches.
In this retrospective study, thirty-one consecutive patients (13 boys, 18 girls; average age 9.5 ± 2.3 years) with a total of 34 impacted permanent upper central incisors were included in the study. Patients were divided into two groups according to method of treatment. Group A comprised patients in whom spontaneous eruption occurred after space opening (n = 12), and Group B comprised patients in whom teeth showed no eruption and required treatment with a modified closed eruption method with palatally oriented traction (n = 19). Treatment time and esthetic outcomes were assessed and compared between groups.
The mean treatment time was 22.0 ± 6.7 months, and all teeth were successfully aligned. No statistically significant difference in average treatment time was found between groups in baseline characteristics (p > 0.05). The amount of attached gingiva was significantly smaller when compared to contralateral reference teeth in the closed eruption group (Group B; p = 0.03). However, no difference in amount of attached gingiva was found between both groups (p = 0.26). Additionally, no difference in the clinical crown length was found between groups (p = 0.27).
The closed eruption method with palatal traction directed at the peak of the alveolar crest provided results comparable to the physiologic tooth eruption.
中切牙阻生是一种罕见的情况，可能对患者的临床和心理产生严重影响。治疗技术因预处理情况和个体因素而异。本研究旨在比较两种不同方法的美学效果和治疗时间。
在这项回顾性研究中，纳入了 31 名连续患者（男 13 名，女 18 名；平均年龄 9.5±2.3 岁），共计 34 颗恒上中切牙阻生。根据治疗方法将患者分为两组。A 组包括空间打开后自然萌出的患者（n=12），B 组包括无萌出且需要用改良的闭合式萌出法进行腭向牵引的患者（n=19）。评估并比较两组之间的治疗时间和美学效果。
平均治疗时间为 22.0±6.7 个月，所有牙齿均成功排列。在基线特征方面，两组之间的平均治疗时间无统计学差异（p＞0.05）。与对侧参考牙相比，闭合式萌出组（B 组）附着龈量明显较小（p=0.03）。但是，两组之间的附着龈量无差异（p=0.26）。此外，两组之间的临床冠长度无差异（p=0.27）。
牙槽嵴顶定向的腭向牵引闭合式萌出方法提供的结果与生理性牙齿萌出相当。
