Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China.
Tianjin Key Laboratory of Oral and Maxillofacial Fuction Reconstruction, Tianjin Stomatological Hospital, Tianjin, 300041, China.
BMC Oral Health. 2023 Jul 8;23(1):468. doi: 10.1186/s12903-023-03123-7.
Clinicians agree that obtaining and retaining good treatment results for missing maxillary central incisors owing to trauma is not easy. Management of adult patients with permanent maxillary central incisor loss who visit the clinic with high expectations for aesthetics and function pose a significant diagnostic dilemma. Therefore, esthetic and functional outcomes should be taken into consideration when deciding the proper treatment method. The treatment described in this study aimed to reestablish smile esthetics by proposing an effective multidisciplinary clinical approach that includes orthodontic-prosthetic-periodontal procedures, optimally reduced lip protrusion, center dental midlines, and establishment of stable occlusion.
The patient was a 19-year-old adult female with bimaxillary arch protrusion who had been wearing removable dentures for several years since the loss of her maxillary central permanent incisors. A multidisciplinary treatment including the extraction of two mandibular primary premolars was adopted. The treatment plan consisted of orthodontic space closure by shifting the adjacent teeth towards the central incisor spaces combined with appropriate morphologic remodeling and gingival reshaping to obtain good aesthetic and functional results. The duration to complete the orthodontic treatment was 35 months. Clinical and radiographic results after treatment suggested smile harmony with an improvement in the facial profile, good function of the occlusion, and a positive effect on bone remodeling in the area of the missing incisors during orthodontic tooth movement.
This clinical case illustrated the necessity for using multidisciplinary methods involving orthodontic, prosthodontic, and periodontic procedures to treat an adult female patient with bimaxillary arch protrusion and long-term absence of anterior teeth due to severe trauma.
临床医生一致认为，获得并保持因外伤缺失的上颌中切牙的良好治疗效果并不容易。对于因外伤而永久缺失上颌中切牙、就诊时对美观和功能期望较高的成年患者的管理，存在显著的诊断难题。因此，在决定适当的治疗方法时，应考虑美观和功能结果。本研究中描述的治疗旨在通过提出一种有效的多学科临床方法来重建微笑美观，该方法包括正畸-修复-牙周程序，最大限度地减少唇突度、中心牙中线和建立稳定的咬合。
患者为 19 岁女性，双颌前突，上颌中切牙缺失后已佩戴可摘义齿数年。采用包括拔除两个下颌第一前磨牙的多学科治疗方法。治疗计划包括通过将相邻牙齿向中切牙间隙移动来关闭正畸间隙，同时进行适当的形态重塑和牙龈重塑，以获得良好的美观和功能效果。正畸治疗完成时间为 35 个月。治疗后的临床和影像学结果表明，微笑和谐，面型改善，咬合功能良好，正畸牙齿移动区骨改建效果积极。
本临床病例说明了需要使用多学科方法，包括正畸、修复和牙周程序，来治疗因严重外伤导致双颌前突和长期缺失前牙的成年女性患者。
