Ruíz-Mora Gustavo Armando, Arriola-Guillén Luis Ernesto, Aliaga-Del Castillo Aron, Rodríguez-Cárdenas Yalil Augusto, Dutra Vinicius, Mejía-Milian Mabel
Division of Orthodontics, Faculty of Dentistry, Universidad Nacional de Colombia, Bogota, Colombia.
Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru.
Case Rep Dent. 2023 Aug 1;2023:6943221. doi: 10.1155/2023/6943221. eCollection 2023.
The objectives of the treatment of impacted canines differ according to the characteristics of dental malocclusion. Traction of the tooth is a conservative and viable alternative, which allows for maintaining stability and occlusal function. The following case report describes the treatment of an 11.6-year-old female patient, who presented bilateral impaction of mandibular canines in contact with the midline, mixed dentition in the inter-transitional period, class I angle malocclusion, with light crowding teeth. The treatment comprised three phases. The first phase, verticalization of the mandibular canines in mixed dentition, was performed to pull the impacted bilateral mandibular canines towards the dental arch to achieve their verticalization, maintaining the molar relationship, and the position of the upper and lower incisors. In the second phase, osteogenic rest was planned to relieve post-traction stress while awaiting the replacement of the mixed dentition. Finally, the third phase in permanent dentition was to align and level canines within the arch after extraction of the deciduous canines. For the viability of the permanent mandibular canines in the dental arch, orthosurgical traction was implemented, with a traction system with closed nickel-titanium coil springs with a transitory rigid dental-mucous-supported anchorage device, which allowed control and protection of the adjacent teeth and movements with helical forces of a controlled three-dimensional range. The results of the treatment were adequate, achieving consolidated molar and canine relationships, overjet, overbite, and optimal facial balance.
根据牙列错合的特征，阻生尖牙的治疗目标有所不同。牙齿牵引是一种保守且可行的替代方法，它能够维持稳定性和咬合功能。以下病例报告描述了一名11.6岁女性患者的治疗情况，该患者双侧下颌尖牙阻生且与中线接触，处于替牙过渡期的混合牙列，安氏I类错合，伴有轻度牙列拥挤。治疗包括三个阶段。第一阶段，在混合牙列期将下颌尖牙竖直，目的是将双侧阻生下颌尖牙拉向牙弓以实现其竖直，维持磨牙关系以及上下切牙的位置。第二阶段，计划进行成骨休息以缓解牵引后应力，同时等待混合牙列的替换。最后，在恒牙列期的第三阶段是在拔除乳尖牙后将尖牙在牙弓内排齐并整平。为了使恒牙列中的下颌尖牙在牙弓中保持活力，实施了正颌外科牵引，采用带有封闭镍钛螺旋弹簧的牵引系统以及临时的刚性牙-黏膜支持式锚固装置，这允许对相邻牙齿进行控制和保护，并通过可控的三维范围的螺旋力进行移动。治疗结果良好，实现了稳固的磨牙和尖牙关系、覆盖、覆合以及最佳的面部平衡。
