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两例水平阻生上颌中切牙的开放手术暴露联合正畸治疗:病例报告

Open surgical exposure of two horizontally impacted maxillary incisors combined with orthodontic treatment: A case report.

作者信息

Alhasyimi Ananto Ali, Indra Putu, Setijanto R Darmawan, Tajudin Abdullah Md, Noviasari Paramita, Rosanto Yosaphat Bayu

机构信息

Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Orthodontist, Smile Cloud Clinic, Indonesia.

出版信息

Int J Surg Case Rep. 2024 May;118:109620. doi: 10.1016/j.ijscr.2024.109620. Epub 2024 Apr 7.

Abstract

INTRODUCTION

Maxillary anterior teeth that have not erupted may substantially alter the appearance of the teeth and face. Orthodontists often encounter a clinical challenge while dealing with an impacted maxillary incisor, which creates space problems in the anterior region. The purpose of this paper is to describe the well-synchronized orthodontic and surgical treatment of a horizontally impacted maxillary central incisors.

CASE PRESENTATION

A male patient, aged 27, presented with a complaint of unerupted two maxillary front teeth. This resulted in the displacement of adjacent teeth into the vacant region. An intraoral examination revealed a Class II molars on both sides, a deep curve of the space with a 2.3 mm overjet, and an edge-to-edge bite of 0.1 mm. The 3D cone beam computed tomography (CBCT) imaging unveiled a labial impacted and a rotation of approximately 90 degrees (horizontal impacted) on both central maxillary incisors.

DISCUSSION

The self-ligating bracket was installed and orthodontic traction aligned the affected tooth in the dental arch. To reach the labial surface of the impacted incisor, open surgical exposure by window excision of soft tissues with a laser was preferable due to the large bulge in the sulcus. Because self-ligating bracket systems employed modest pressures to position the maxillary right central incisor in the arch, the window surgical technique did not produce gingival scarring or increased clinical crown length.

CONCLUSION

The impacted upper central incisor was successfully treated using a collaborative interdisciplinary (surgical-orthodontic) approach, which resulted in a favorable aesthetic and functional outcome.

摘要

引言

未萌出的上颌前牙可能会显著改变牙齿和面部外观。正畸医生在处理上颌中切牙阻生时经常会遇到临床挑战,这会在前牙区造成间隙问题。本文旨在描述一例水平阻生上颌中切牙的正畸与外科同步治疗。

病例介绍

一名27岁男性患者,主诉上颌两颗前牙未萌出。这导致相邻牙齿向空缺区域移位。口腔检查发现双侧磨牙为II类关系,Spee曲线深,覆盖2.3mm,前牙对刃0.1mm。三维锥形束计算机断层扫描(CBCT)影像显示双侧上颌中切牙唇侧阻生且近90度旋转(水平阻生)。

讨论

安装了自锁托槽,通过正畸牵引将患牙排入牙弓。由于龈沟处隆起较大,为了暴露阻生中切牙的唇面,采用激光软组织开窗的开放手术暴露方式更为可取。由于自锁托槽系统采用适度压力将上颌右侧中切牙排入牙弓,开窗手术技术未产生牙龈瘢痕或增加临床冠长度。

结论

采用多学科协作(外科-正畸)方法成功治疗了阻生的上颌中切牙,取得了良好的美学和功能效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bd2/11033169/cb883313571e/gr1.jpg

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