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日常临床实践中的正畸牙齿伸出:折断或受损前牙的处理

Orthodontic Extrusion in Daily Clinical Practice: Management of Fractured or Damaged Anterior Teeth.

作者信息

Malcangi Giuseppina, Marinelli Grazia, Di Giulio Cesare Maral, Di Serio Sharon, Longo Marialuisa, Carbonara Andrea, Inchingolo Francesco, Inchingolo Alessio Danilo, Bordea Ioana Roxana, Palermo Andrea, Inchingolo Angelo Michele, Dipalma Gianna

机构信息

Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.

Department of Oral Rehabilitation, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hatieganu, 400012 Cluj-Napoca, Romania.

出版信息

J Pers Med. 2025 Sep 1;15(9):408. doi: 10.3390/jpm15090408.

Abstract

. Orthodontic extrusion (OE), or forced eruption, is a conservative technique used to recover teeth affected by coronal fractures, traumatic intrusions, or severe caries. It involves applying light, continuous forces to induce vertical tooth movement, promoting tissue remodeling through periodontal ligament stimulation. . This narrative review included studies investigating OE as a therapeutic approach for the management of deep or subgingival carious lesions, traumatic dental injuries (such as intrusion or fracture), or for alveolar ridge augmentation in implant site development. OE is typically performed using fixed appliances such as the straight-wire system or, in selected cases, clear aligners. Forces between 30 and 100 g per tooth are applied, depending on the clinical situation. In some protocols, OE is combined with fiberotomy to minimize gingival and bone migration. . Studies show that OE leads to significant vertical movement and increases in buccal bone height and interproximal septa. It enhances bone volume in targeted sites, making it valuable in implant site development. Compared to surgical crown lengthening, OE better preserves periodontal tissues and improves esthetics. . In this narrative review is analized how OE is effective for managing traumatic intrusions and compromised periodontal sites, particularly when paired with early endodontic treatment. It reduces the risks of ankylosis and root resorption while avoiding invasive procedures like grafting. Although clear aligners may limit axial tooth movement, OE remains a minimally invasive, cost-effective alternative in both restorative and implant dentistry.

摘要

正畸牵引(OE),即强制萌出,是一种保守技术,用于修复受冠折、外伤性牙嵌入或严重龋齿影响的牙齿。它包括施加轻柔、持续的力以诱导牙齿垂直移动,通过刺激牙周膜促进组织重塑。

本叙述性综述纳入了调查OE作为治疗方法用于处理深龋或龈下龋损、外伤性牙损伤(如牙嵌入或折断)或用于种植位点开发中牙槽嵴增高的研究。OE通常使用固定矫治器进行,如直丝弓系统,在某些情况下也使用透明矫治器。根据临床情况,每颗牙齿施加30至100克的力。在一些方案中,OE与纤维切断术联合使用以尽量减少牙龈和骨的移动。

研究表明,OE可导致显著的垂直移动,并增加颊侧骨高度和邻间隙。它增加了目标部位的骨量,使其在种植位点开发中具有价值。与外科冠延长术相比,OE能更好地保留牙周组织并改善美观。

在本叙述性综述中,分析了OE如何有效地处理外伤性牙嵌入和受损的牙周部位,特别是与早期牙髓治疗联合使用时。它降低了牙根粘连和牙根吸收的风险,同时避免了诸如植骨等侵入性手术。尽管透明矫治器可能会限制牙齿的轴向移动,但OE在修复和种植牙科中仍然是一种微创、经济有效的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9821/12470968/377eb0796ba0/jpm-15-00408-g001.jpg

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