Villani S, Stellzig A, Komposch G
Clinica Odontostomatologica, Ruprecht-Karls-Universität Heidelberg.
Minerva Stomatol. 1995 May;44(5):211-22.
The authors have investigated different clinical cases having in common the agenesis of the permanent upper lateral incisors, to evaluate from a clinical and esthetic point of view the possibilities, results and the limits of the orthodontic treatment. These are nowadays increasingly associated with esthetic dentistry, prosthodontics, implantology and finally with dental transplantation. The patients presented the absence of one or both permanent upper lateral incisors or the agenesis of other teeth, sometimes associated with dental crowding or a not favourable intermaxillary relation. Most of the cases were treated with compensatory extraction of the other normal or hypoplastic permanent upper lateral incisor. The results were satisfactory but the mean treatment time was relatively long (56 months, including the retention phase), according to the difficulty of obtaining a good esthetic result in the smile line. The importance of a correct point of time of the interception for the choice of the most adequate therapy is emphasized. The possibility of correcting occlusal relation by means of the orthopedic treatment of the maxillary structures is limited to the end of the deciduous dentition. The diagnostic criteria for a correct and opportune interception of this anomaly are being stressed on. Finally the esthetic problems arising of the orthodontic space closure and the possible solutions were discussed.
作者研究了具有恒牙上侧切牙先天缺失这一共同特征的不同临床病例，从临床和美学角度评估正畸治疗的可能性、结果及局限性。如今，正畸治疗越来越多地与美容牙科、口腔修复学、种植学以及最终的牙移植相关联。患者表现为一颗或两颗恒牙上侧切牙缺失，或其他牙齿先天缺失，有时伴有牙列拥挤或不利的颌间关系。大多数病例采用对另一颗正常或发育不全的恒牙上侧切牙进行代偿性拔牙的方法进行治疗。根据在微笑线获得良好美学效果的难度，结果令人满意，但平均治疗时间相对较长（56个月，包括保持阶段）。强调了在合适的时间点进行干预对于选择最恰当治疗方法的重要性。通过对上颌结构进行正畸治疗来纠正咬合关系的可能性仅限于乳牙列末期。文中着重阐述了正确且适时干预这种异常情况的诊断标准。最后讨论了正畸关闭间隙所产生的美学问题及可能的解决方法。
