CAJ | 학술논문

目的：探讨阻生上颌尖牙合适的临床处理策略，为其合理治疗提供依据。方法回顾2000-2012年期间在大连市口腔医院正畸科接受治疗的35例阻生上颌尖牙病例的临床资料，总结分析尖牙阻生状况及相应的治疗措施和疗效。临床处理方法包括拔除、助萌和导萌。结果拔除2例；只做正畸治疗的助萌法16例，留出足够间隙后等待阻生尖牙自行萌出，观察时间5～24个月，均取得良好治疗效果，矫治后阻生尖牙牙龈形态及牙根状况良好；正畸附加外科手术牵引的导萌法17例，除1例21岁男性患者外，其余16例均牵引到位，但矫治后部分阻生尖牙牙龈形态不如助萌法矫治后。结论当阻生上颌尖牙牙体严重畸形、根弯曲短小及高位近远中向横位阻生时考虑拔除；阻生上颌尖牙近远中向错位不严重，扩弓或减数拔牙即可为阻生尖牙留出足够萌出间隙，判断其能自然萌出时首选助萌法；阻生上颌尖牙近远中向错位严重或阻生尖牙已伤及邻牙牙根、仅用正畸治疗无法去除阻生尖牙萌出障碍时采用导萌法，导萌术后的牵引需注意控制牵引方向及大小，要避免伤及邻牙牙根，尽量使阻生牙从附着龈萌出，有利于形成良好的牙龈形态。
목적：탐토조생상합첨아합괄적림상처리책략，위기합리치료제공의거。방법회고2000-2012년기간재대련시구강의원정기과접수치료적35례조생상합첨아병례적림상자료，총결분석첨아조생상황급상응적치료조시화료효。림상처리방법포괄발제、조맹화도맹。결과발제2례；지주정기치료적조맹법16례，류출족구간극후등대조생첨아자행맹출，관찰시간5～24개월，균취득량호치료효과，교치후조생첨아아간형태급아근상황량호；정기부가외과수술견인적도맹법17례，제1례21세남성환자외，기여16례균견인도위，단교치후부분조생첨아아간형태불여조맹법교치후。결론당조생상합첨아아체엄중기형、근만곡단소급고위근원중향횡위조생시고필발제；조생상합첨아근원중향착위불엄중，확궁혹감수발아즉가위조생첨아류출족구맹출간극，판단기능자연맹출시수선조맹법；조생상합첨아근원중향착위엄중혹조생첨아이상급린아아근、부용정기치료무법거제조생첨아맹출장애시채용도맹법，도맹술후적견인수주의공제견인방향급대소，요피면상급린아아근，진량사조생아종부착간맹출，유리우형성량호적아간형태。
Objective To investigate the suitable treatment methods of maxillary impacted canine of different status. Methods A retrospective study was done. Treatment records for 35 maxillary canine impacted cases treated of recently 10 years were analyzed .The treatment methods included helping eruption,surgically guided eruption and extraction. Re-sults There were 2 cases extracted and helping eruption in 16 cases. The waiting eruption time was 5-24 months. Good results were obtained in all cases except one 16-year old boy’s upper left canine pulp necrosis while erupting. Surgically guided eruption was done in 17 cases,and in 16 cases the impacted teeth were moved to the dental arch. Only one 21-year old patient,impacted canine was supposed partially ankylosed,the impacted tooth was moved slowly and the pa-tients refused to pull the tooth. Conclusion The teeth should be extracted it they are with severity deformity,curved short root,and are impacted in high position mesiodistally. When orthodontic expansion or extraction can achieve enough space for impacted canine and the canine can erupt spontaneously,helping eruption is preferred.When orthodontic treat-ment alone cannot remove the obstacle in the path of the canine eruption ,or ectopic canine presses to adjacent tooth root ,causing the root desorption,surgically guided eruption methods should be performed as quickly as possible. During surgically guided eruption,the direction and the force should be proper to avoid damage to gingiva.