手術置位合併矯正治療 ─ 混合齒列期阻生門齒難症之簡化療程

Surgical Repositioning Combining Orthodontic Therapy: A Simplified Treatment for Difficult Impacted Incisors in Mixed Dentition

蔡宗平(Tzong-Ping Tsai)

《中華民國兒童牙科醫學會雜誌》 2卷3期 (2002/10) Pp. 58-67

https://doi.org/10.6319/JTAPD.2002.2(3).4

摘要

研究目的：門齒阻生常於孩童時期被診斷出來。在臨床上治療之選擇，可為拔除阻生門齒，手術露出合併矯正牽引及手術置位等。本文之目的在於報告採用手術置位合併矯正治療，在混合齒列期處理阻生門齒的術式及追蹤結果。方法：本報告中共有五位病例，6顆阻生門齒，其中三顆為牙冠倒長，4顆具有彎曲之牙根。 在手術置位之前，將空間以矯正方式打開。阻生門齒連同齒濾胞自骨槽中剝離開後，重新置位為正常方向及半萌發狀態。術後4個月進行矯正牽引完成治療。結果：所有手術置位之門齒均可作矯正之移動。年齡平均9歲。平均治療時間14.6個月。追蹤之時間平均33個月。置位門齒之牙齦外觀正常，4顆未成熟牙根之牙，均有牙根繼續成長及根管鈣化之情形，2顆已具關閉根尖之牙接受根管治療。結論：手術置位合併矯正治療有許多好處，牙齒移動快且自由度大，美觀立即獲得改善，手術本身單次完成且不複雜，矯正治療簡單省時，治療結果牙齦外觀正常且可與生長發育相容配合。對於困難之阻生門齒，此術式當可視為一安全，有效，簡化，可靠之治療選擇。

關鍵字

門齒阻生 ； 手術置位 ； 矯正治療

並列摘要

Purpose: Children with incisor impaction create challenge to clinicians. Treatment options for difficult impacted incisor including extraction of the incisor, surgical exposure / orthodontic traction, and surgical repositioning / orthodontic therapy. The purpose of the report is to present the treatment procedure and follow-up results of the surgical repositioning approach. Methods: Five cases with total of six impacted maxillary incisors were treated. Of them three incisors were inverted and four incisors had root dilacerations. After adequate space was created, the involved incisor was uncovered and repositioned in semi-erupted position. Fixed orthodontic appliance was used to bring the incisor into proper alignment. Results: All repositioned incisors responded to orthodontic treatment. The mean age of the patients was 9Y 3M. The average treatment time to achieve proper incisor alignment was 14.6 months, including 4 months of observation after the surgery. The average follow-up period was 33 months. Two incisors required root canal therapy due to closed apex at the time of surgery. Continued root developments were observed in the rest of the repositioned incisors. Conclusions: Surgical repositioning combining orthodontic therapy has the advantages of immediate esthetic improvement, single and simple surgery, easy and short orthodontic treatment, good gingival margin, and compatible to normal dental and skeletal development. Surgical repositioning is a safe, fast and simplified treatment for impacted incisors. With proper management, it is a reliable treatment option, especially in difficult impacted cases.

並列關鍵字

Incisor Impaction ； Surgical Repositioning ； Orthodontic Therapy