Maxillary Molar Intrusion with Fixed Orthodontic Appliances and Bony Anchorage-A Preliminary Report with a 3-D Analysis

應用骨性錨定系統於上顎大臼齒矯正壓入治療－三度空間分析之初期報告

陳幸妤(Hsing-Yu Chen) ； 姚宗珍(Chung-Chen Jane Yao) ； 張端青(Zwei-Chieng Jenny Chang) ； 張心涪(Hsin-Fu Frank Chang) ； 陳坤智(Kun-Chee Chen) ； 陳羿貞(Yi-Jane Chen)

《中華牙醫學雜誌》 23卷5期 (2004/10) Pp. 353-360

https://doi.org/10.7105/CDJ.200410.0353

摘要

因失去對咬牙而過度萌發的上顎大臼齒可能造成牙周、咬合幹擾等問題。要壓入過度萌發的牙齒需要充分的錨定支持，包括口內多顆牙的連結、口外裝置如頭套的配戴、以及新發展的微植體作為骨性錨定運用等等方式。本研究的目的是探討當過度萌發的上顎大臼齒接受微植體以及部分或全口的矯正治療後，大臼齒的壓入性移動程度確實為何？以及同一牙弓內相鄰牙齒的各自移動情形。本研究取二十名上顎大臼齒過度萌發之患者的治療前及完成臼齒壓入後的牙齒模型進行分析。利用三度空間五軸同動測量儀測量並記錄欲分析之牙齒的牙尖點和齶皺褶上之參考點，治療前後牙齒模型之三度空間資料以齶皺褶之參考點進行疊合，並且分析相對於咬合平面的牙齒壓入位移量。研究結果顯示上顎第一大臼齒平均壓入量為3~4mm，最大值可達8mm。與上顎第一大臼齒相鄰近之其他牙齒，包括上顎第二大臼齒，以及上顎第一、第二小臼齒，平均壓入量為l~2mm。各個牙齒的頰側和齶側壓入量並沒有明顯差異。因此，固定矯正裝置配合微植體如鈦金屬骨釘與骨板的運用，對於過度萌發的上顎臼齒可獲得確實有效的壓入治療結果。

關鍵字

骨釘 ； 骨板 ； 矯正錨定 ； 臼齒壓入

並列摘要

Overeruption of upper molars due to loss of antagonists may cause problems such as periodontal defects and occlusal interference. Molar intrusion requires anchorage support from intraoral multi-unit teeth, extraoral headgear wear or newly adopted miniscrew and miniplate as bony anchorages. The aim of this study was to investigate the amount of individual tooth movement within the same arch in cases of overerupted maxillary molars receiving partial or full-mouth fixed orthodontic treatment with miniscrews and miniplates used as anchorage. The surface topology of the cusp tips and incisal edges of the pretreatment and post-intrusion dental casts were recorded using a desktop mechanical 3D digitizer. The 3D data of the pretreatment and the post-intrusion dental casts were traced, processed, synthesized, and analyzed to distinguish the direction and magnitude & individual tooth movements. Results of this study demonstrated that the average intrusive movement of the upper first molars was 3 to 4mm with a maximum value of over 8mm. For the adjacent upper second molar and the upper first and second premolars, the amount of intrusion was around 2mm. A small difference between the buccal and palatal cusps was noted in the quantitative analysis of intrusive tooth movement. In conclusion, a significant amount of intrusion for overerupted maxillary molars can be obtained in a well-controlled manner using fixed appliances with mini-implants such as titanium miniscrews and miniplates serving as bony anchorage.

並列關鍵字

miniscrew ； miniplate ； arthodontic anchorage ； molar intrusion