微小种植体支抗压低前牙改善露龈笑临床探究.docVIP

微小种植体支抗压低前牙改善露龈笑临床探究[摘要]目的：评价利用微小种植体作为支抗压低前牙改善露龈笑的临床效果。方法：选取我科室9例（男5例，女4例）前牙过长，开唇露齿露龈笑的深覆牙合病例，年龄18.6～28.3岁，平均24.7岁。9例患者前牙区存在II度或III度深覆牙合，5例病例伴有不同程度的牙列前突。9例患者在佩戴固定戴矫治器后在上、下颌前牙区相应部位植入微小种植体，治疗前后拍摄全口曲面断层片进行测量对比，观察切牙的变化和改善露龈笑的情况。结果：9例患者治疗前后上下颌前牙均有不同程度的压低，上颌前牙平均压低3.8mm，下颌切牙平均压低3.0mm，深覆牙合得到有效的治疗，同时露龈笑有一定程度的改善。其中2例患者出现一定程度的牙根吸收。结论：利用微小种植体支抗能有效地治疗前牙过长开唇露齿，达到真正压低前牙解除深覆牙合的效果。 [关键词]微小种植体；开唇露齿；露龈笑 [中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455（2011）04-0655-03 Clinical Application of Miniscrew Implant anchorage for Intruding upper incisors in patients with gummy smile SHEN Huan,YANG Yong-jin,FA Yong-Hong,CAI Xing-wei (Department of Stomatology, General Hospital of the Second Artillery, Beijing100088, China) Abstract: ObjectiveThis study aims to evaluate the clinical effect of improving gummy smile by micro-implant anchorage for the anterior teeth intrusion.Methods 9 patients have been diagnosed with anterior teeth Ⅱ°or Ⅲ°deep overbite with gummy smile and incompetent lips, 5 males and 4 females, aged from 18.6 to 28.3 years, with the average of 24.7 years and 5 patients presents with protruding anterior teeth. Miniscrew Implants are inserted into the situation with fixed orthodontic appliances. Results All patients are taken panoramic radiograph before and after treatment. The edges of maxillary incisors are avergely intruded 3.8mm and mandibular incisors are avergely intruded 3.0mm. There are some degree of root resorption in 2 patients. Conclusion Miniscrew Implant anchorage can provide necessary anchorage to retract the front teeth in the clinical treatment of gummy smile and incompetent lips. Key words: Miniscrew Implant; incompetent lips ;gummy smile 正畸深覆牙合患者中，常伴随开唇露齿，其在临床矫正患者中的发生率较高，可达20.48%[1]。患者上下唇在自然状态下不能完全闭合，对患者的美观、功能及心理产生影响。传统上打开咬合主要依赖后牙的萌出，而在真正想达到压低上下前牙还是很困难的。而成年人由于面颌部垂直生长已经停止，通过后牙盟出矫正深覆牙合存在一定难度。20世纪90年代后，微小种植体作为一种新型支抗手段开始逐步应用于正畸临床[2]。本研究利用微小种植体植入上下前牙区作为支抗，成功压低上下前牙，治疗成年深覆牙合患者的开唇露齿，取得良好的效果。 1材料和方法 1.1临床资料：本研究选取2007～2009年我科收治的9例（男5例，女4例）前牙过长，Ⅰ度或II度