下切牙先天缺失错牙合畸形的临床治疗(1)
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[摘要]目的：探讨下切牙先天缺失错牙合畸形的临床治疗方法。方法：选择下切牙先天缺失的错牙合畸形患者22例，对缺牙部位、缺牙数目、错牙合类型、矫治方法等进行分析。结果：10例单颗下切牙先天缺失患者中，有5例采用减数矫治，2例采用减径矫治，3例采用正畸结合修复的方法进行治疗。12例两颗下切牙先天缺失患者中，有8例采用减数矫治，4例采用正畸结合修复的方法进行治疗。治疗后所有患者上下牙列Bolton指数协调，咬合关系达到正常，侧貌外形得到改善。结论：对于下切牙先天缺失的错牙合畸形，应该根据患者的年龄、面型、牙弓突度、下切牙缺失部位、数目、中线及错牙合畸形等情况，在Bolton指数的指导下，制定不同的治疗计划，以达到良好的咬合关系和美观效果。
[关键词]下切牙先天缺失；正畸；Bolton指数
[中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455(2011)02-0291-02
Treatment for malocclusions with congenital missing lower incisors
YUAN Dai-run1,QIAN Hong2,YAN Ying-jian3
(1.People's Hospital of Qingchuan,Qingchuan 628100,Sichuan,China;2.Department of Orthodontics,School of Stomatology,The Fourth Military Medical University;3.Department of Stomatology,Shijiazhuang Medical College)
Abstract:ObjectiveTo investigate the treatment strategies for malocclusions with congenital missing lower incisors Methods22 patients who had malocclusions with congenital missing lower incisors were selected.The position and number of congenital missing lower incisors，classification of malocclusions and treatment strategies were studied.ResultsIn 10 patients with one congenital missing lower incisor,5 had tooth extraction, 3 had interproximal enamel stripping and 2 had combined orthodontic and prosthetic treatment.In 12 patients with two congenital missing lower incisors,8 had tooth extraction and 4 had combined orthodontic and prosthetic treatment.After treatment,all patients acquired normal occlusion and the Bolton index was coordinated in the upper and lower dentitions. Conclusion In malocclusions with congenital missing lower incisors,different treatment strategies should be made according to patient's age,facial type,protrusion of incisors,midline,absent incisor position and number, and manifestation of malocclusions,in order to acquire good occlusion and esthetics.
Key words:congenital missing lower incisors;orthodontics;Bolton index
下颌先天缺失一颗或两颗切牙在临床上较为常见，常导致咬合关系絮乱，前牙覆牙合、覆盖关系异常，上下中线不齐，下牙列散在间隙，上下牙列Bolton指数不调等，对患者的美观和功能均造成严重影响。本研究通过对下切牙先天缺失的错牙合畸形病例进行分析，探讨下切牙先天缺失的矫治方法，以期为临床治疗提供参考。
1资料和方法
1.1临床资料：选取2006～2009年来我院就诊的下切牙先天缺失的错牙合畸形患者22例(男10例，女12例)，年龄12～34岁，平均21岁。病例纳入标准：无恒牙拔牙史；全口曲面断层片显示：一颗或两颗下切牙牙胚先天缺失。错牙合畸形表现：下颌缺失一颗或两颗切牙，前牙深覆盖，深覆牙合，上下中线不齐 ......
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