目的 分析儿童上颌前牙弓外牙的临床特点,研究矫正治疗,探讨其矫治效果.方法 选择46例上颌前牙弓外牙的儿童患者,采用减数拔牙,使用方丝弓,直丝弓固定矫治,结合Ⅰ类、Ⅱ类牵引,方丝控根移动使12、22完全移至牙弓内,关闭牙弓间隙,调正上、下关系正中牙合.治疗前、后经临床检查,X线头影测量分析,曲面断层片,头颅侧位片、以及治疗前后模型测量分析对照,评价治疗效果.结果 46例儿童固定矫治后,ANB角减小0.98°;UI/SN和UI/PP分别减小7.86°和9.82°;LI/MP减小了4.1°;UIA-PTV和UIE-PTV分别减小了2.73mm和5.12mm;LIE-PTV和LIA-PTV分别减小了3.38mm、1.31mm;UM-PTV和LM-PTV分别增加了3.56m和4.38,与矫治前相比,差异均在5%上,统计学显著,大部分在差异的P值小于1%.另外,患者面部左右对称,上、下牙弓排列整齐,磨牙中性关系,覆牙合、覆盖关系正常.结论 儿童前牙弓外牙通过临床早期矫治或双期矫治可达到明显的临床效果.%Objective To analyze the clinical characteristics of teeth outside maxillary anterior arch in children, and to investigate the effects of orthodontic treatment on retaining teeth outside arch. Methods 46 chil-dren patients with teeth outside maxillary anterior arch were selected, using subtractive extraction, with edgewise and straight wire fixed appliance. Combined with class I, II traction, controlling root movement by edgewise com-pletelymovedteeth (12, 22) inside the dental arch, caused space closure and adjusted the centric relation occlusion. The result of X-ray analysis, cephalometric roentgenography, lateral cephalogram, as well as the measurement of the model before and after clinical examinationwere compared and analyzed. Results After the treatment of 46 children with fixed orthodontic treatment, ANB angle decreased by 0.98 degree. UI/PP and UI/SN, respectively, de-creased by 7.86 degrees and 9.82 degreesthan before. While LI/MP decreased by 4.1 degrees, and UIE-PTV, UIA-PTV decreased by 2.73mm, 5.12mm. LIE-PTV and LIA-PTV also decreased by 3.38mm and 1.31mm, respec-tively. At the meantime, UM-PTV, LM-PTV increased by 3.56mm and 4.38mm, respectively. There are statistically significant differences between two groups before and after treatment(P<0.01). Moreover, Patients'faces were-bilateral symmetry.,and dental arch were in alignment. Also the centric relation occlusion, overbite and covering relationships are normal. Conclusion Children's teeth outside the dental arch can be corrected well via clinical early orthodontic treatments.
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