腭中缝微种植钉间接支抗压低上颌磨牙的临床研究

摘要

目的：评价应用腭中缝微种植钉间接支抗压低上颌磨牙的临床效果。方法选择上颌磨牙伸长的患者30例，平均年龄37岁。腭中缝两侧2~3mm区各植入微种植支抗钉1枚，利用铸造支架在伸长牙颊舌侧各设计2个加力点，流体树脂将微种植支抗钉、铸造支架、伸长磨牙附件2个天然牙稳定连接形成新的绝对支抗源，橡皮链十字交叉加力压低，力值1.47~1.96N。分别测量治疗前后伸长磨牙近颊尖到腭平面、近中牙槽嵴顶到平面以及近腭尖到根尖的距离，并记录牙周探针的深度，最后进行统计学分析。结果30例患者磨牙均实现有效压低，压低值平均为3.4mm，治疗时间4~8个月，平均为6.5个月。治疗前后伸长牙牙周探诊深度、伸长磨牙近中牙槽嵴顶到磨面距离、近中颊尖到根尖长度的差异没有统计学意义（P>0.05）。治疗前后近颊尖到腭平面之间的距离差异具有统计学意义（P<0.01）。治疗中未发现患牙牙髓坏死以及种植钉松动脱落。结论腭中缝微种植钉间接支抗可以有效压低伸长的上颌磨牙。%Obejective To evaluate the effect of midpalatal miniscrew on indirect anchorage for maxil-lary molar intrusion. Methods 30 cases with maxillary molar extrusion were selected and the average age was 37 years old. In the area 2-3mm beside the midpalatal suture, the miniscrews were inserted on each side separately. Two intruding force point on the buccal and lingual side of the extruded molars was made by customized casting four-point intruding frame . The flowable resin rigidly connected the miniscrews, cast frame and 2 teeth near the extruded molars and formed the new absolute anchorage. The elastic chain was used to provide intruding force and the force of 1.47-1.96N was applied across the occlusal surface. The distances between the mesical buccal cusp and the paltal plane, the alveolar crest and the occlusal surface, the mesial lingual cusp and the apical apex of the extruded molars before and after treatment were measured and the periodonfal probing depth was also recorded. All data obtained were statistically analyzed. Results All the extruded molars were intruded effectively and the average intrusion distance was 3.4mm. Treatment time was 4-8 months and the average time was 6.5months. There were no significant difference in periodontal probing depth, the distance between the alveolar crest and the oc-clusal surface of the extruded molars and the distance between the mesial lingual cusp and the apical apex before and after treatment(P>0.05), while there is significant difference in the distance between the medial buccal cusp and the paltal plane(P<0.01). During the treatment , no pulp necrosis and loosening of the miniscrews been observed. Conclusions The extruded upper molars can be intruded effectively by the indirect anchorage of the midpalatal miniscrews.