牙间隔骨外科改建加速尖牙移动的临床疗效评价

目的　应用牵引装置牵引牙周韧带加速尖牙的移动。方法　选取临床上需拔除第一双尖牙后退尖牙的双颌前突正畸患者 13例 ,共 2 2颗尖牙 ,拔除第一双尖牙的同时 ,配合牙槽骨小手术 ,削弱尖牙远中移动的骨阻力 ,放置自制的牵引装置 ,牵引尖牙向远中的拔牙间隙 ,尖牙后退之前和之后均拍摄头颅侧位定位片和牙片。结果　 2 2颗尖牙在 3周内后退移动 6 .2 7mm ,第一磨牙近中移动 0 .84mm ,患者无明显疼痛。放射学检查显示 :尖牙的牙根吸收少 ,在牵张过程中和牵张后 ,在尖牙近中的牙周韧带中有新骨产生并迅速改建 ,牵张后 3个月牙槽骨逐渐成熟 ,已不能区分新旧牙槽骨。结论　通过牵引牙周韧带3周内完成尖牙的后退移动 ,尖牙的牙根吸收少 ,磨牙的支抗丧失少 ,患者无明显疼痛 ,临床应用安全。

A Clinical Study on Rapid Canine Movement through Undermined Interseptal Bone

Objective To use clinical application of the distraction device for a rapid canine retraction through distraction of the periodontal ligament. Methods Thirteen orthodontic patients (22 canines) who needed canine retraction and first premolar extraction were included. At the time of the first premolar extraction, the interseptal distal bone of the canine was undermined to weaken its resistance. Then a self-made distraction device was placed to distract the canine distally into the extraction space. Cephalometric and periapical X-rays were taken before and after the canine retraction. Results 22 canines were distracted 6.27mm into the extraction space within 3 weeks. The average mesial movement of the first molars was 0.84mm within 3 weeks. The patients reported no severe pain. The radiographic examination revealed that apical root resorption of the canine was minimal. New alveolar bone was generated and remodeled rapidly in the mesial periodontal ligament of the canine during and after the distraction. It became mature and indistinguishable from the native alveolar bone 3 months after the distraction. Conclusion The canines could be distracted distally into the extraction space within 3 weeks without significant complication.