微种植体支抗结合选择性上颌第一磨牙拔除应用于二次正畸治疗错殆畸形的疗效分析

目的探讨使用微种植体支抗对二次正畸病例拔除上颌第l磨牙矫正错牙合畸形的临床疗效。方法对在外院矫治失败后病例24例，采用拔除上颌双侧第1磨牙，以及运用微种植体从颊部牙槽嵴置入上颌骨，以此作为支抗矫正错黯畸形。拍摄所有患者治疗前后的头颅侧位x线片，口内和面部像片，比较治疗前后的覆黯、覆盖、磨牙关系和前牙内收程度。结果除2例患者因3枚种植体松动再次手术置人外，其他病例均一次性种置成功。所有病例均获得了磨牙强支抗；建立r正常的前牙覆船、覆盖关系，面型得到了明显改善。结论微种植体支抗及选择性拔除上颌第1磨牙以矫正正畸失败后病例，在减数拔牙条件不宽的情况下，采用：诈常规拔牙方式，支抗位置稳定，患者易于接受，疗效肯定，是正畸失败后二次矫正的理想选择。

Effect of micro-implant anchorage combined with selective extracting maxillary first molar on second orthodontic treatment of malocclusion

Objective To analyze the clinical effect of both micro-implant anchorage and selec tive extracting maxillary first molar to correct the failure of orthodontics. Methods From January 2006 to June 2012, 24 cases who suffered from failure of orthodontics were treated in this department. To all patients, bilateral maxillary first molars were extracted, and micro-implant anchorage were planted into maxilla from buccal alveolar ridge to correct malocclusion acting as anchorages. Lateral cephalometric radiographs, intraoral photograph and facial photograph of every patient were taken he fore and after treatments; Their over bite and overjet molar relationship and incisors retraction were compared before and after treatments. Methods All the micro implant anchorages were sucessfuly im planted except two patients who experienced second operation owing to luxation of three implants. All the molars were strengthed and the profile improved along with their normal over bite and overjet. Conclusions The treatment of using micro-implant anchorage and selective extracting maxillary first molar is an ideal option of second orthodontics. Unconventional tooth extraction is used in this treat ment. Micro implant anchorages are stable, acceptable and effective in clinical application.