Orthodontic traction

正畸牵引
  • 文章类型: Journal Article
    偶尔会发现永久第二摩尔(PM2)的撞击。这项研究试图探索与受影响的PM2牙齿相关的危险因素,并展示如何使用不同的治疗方式来纠正PM2牙齿的受影响。
    这项研究使用了三例PM2嵌塞,以说明如何识别PM2嵌塞的危险因素,以及如何消除这些危险因素,以促进受影响的PM2牙齿萌出到正确的咬合位置。
    第一和第二病例均显示两个上颌PM2牙齿的延迟萌出。在切除牙齿萌出路径上的致密纤维化牙龈组织后,这两个受影响的上颌PM2牙齿最终由于其固有的牙齿萌出潜力而萌出到正常的咬合位置。第二例也有两个下颌PM2牙齿的近角撞击。牙齿38和48的牙齿进行牙齿切除术后,两个受影响的下颌PM2牙齿也因其固有的牙齿萌出潜力而萌出到正常的咬合位置。第三种情况是牙齿17、27和47的撞击。拔除四个第三磨牙和四个选定的前磨牙后,四个永久性第一磨牙的正畸中介化,使用微型螺钉进行正畸牵引,三颗受影响的牙齿最终爆发到正常的咬合位置。
    我们得出结论,在消除牙齿萌出路径上的障碍之后,受影响的PM2牙齿通常可以通过其固有的牙齿萌出潜力在有或没有正畸牵引的帮助下萌出到正常的咬合位置。
    UNASSIGNED: Impaction of permanent second molar (PM2) is found occasionally. This study tried to explore the risk factors associated with the impacted PM2 teeth and show how to use different treatment modalities to correct the impaction of PM2 teeth.
    UNASSIGNED: This study used three cases of PM2 impaction to show how to identify the risk factors of PM2 impaction and how to remove these risk factors to facilitate the eruption of impacted PM2 teeth to the correct occlusal positions.
    UNASSIGNED: The first and second cases both showed delayed eruptions of two maxillary PM2 teeth. After resection of the dense fibrotic gingival tissues on the tooth eruption pathway, these two impacted maxillary PM2 teeth finally erupted to the normal occlusal positions by their inherent tooth eruption potential. The second case also had mesioangular impaction of two mandibular PM2 teeth. After odontectomy of teeth 38 and 48, the two impacted mandibular PM2 teeth also erupted to the normal occlusal positions by their inherent tooth eruption potential. The third case had impaction of teeth 17, 27 and 47. After extraction of four third molars and four selected premolars, orthodontic mesialization of four permanent first molars, and orthodontic traction using a mini-screw, the three impacted teeth finally erupted to the normal occlusal positions.
    UNASSIGNED: We conclude that after removing the obstacles on the tooth eruption pathway, the impacted PM2 teeth usually can erupt to their normal occlusal positions by their inherent tooth eruption potential with or without the assistance of orthodontic traction.
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  • 文章类型: Case Reports
    牙源性囊肿是一种发育性牙源性无症状囊肿,与未萌出或受影响的牙齿的牙冠有关。早期诊断对于避免任何未来并发症和选择最佳治疗方案很重要。本病例报告的目的是描述使用正畸牵引作为保守治疗方法的年轻女性患者与下第二磨牙相关的牙病囊肿的处理。该程序有助于为患者节省不必要的手术切除程序和相关的过度骨切除,以获得安全裕度。刺激骨骼愈合并促进囊肿相关牙齿的萌出。
    The dentigerous cyst is a developmental odontogenic asymptomatic cyst, that is associated with the crown of an unerupted or impacted tooth. Early diagnosis is important to avoid any future complications and choose the best treatment option. The purpose of this case report is to describe the management of a dentigerous cyst related to lower second molar in a young female patient using orthodontic traction as a conservative treatment approach. This procedure helps to spare the patient an unnecessary surgical excision procedure and the associated excessive bone removal for a safety margin, stimulates bone healing and promotes the eruption of the cyst-associated tooth.
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  • 文章类型: Journal Article
    目的:拔除下颌阻生第三磨牙(IMTM)是口腔颌面外科最常见的手术。下牙槽神经(IAN)损伤是一种罕见但严重的并发症,在下牙槽管(IAC)附近的IMTM病例中,风险明显更高。提取这种IMTM的现有手术方法不够安全或耗时。需要更好的外科手术设计。
    方法:2019年8月至2022年6月,南京口腔医院赵医生对23例患者进行了IMTM摘除术,医学院附属医院,南京大学,并被发现在IAC附近有IMTM。由于IAN受伤风险很高,
    结果:冠状动脉切除术-微型手术插入和完全切除IMTM之间的时间为32.65±2.110天,明显短于传统正畸牵引。两点辨别测试显示没有IAN受伤,随访期间患者未报告损伤。其他并发症,如严重肿胀,严重出血,干燥插座,和有限的张嘴,没有被观察到。与传统的IMTM拔除组相比,冠状动脉切除术-微型牵引组的术后疼痛水平并没有显着升高。
    结论:对于靠近IAC且必须提取的IMTM,冠状动脉切除术-微型机组人员牵引是一种新颖的方法,可以以更省时的方式将IAN损伤的风险降至最低,并发症的可能性较低。
    OBJECTIVE: Extraction of impacted mandibular third molars (IMTMs) is the most common surgery performed in the Department of Oral and Maxillofacial Surgery. Inferior alveolar nerve (IAN) injury is a rare but severe complication, and the risk is significantly higher in cases of IMTM near the inferior alveolar canal (IAC). The existing surgical method to extract such IMTMs is either not safe enough or is time-consuming. A better surgical design is needed.
    METHODS: From August 2019 to June 2022, 23 patients underwent IMTM extraction by Dr. Zhao at Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, and were found to have IMTMs in close proximity to the IAC. Due to high IAN injury risk, these patients underwent coronectomy-miniscrew traction to extract their IMTMs.
    RESULTS: The time between coronectomy-miniscrew insertion and complete removal of the IMTM was 32.65 ± 2.110 days, which was significantly shorter than that of traditional orthodontic traction. Two-point discrimination testing revealed no IAN injury, and no injury was reported by patients during follow-up. Other complications, such as severe swelling, severe bleeding, dry socket, and limited mouth opening, were not observed. Postoperative pain levels were not significantly higher in the coronectomy-miniscrew traction group than in the traditional IMTM extraction group.
    CONCLUSIONS: For IMTMs that are in close proximity to the IAC and must be extracted, coronectomy-miniscrew traction is a novel approach to minimize the risk of IAN injury in a less time-consuming way with a lower possibility of complications.
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  • 文章类型: Clinical Trial Protocol
    背景:上颌恒切牙的萌出失败通常出现在7至9岁的混合牙列中。缺失和未萌出的上颌切牙可以被认为是没有吸引力的,并且对面部和牙齿美学有潜在的负面影响。多余牙齿(或牙瘤)的存在通常是导致永久性上颌切牙萌出或嵌塞失败的原因。这项试验的主要目的是调查与上颌切牙相关的萌出的成功,这些切牙由于上颌前牙的多余牙齿而未能萌出。
    方法:本方案描述了一项介入多中心双臂随机临床试验。符合资格标准的参与者将被随机分配(不受限制的平等参与者分配[1:1]),以使用正畸矫治器创建空间,去除多余的牙齿,并使用正畸矫治器进行直接正畸牵引或空间创造,去除多余的牙齿和监测。该试验的主要结果是确定移除多余牙齿后6个月成功爆发的上颌中央永久切牙的患病率。次要结果指标包括(1)初始牙齿位置(影像学评估)对牙齿萌出时间的影响,(2)将未萌出的牙齿对准正确的咬合位置所需的时间,(3)牙龈美学和(4)自我报告的口腔健康相关生活质量(OHRQoL)(治疗前后)的变化。
    结论:缺乏对干预措施的有效性进行比较的高质量、稳健的前瞻性研究。此外,英国国家临床指南强调,缺乏明确的治疗方案来治疗因多生牙齿而出现上颌切牙未萌出的儿童.该试验的结果将为未来的治疗指南提供指导,以管理幼儿的这种情况。
    背景:ISRCTN注册表ISRCTN12709966。2022年6月16日注册。
    BACKGROUND: Failure of eruption of the maxillary permanent incisor teeth usually presents in the mixed dentition between the ages of 7 and 9 years. Missing and unerupted maxillary incisors can be regarded as unattractive and have a potentially negative impact on facial and dental aesthetics. The presence of a supernumerary tooth (or odontoma) is commonly responsible for failed eruption or impaction of the permanent maxillary incisors. The primary objective of this trial is to investigate the success of eruption associated with maxillary incisor teeth that have failed to erupt because of a supernumerary tooth in the anterior maxilla.
    METHODS: This protocol describes an interventional multicentre two-arm randomised clinical trial. Participants meeting the eligibility criteria will be randomised (unrestricted equal participant allocation [1:1]) to either space creation with an orthodontic appliance, removal of the supernumerary tooth and application of direct orthodontic traction or space creation with an orthodontic appliance, removal of the supernumerary tooth and monitoring. The primary outcome of this trial is to determine the prevalence of successfully erupted maxillary central permanent incisors at 6 months following removal of the supernumerary tooth. Secondary outcome measures include (1) the effect of initial tooth position (assessed radiographically) on time taken for the tooth to erupt, (2) time taken to align the unerupted tooth to the correct occlusal position, (3) gingival aesthetics and (4) changes in the self-reported Oral Health Related-Quality of Life (OHRQoL) (pre-and post-treatment).
    CONCLUSIONS: There is a lack of high-quality robust prospective studies comparing the effectiveness of interventions to manage this condition. Furthermore, the UK national clinical guidelines have highlighted a lack of definitive treatment protocols for the management of children who present with an unerupted maxillary incisor due to the presence of a supernumerary tooth. The results of this trial will inform future treatment guidelines for the management of this condition in young children.
    BACKGROUND: ISRCTN Registry ISRCTN12709966 . Registered on 16 June 2022.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    本综述的目的是评估传统方法和加速方法在治疗持续时间方面的疗效,速度,牙周,和患者报告的变量。在9个数据库中对1990年1月至2021年10月之间发表的随机对照试验(RCT)和对照临床试验(CCT)进行了电子搜索。手工搜索了五个主要的正畸期刊以进行其他研究。参与者是单侧或双侧PICs患者,他们接受了固定矫治器的常规或加速正畸治疗。使用Cochrane的RCT偏倚风险工具(RoB2工具)和CCT的ROBINS-I工具评估偏倚风险。建议评估的分级,发展,和评估(GRADE)指南用于评估证据的总体质量。本综述包括9篇文章(8篇RCT和1篇CCT)(371例患者)。在大多数研究中,机械牵引方法对治疗结果的可能影响尚不清楚。当使用传统技术进行开放手术时,治疗时间缩短(约3至6个月),而使用加速方法时,牵引速度显着增加(约1-1.5mm/月)。常规干预组之间无显著差异,以及传统和加速群体之间,就大多数牙周变量而言(p>0.005)。在短期随访(1-10天)中比较不同的暴露方法时,与传统PICs牵引相关的疼痛水平没有显着差异,而在这些方法之间的疼痛发生率中发现了矛盾的结果。未评估疼痛/不适水平与机械牵引方法类型之间的关系。根据等级,支持这些发现的证据质量从低到极低不等.开放式手术技术与超弹性丝或弹性牵引装置的各种设计的组合可以导致PIC的正畸治疗持续时间的减少。通过微型支架使用直接锚固将PIC从相邻的牙齿根部移开可以导致根部吸收的减少并缩短治疗时间。支持这些发现的证据从低到非常低。使用不同类型的机械装置进行常规PIC牵引,使用开放式或封闭式牵引技术,并不会导致干预组之间牙周结局的显着差异。关于感知疼痛的严重程度与手术暴露类型存在矛盾的结果,该变量与机械牵引方式的关系尚不清楚。在PIC牵引中使用加速方法可导致牵引运动速度的增加,而加速方法与常规方法之间的牙周结局没有显着差异。支持这些发现的证据从低到非常低。需要更多高质量的随机CCT来建立该领域的良好证据。在本审查的第一阶段,本系统审查的方案已在国际前瞻性系统审查登记册(PROSPERO;CRD42021274476)中注册。
    The objective of the current review was to evaluate the effectiveness of traditional and accelerated methods of palatally impacted canine\'s (PIC) traction in terms of treatment duration, velocity, periodontal, and patient-reported variables. An electronic search for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) published between January 1990 and October 2021 was conducted in nine databases. Five major orthodontic journals were hand searched for additional studies. The participants were patients with unilateral or bilateral PICs who received conventional or accelerated orthodontic treatment with fixed appliances. Cochrane\'s risk of bias tool (RoB 2 tool) for RCTs and ROBINS-I tool for CCTs were used to assess the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines were used to assess the overall quality of the evidence. Nine articles (eight RCTs and one CCT) were included in this review (371 patients). There was no clarity in most studies about the possible effect of the mechanical traction method on treatment outcomes. The treatment duration decreased (about three to six months) when the open surgical method was used with traditional techniques and the traction velocity increased significantly (about 1-1.5 mm/month) when acceleration methods were used. No significant differences were found between the conventional intervention groups, as well as between the traditional and accelerated groups, in terms of most periodontal variables (p > 0.005). No significant differences were found in the pain levels associated with traditional PICs\' traction when comparing different exposure methods in the short-term follow-up (1-10 days), while contradictory results were found in the pain incidence between these methods. The relationship between the pain/discomfort levels and the type of mechanical traction method was not evaluated. According to the GRADE, the quality of evidence supporting these findings ranged from low to very low. The combination of the open surgical technique with various designs of either superelastic wires or elastic traction means can lead to a reduction in the orthodontic treatment duration of PICs. The use of direct anchorage by miniscrews to move the PICs away from the adjacent teeth roots can lead to a reduction in root resorption and shorten the treatment duration. The evidence supporting these findings ranged from low to very low. The use of different types of mechanical means for conventional PICs\' traction, with the use of open or closed traction techniques, does not lead to significant differences in periodontal outcomes between intervention groups. Contradictory results exist regarding the severity of the perceived pain in relation to the surgical exposure type, and the relationship between this variable and the mechanical traction method is still unclear. The use of accelerated methods for PICs\' traction can lead to an increase in the velocity of traction movement with no significant differences in periodontal outcomes between accelerated and conventional methods. The evidence supporting these findings ranged from low to very low. More high-quality randomized CCTs are needed to establish good evidence in this field. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021274476) during the first stages of this review.
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  • 文章类型: Case Reports
    Impaction of canine is frequently encountered clinical problem in orthodontics. Canine usually erupts when two third of the root development is complete. It is considered as impacted if the root development is completed, but unaided eruption is not expected to occur. Surgical exposure of impacted canine and orthodontic traction to align the tooth is a major challenge in which the management requires a multidisciplinary approach. This article presents a case of impacted canine in a 20-year-old female patient. Impacted canine was aligned by orthodontic traction using a modified eyelet attachment and guided eruption without repeated surgical intervention or tissue damage. In the clinical case discussed, the bonding attachment used was a low-profile Begg bracket containing multiple eyelets for varying the force of traction and also to apply force along the long axis of the tooth. An ideal traction force was applied for the adequate period of time thus minimizing the side effects. This method proved to be efficient in maintaining good periodontal and mucogingival health and thus satisfying both esthetic and function goals.
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  • 文章类型: Journal Article
    The use of orthodontic traction to preserve healthy subgingival residual root is a classical method combining the treatment of restoration and orthodontics. Based on the target restoration space (TRS), by establishing a TRS digital model, the final traction position of the subgingival residual root can be preset. After evaluating the key parameters such as crown-to-root ratio and minimum crown height, clinicians can estimate the treatment time and exclude cases with bad preset position. The time of traction treatment can be effectively reduced, and the efficiency and efficacy of the entire treatment can also be improved.
    牵引保存患者健康的龈下残根是当前修复与正畸联合治疗的经典内容。以满足最终目标修复体空间(TRS)需求为核心,通过TRS数字化模型,可以选择预设适合的龈下残根的最终牵引位置,并自动评估牵引后的冠根比、最小冠高度等关键参数后,预估治疗时间,并排除预设位置不良的病例,最终获得符合TRS的正畸牵引-修复方案,可以有效地减少牵引治疗时间,也提高了整个修复正畸联合治疗的效率和疗效。.
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  • 文章类型: Journal Article
    OBJECTIVE: Maxillary impacted canines (MIC) could suffer root changes after canine traction. The aim of this study was to evaluate the 3-dimensional root changes in buccal versus palatal MIC after orthodontic traction.
    METHODS: This longitudinal and retrospective study included pre-treatment and after traction cone beam computed tomography scans (CBCTs) of 30 subjects with unilateral/bilateral MIC. A total of 43 MIC were divided into 2 groups: buccal (n=17) or palatal (n=26). Root changes in length and area after orthodontic traction were measured at sagittal, coronal and axial sections. Intergroup comparison was carried out by t or U Mann-Whitney tests, depending on normality. Multiple linear regression analysis was used to evaluate the influence of all predictor variables on root changes (P<0.05).
    RESULTS: Significant difference between groups was found for root area changes in the upper limit of the cervical third at axial section that showed greater appositional values for the palatal impacted canine group (-1.18mm2) and resorptive values for the buccal impacted canine group (0.62mm2) (P=0.024). Position of impaction palatal influenced the increase of root area in the coronal section and in the upper limit of the cervical third at axial section. Age directly influenced the decrease of total length and root area in sagittal and coronal sections, respectively.
    CONCLUSIONS: Orthodontic traction of MIC produced an important appositional root change in the palatal impaction group in the axial root area of the upper limit of the cervical third. Impaction position and age influenced the increase and decrease of root area and length of some specific radicular regions.
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  • 文章类型: Case Reports
    Odontogenic keratocysts (OKCs) are one of the most aggressive cysts in the oral and maxillofacial area because of their high recurrence rate and infiltrative behavior. In growing patients with OKCs, a radical treatment approach might cause numerous complications, including the disturbance of jaw growth and loss of the involved tooth. This case report describes successful comprehensive orthodontic treatment combined with marsupialization of the cyst in a young girl who exhibited an OKC with impacted teeth. The 10-year-old girl presented with an OKC extending from the mandibular symphysis through the left mandibular body, with ectopic impaction of the mandibular left canine and first premolar, as well as congenitally missing bilateral mandibular second premolars. Interestingly, spontaneous improvement of the positions of the ectopic impacted teeth, along with a reduction in the size of the cyst, occurred during marsupialization. The sequential use of removable and fixed appliances enabled orthodontic traction of the impacted teeth. The treatment outcome was stable at 2.5 years after the end of the treatment. We speculate that comprehensive orthodontic treatment combined with marsupialization can be an effective treatment strategy for patients with OKCs, especially when they are encountered in young, growing patients with impacted teeth.
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