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中华口腔医学研究杂志(电子版) ›› 2024, Vol. 18 ›› Issue (02) : 111 -116. doi: 10.3877/cma.j.issn.1674-1366.2024.02.006

病例分析

上颌窦过度气化正畸牙齿关闭间隙1例
李宇欣1, 曹阳2, 徐开凡2,()   
  1. 1. 梅州市中医医院口腔科,梅州 514021
    2. 中山大学附属口腔医院,光华口腔医学院,广东省口腔医学重点实验室,广东省口腔疾病临床医学研究中心,广州 510055
  • 收稿日期:2023-11-29 出版日期:2024-04-01
  • 通信作者: 徐开凡

A case report of orthodontic teeth space closure through extensively pneumatized maxillary sinus

Yuxin Li1, Yang Cao2, Kaifan Xu2,()   

  1. 1. Department of Stomatology, Meizhou Hospital of Traditional Chinese Medicine, Meizhou 514021, China
    2. Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Guangzhou 510055, China
  • Received:2023-11-29 Published:2024-04-01
  • Corresponding author: Kaifan Xu
引用本文:

李宇欣, 曹阳, 徐开凡. 上颌窦过度气化正畸牙齿关闭间隙1例[J]. 中华口腔医学研究杂志(电子版), 2024, 18(02): 111-116.

Yuxin Li, Yang Cao, Kaifan Xu. A case report of orthodontic teeth space closure through extensively pneumatized maxillary sinus[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(02): 111-116.

患者,女性,22岁,上颌双侧缺牙来诊求治。正面观直面型,口内15、25未见,X线检查显示双侧上颌窦过度气化至牙槽嵴顶处,缺牙间隙处牙槽骨菲薄。矫治方案为减数35、45正畸治疗,试关闭15、25缺牙间隙。直丝弓固定矫治器排齐整平上下牙列后,通过持续轻力实现后牙穿上颌窦移动关闭缺牙间隙。疗程25个月,治疗结束后患者咬合关系良好,牙根平行无明显吸收,牙髓活力良好。

The female patient was 22 years old at the time of initial diagnosis, complaining of maxillary bilateral missing teeth. The face was straight type, and the 15, 25 were missing. X-ray analysis showed the bilateral maxillary sinuses were over gasified to the alveolar crest, and the alveolar bone at 15, 25 were extremely thin. The treatment plan of this case was to extract 35 and 45, and attempted to close the space between the missing teeth. Straight wire fixed appliance was used to align the upper and lower teeth, then the space closure through the maxillary sinuses was achieved by continuous light force. The treatment lasted 25 months. After treatment, the occlusion relationship was normal. The radix dentis were parallel without obvious absorption, and the dental pulp vitality was normal.

图1 治疗前面相、口内相及X线影像 A:正面相;B:正面微笑相;C:侧面相;D:右侧咬合相;E:正面咬合相;F:左侧咬合相;G:上颌口内相;H:下颌口内相;I:头颅侧位片;J:口腔全景曲面体层片。
表1 治疗前后头影测量值对比
图2 双侧上颌窦区正畸前后三维方向对比 A:正畸治疗前右侧矢状向;B:正畸治疗前左侧矢状向;C:正畸治疗前第二前磨牙区冠状向;D:正畸治疗前上颌水平向;E:正畸治疗后右侧矢状向;F:正畸治疗后左侧矢状向;G:正畸治疗后第二前磨牙区冠状向;H:正畸治疗后上颌水平向。
图3 治疗前后双侧颞下颌关节锥形束CT对比 A:治疗前右侧髁状突矢状位;B:治疗前左侧髁状突矢状位;C:治疗前右侧髁状突冠状位;D:治疗前左侧髁状突冠状位;E治疗后右侧髁状突矢状位;F:治疗后左侧髁状突矢状位;G:治疗后右侧髁状突冠状位;H:治疗后左侧髁状突冠状位。
图4 上下颌第一前磨牙区基骨宽度 A:上颌骨基骨宽度为42.29 mm;B:下颌骨基骨宽度为38.25 mm。
图5 治疗中咬合及口内相 A:右侧咬合相;B:正面咬合相;C:左侧咬合相;D:上颌口内相;E:下颌口内相。
图6 治疗中咬合、口内相及X线影像 A:右侧咬合相;B:正面咬合相;C:左侧咬合相;D:上颌口内相;E:下颌口内相;F:头颅侧位片;G:口腔全景曲面体层片。
图7 治疗后面相、口内相及X线影像 A:正面相;B:正面微笑相;C:侧面相;D:右侧咬合相;E:正面咬合相;F:左侧咬合相;G:上颌口内相;H:下颌口内相;I:头颅侧位片;J:口腔全景曲面体层片。
图8 治疗前后上颌第一前磨牙与第一磨牙间隙及根间距定量测量 A:治疗前右侧间隙为5.12 mm,根间距为17.41 mm;B:治疗前左侧间隙为4.04 mm,根间距为16.28 mm;C:治疗后右侧间隙闭合,根间距为7.80 mm;D:治疗后左侧间隙闭合,根间距为10.02 mm。
图9 治疗前后头影测量描记重叠图(蓝色为治疗前,红色为治疗后)。
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