Wykorzystanie stałych i ruchomych aparatów ortodontycznych w chirurgiczno-ortodontycznym leczeniu niewyrzniętych lub zatrzymanych zębów
The management of unerupted and impacted teeth involves surgical exposure and placing an orthodontic bracket on the crown. The treatment can be conducted with the use of removable or fixed orthodontic appliances.
The purpose of this study is to evaluate the results of treatment of unerupted and impacted incisors and canines with the use of removable or fixed orthodontic appliance.
The study involved 58 patients (34 females and 24 males), aged 12-35 years. A total of 72 maxillary teeth, 26 incisors and 46 canines, were treated.
The crowns of impacted/unerupted teeth were exposed with the “closed eruption” (CE) technique and subsequently aligned in the dental arch with the use of elastic orthodontic traction connected to a removable or fixed orthodontic appliance.
The orthodontic treatment was determined by many factors: the aetiology of tooth impaction, tooth position in the alveolar bone, its relation to adjacent teeth and the patient’s age. The follow-up examination was performed no sooner than 12 months post-retention. The treated teeth were evaluated and divided into two groups regarding whether a fixed or a removable appliance was used. The duration of treatment, a clinical crown length, the width of aligned gingiva and the final alignment of previously impacted teeth in relation to adjacent teeth were noted. The periodontal status and its relation to the orthodontic treatment of the aligned teeth, as well as the clinical appearance of gingiva, gingival sulcus depth, tooth mobility and oral hygiene were evaluated.
The clinical examinations showed that with the use of removable orthodontic appliances unerupted incisors and some cases of superficially impacted canines may be successfully treated. Fixed orthodontic appliance enables the affected teeth to be moved into their alignment successfully, especially in cases of severe incisor and canine impaction. The aetiology of tooth impaction was the most important factor influencing the treatment results. The alignment of teeth treated with a fixed appliance was better than the alignment of teeth treated with a removable one. Other differences were not statistically significant. Increased movability of the treated teeth was evidently related to the aetiology of tooth impaction, which in most cases was the presence of supernumerary teeth.
The analysis of the treatment results suggest that fixed orthodontic appliances are more effective in difficult cases. Whereas the use of removable orthodontic appliance should be limited to the cases of incisor impaction.
Adres: dr n. med. Bożena Soroka-Letkiewicz
Katedra i Klinika Chirurgii Szczękowo-Twarzowej AMG
ul. Dębinki 7, 80-211 Gdańsk