刘筱佳 潘刚

[摘要]目的：探讨正畸联合种植修复先天缺失上颌侧切牙的临床效果。方法：选取笔者医院2016年1月-2017年12月收治的78例先天缺失上颌侧切牙患者为研究对象，随机分为对照组及观察组，每组39例。对照组仅种植义齿，观察组在对照组的基础上加以正畸治疗。采用χ2检验分析两组治疗方式的临床效果及并发症发生情况。结果：两组患者临床疗效比较，具有显著性差异（P<0.001），观察组的总有效率显著高于对照组（P=0.003）;对照组并发症的总发生率显著高于观察组（P<0.001）。总体来说，男性患者治疗后的有效情况优于女性;对照组男性有效率和总有效率均高于女性，而观察组男性治愈率高于女性，差别均有统计学意義，P<0.05。对照组不同年龄患者治疗效果比较未见统计学意义，观察组年龄<30岁的患者治愈率以及总有效率均最高，差别有统计学意义（P<0.05），且观察组的咀嚼效率优等比例高于对照组，差别有统计学意义（P<0.05）。结论：正畸联合种植修复先天缺失上颌侧切牙的临床效果显著优于仅单纯种植义齿，可有效增加患者牙齿修复间隙，进而改善患者语言、咀嚼能力，且并发症发生率低。

[关键词]正畸联合种植;先天缺失;上颌侧切牙;美学效果;语言能力;咀嚼能力

Abstract： Objective  To investigate the clinical effects of orthodontic combined implant in the repair of congenital maxillary lateral incisors. Methods  A total of 78 patients with congenital missing maxillary lateral incisors who were admitted to our hospital from January 2016 to December 2017 were randomly divided into control group and observation group， 39 cases， and control group only implanted dentures. The observation group was treated with orthodontic combined implant denture. The χ2 test was used to analyze the difference in treatment outcome and complication rate between the two groups. Results The clinical efficacy of the two groups was statistically significant （P<0.001）. The total effective rate of the observation group was significantly higher than that of the control group （P=0.003）. The total incidence of complications in the control group was significantly higher than that of the control group （P<0.001）. In general， the effective condition of male patients after treatment was better than that of females. The effective rate and total effective rate of males in control group were higher than those of females， while the cure rate of males in observation group was higher than that in females， the difference was statistically significant （P<0.05）. There was no statistically significant difference in the therapeutic effect between the different age groups in the control group. The cure rate and total effective rate were the highest in the observation group aged <30 years old， and the difference was statistically significant （P<0.05）. The superior chewing efficiency of the observation group was higher than that of the control group， and the difference was statistically significant （P<0.05）. Conclusion The clinical effect of orthodontic combined implant restoration for congenital absence of maxillary lateral incisors is significantly better than that of implant-only dentures. It can effectively increase the repair gap and improve the language and chewing ability of patients. The incidence is low.

Key words： orthodontic combined implantation; congenital absence; maxillary lateral incisor; aesthetic effect; language ability; chewing ability

先天性缺牙是一种口腔常见畸形，在形成过程中指牙胚未能完全发育及形成的牙[1]。目前，对造成先天性缺牙的病因不明确，有研究显示其与多基因遗传相关，也有可能由于局部组织感染发炎，导致牙胚发育不良而阻碍牙齿形成[2]。多种治疗先天性缺牙的方案在临床得以应用，传统的主要是安装活动义齿，但这种方法对固位力不佳、牙槽骨條件差的患者来说并不理想。对于这类患者，种植义齿的治疗效果相比传统方法更为理想，这种方法具有不损伤临近牙齿、稳固、美观及功能好等优点，而且对颌骨有生理性的刺激作用[3]。在种植义齿前应当先矫正畸形，正畸治疗既能扩大种植手术适应范围，又能为其营造良好的手术条件。目前临床上通常将正畸治疗与种植义齿相联合，不仅能够提高义齿稳定程度及修复效果，而且能达到最大可能限度功能及美观[4-5]。本研究主要通过对笔者医院收治的78例患者进行研究，探讨正畸联合种植修复先天缺失上颌侧切牙的治疗效果。……