應用微型種植釘壓低前牙改善露齦笑的臨床觀察
齒科美容
作者：張利 李少鵬 劉明
[摘要]目的：分析微螺釘種植體作為支抗矯治露齦笑的臨床效果。方法：選擇18名露齦笑患者，在其兩側上頜側切牙與尖牙間靠近牙根部植入微螺釘，用橡皮圈-結紮絲將微螺釘與上頜中切牙和側切牙連起來，每側即刻加力50～100g，每4周更換一次橡皮圈。矯治前後比較露齦笑及上切牙壓低程度。結果：平均療程6.8個月，上切牙齦緣到上唇下緣距離平均縮短（2.6±1.2）mm，露齦笑得到改善。結論：微螺釘種植體作為支抗性能穩定，療效肯定，操作簡單，是矯治露齦笑的理想支抗選擇。
[關鍵詞]微螺釘；支抗；露齦笑
[中圖分類號]R783 [文獻標誌碼]A [文章編號]1008-6455（2015）11-0074-03
Abstract： Objective To analysis the clinical effective of improving gummy smile with microscrew anchorage. Methods 18 patients with gummy smile were choosen，microscrews were implanted into each side between the lateral incisor and the canine，near the roots.Connected the microscrew and the incisor with elastometric chain 50-100g force each side was aplied immediately，changed the elastometric chain every 4 weeks.Compared the degree of gummy smile and incisor intrusion before and after treatment. Results The average period of treatment was 6.8 months，the average distance of gummy smile was reduced（2.6±1.2）mm，and the gummy smile was improved. Conclusion With stabile capability，affirm curative effect，and easy operation，the microscrews implant was an ideal anchorage to improve the gummy smile.
Key words：microscrew；anchorage；gummy smile
隨著人們對容貌美的要求越來越高，一些正畸患者在牙齒排列整齊後對於因微笑時牙齦暴露過多而產生對治療效果的不滿意。尤其在伴有深覆牙合患者中，露齦笑即開唇露齒的發生率較高，可達20.48%[1]。以往正畸臨床對這類病例壓低上前牙多采用頭帽J鉤高位牽引或多用途弓等方法，但臨床效果並不理想。近年來隨著微型種植釘作為支抗應用於正畸臨床，國內外學者作了大量基礎研究[2]，取得了較好的臨床效果，為臨床使用微型種植釘作為支抗壓低上前牙改善露齦笑提供了有利的理論依據。