| BackgroundImpacted teeth is a very common orthodontic disease in clinical work.Except for the third molars,the prevalence of the impacted maxillary canines is the highest.Due to the important role of the maxillary canine in dentition and the supporting function of facial corners of the mouth,the impacted maxillary canine not only lead to irregular dentition,deviation of the Central Line and reduced chewing function,but also affect craniofacial development.But in clinical research,the investigatation between the impacted maxillary canines of craniofacial growth and development has focused on the surface of upper jaw,teeth and soft tissue,rarely involved in the related research of maxillary sinus,and the maxillary sinus as an important anatomical structure in maxillary complex body,it is closely related to the development of the midface of the craniofacial region.ObjectiveTo explore the development of maxillary sinus and whether the impacted maxillary canine would have an adverse effect on the development of maxillary sinus and provide reference for the basic research on the development of maxillary sinus and the treatment of impacted canines.MethodsTwenty adolescent patients with the unilaterally impacted maxillary canine were selected,10 males,10 females,and the mean age is 11.0±0.8,CBCT was taken before correction,and the working model and the storage model were prepared,and then made personalized traction devices,closed flap traction was performed by the combination of oral and maxillofacial surgery and orthodontics,CBCT was taken again after the successful traction of the impacted canine.In a period of time,InVivo Dental 3D analysis software was used to measure the three dimensional diameters,volume and gasification coefficient of the maxillary sinus both the side with impacted tooth and the normal side.SPSS 21.0 was used for statistical analysis of the measurement results,to compared the morphological changes of bilateral maxillary sinus before and after the traction treatment.ResultsThe twenty maxillary impacted canines were successfully extracted,after the traction,the pulp activity were normal and the periodontal adhesion were good,and no loose and significant root resorption were discovered.The traction duration is about(6-12)months,the mean time is(7.45±1.50)months.1.Before the treatment,there was no significant difference in anteroposterior diameter and gasification coefficient of the maxillary sinus between the normal side and the impacted side(P>0.05).The transverse diameter,axial diameter and the volume of the maxillary sinus in normal side were bigger than the impacted side(P<0.05),and the difference was statistically significant.2.After the maxillary impacted canines were successfully extracted into the mouth,the difference between the anteroposterior diameter,axial diameter,the volume and gasification coefficient of the maxillary sinus between the normal side and the impacted side was no statistical significance(P>0.05),while the transverse diameter of the maxillary sinus between the normal side and the impacted side was statistically significant(P<0.05).3.After the traction treatment,the anteroposterior diameter increased(0.83±0.42)mm,the transverse diameter increased(0.80±0.48)mm,the axial diameter increased(1.55±0.49)mm,the volume increased(1.13±0.50)cm~3 and the gasification coefficient of the maxillary sinus on the non-impacted side decreased(0.01±0.01),and the difference was statistically significant.4.After the traction treatment,the anteroposterior diameter of the maxillary sinus on the impacted side increased(0.64±0.46)mm,the transverse diameter increased(0.87±0.51)mm,the axial diameter increased(2.08±0.87)mm,the volume increased(1.76±0.59)cm~3,and the difference was statistically significant.But the change of gasification coefficient of the maxillary sinus on the impacted side was not statistically significant.5.After the traction treatment of the maxillary impacted canines,the anteroposterior diameter and the transverse diameter of the maxillary sinus were both inceased of the impacted side and the normal side,but there was no statistically significant difference in the changes between the two sides.While the change of the axial diameter,the volume and the gasification coefficient of the maxillary sinus on the impacted side was greater than the normal side,and the difference was statistically significant.Conclusions1.Impacted maxillary canines have a certain influence on the size and volume development of maxillary sinus,but there is no influence on the gasification degree of maxillary canines2.Before 12 years old,the size and volume of the maxillary sinus were still in a fgrowth stage.In clinical work,when there is a maxillay canine impacted in skeletal malocclusion Class?patients,the traction treatment should be taken as early as possible,in order to improve class?bone profile in the growth stage.3.Closed flap combined with orthodontic traction in the treatment of maxillary high impacted canine can achieve good clinical effect through the oral and maxillofacial surgery and orthodontics department. |
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