Clinical Case Report Of Orthodontic Retraction Of Maxillary Ambulatory Obstructive Anterior Teeth

Objective: This study retrospectively analyze and evaluate the orthodontic design,orthodontic process and orthodontic effect of the cases of embedded anterior maxillary teeth early mixed dentition treated in orthodontic clinic,which can provide reference and basis for the orthodontic treatment of early maxillary anterior teeth with ambiguous obstruction in the future.Methods: Three patients with embedded anterior maxillary teeth were selected for treatment in the Department of Orthodontics,Yiji Shan Hospital,Wanan Medical College,from September 2020 to December 2022,including two males and one female,aged 10 years at the oldest and 8 years at the youngest,with an average age of9 years.Under the precise three-dimensional positioning of oral cone-beam CT(CBCT),fixed orthodontic techniques were used to retract the maxillary ambiguous anterior teeth into the dental arch supported by oral and maxillofacial surgical openings to expose the affected teeth.The characteristics and location of the ambulatory obstruction were analyzed,and the clinical orthodontic design,orthodontic points and orthodontic effects were retrospectively analyzed and studied.Results: In these three cases,after oral and maxillofacial surgical openingsand combination with fixed orthodontic traction,the affected teeth were incorporated into the normal position of the dental arch and aligned,restored the aesthetics of the anterior region,restored the masticatory function of the teeth,and formed a normal occlusal relationship;the shortest treatment time was 9 months and the longest was 13 months.The maxillary ambiguous obstructed central incisors were tractioned into place and stabilized in the alveolar bone,with no obvious loosening,normal pulp vitality,no periodontal lesions,no gingival inflammation,relatively low periodontal attachment,healthy adjacent teeth,and satisfactory overall curative effect.Conclusion: The clinical orthodontic plan design and orthodontic points of patients with embedded anterior maxillary teeth in early mixed dentition includes the clarification of the three-dimensional spatial location of the ambiguous anterior teeth by taking oral CBCT before traction,developing a suitable traction device and reasonable support design,adopting the appropriate size and direction of traction in conjunction with oral surgery openings,and considers the three aspects of function,health and aesthetics for such patients with ambiguous anterior maxillary teeth in clinical practice.This study will provide the conditions and guarantee the best oral orthodontic results for these patients with ambiguous orthodontic obstructions.