Orthodontic Treatment of an Adult Maxillomandibular Protrusion Case with Impacted Mandibular Second Molars Using the Physiologic Anchorage Spee-wire System: a Case Report.

Huan Huan Chen, Gui Chen, Guang Yao Feng, Xiu Jing Wang, Tian Min Xu, Hong Su
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Abstract

Impaction of mandibular second molars should be resolved as soon as possible once diagnosed, since it may lead to many functional, periodontal, hygienic and endodontic problems. Treatment options for impacted second molars include orthodontic-assisted eruption following surgical exposure, surgical uprighting and, in some cases, surgical extraction with possible subsequent implant placement if the tooth is deemed non-restorable or the patient prefers an implant restoration. This case report describes the orthodontic treatment of a 21-year-old woman with maxillomandibular protrusion and impacted bilateral mandibular second molars. The Physiologic Anchorage Spee-wire System (PASS) was adopted due to its innovative strategy of physiological anchorage control and unique design involving the multilevel low-friction (MLF) bracket and cross buccal tube (XBT). After 22 months of treatment, a well-aligned dentition, a normal functional occlusion and a harmonious facial profile were obtained, and impaction of the bilateral mandibular second molars was finally resolved. This case report demonstrates a simple and efficient solution to dental impaction. The PASS technique is superior to other preadjusted straight wire appliances in the treatment of maxillomandibular protrusion cases without auxiliary anchorage devices, and the mandibular buccal tube involved in the PASS technique can assist in uprighting the impacted mandibular second molars with NiTi round wire and minimising oral discomfort for the patient.

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正畸治疗成人上颌下颌前突伴下颌第二磨牙阻生1例。
下颌第二磨牙嵌塞一旦确诊应尽快解决,因为它可能导致许多功能,牙周,卫生和牙髓问题。阻生第二磨牙的治疗选择包括手术暴露后的正畸辅助出牙,手术扶正,在某些情况下,如果认为牙齿不可修复或患者更喜欢种植体修复,则手术拔牙并可能随后放置种植体。本病例报告描述了一名21岁女性上颌下颌骨突出和双侧下颌第二磨牙阻生的正畸治疗。由于采用了创新的生理支抗控制策略和独特的多级低摩擦(MLF)托槽和跨颊管(XBT)设计,采用了生理支抗速丝系统(PASS)。经过22个月的治疗,牙列排列整齐,牙合功能正常,面部轮廓和谐,双侧下颌第二磨牙嵌塞最终得到解决。本病例报告展示了一种简单有效的牙嵌塞治疗方法。PASS技术在治疗无辅助支抗的上颌下颌骨前突病例中优于其他预调节直丝矫治器,并且PASS技术中涉及的下颌颊管可以帮助用NiTi圆丝扶正下颌第二磨牙,减少患者的口腔不适。
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