正畸医师与普通人对尖牙替代上颌侧切牙患者微笑的审美差异分析

[摘要]目的：比较正畸医师与普通人对尖牙替代上颌侧切牙正畸治疗和正常完整牙列者的微笑审美差异。方法：选取以尖牙替代上颌侧切牙进行矫治的患者25例，分为两组，即单侧组（单侧尖牙替代）10例和双侧组（双侧尖牙替代）15例。选取完整牙列者20例为对照组。拍摄患者治疗后面下1/3微笑像，由正畸医师和普通人两组用VAS方法评价每一张微笑像吸引人的程度。结果：正畸医师与普通人对单侧尖牙替代患者的微笑美学评价有统计学差异（P

[关键词]微笑；上颌侧切牙畸形；尖牙替代

[中图分类号]R783.5 [文献标志码]A [文章编号]1008-6455（2015）12-0076-03

Smile attractiveness of canine substitution in cases with maxillary lateral incisors agenesis as rated by orthodontists and laypersons

WEI Jian-ping，MA Jia-jun，ZHANG Xi-zhong

（Department of Orthodontics，Tianjin Stomatological Hospital，Tianjin 300041， China）

Abstract： Objective The purpose of this study was to evaluate the smile attractiveness of canine substitution in cases with maxillary lateral incisors agenesis compared with that of individuals with a complete dentition as rated by orthodontists and laypersons. Methods Smiling photographs were made of patients with maxillary lateral incisor agenesis who were treated with unilateral canine substitution （n=10） or bilateral canine substitution （n=15） and a control group with a complete dentition （n=20）.The images of the smile were judged by orthodontists and laypersons， using the visual analog scale （VAS）. Results Attractiveness ratings by orthodontists and laypersons differed significantly in unilateral canine substitution group， but no significant differences were found in bilateral canine substitution group and the control group. The orthodontists，ratings of unilateral canine substitution group were significantly lower than the other two groups.The laypersons，ratings did not differ significantly among the three groups. Conclusion The smile of patients treated with unilateral canine substitution was judged less attractive than that of controls in orthodontists，but the same attractive in laypersons.The smile of patients treated with bilateral canine substitution was judged to be as attractive as that of controls both in orthodontists and laypersons.

Key words：smile；maxillary lateral incisors agenesis；canine substitution

上颌侧切牙先天缺失或畸形是临床常见的错牙合畸形之一，常导致上前牙间隙、上中线偏斜、上下前牙覆牙合、覆盖关系异常等，严重影响面部美观。目前的治疗方法主要有两种，即拔除畸形侧切牙关闭间隙尖牙改形替代和开展间隙固定义齿修复或种植义齿修复。治疗方法的选择取决于患者的年龄、错牙合类型、面型、牙弓拥挤情况和尖牙的形态色泽等因素。尖牙替代治疗可以使该类患者获得良好的疗效和长期稳定的口颌功能，并最有利于此类患者的远期利益[1-2]。

美观的微笑让人们觉得自己更年轻更自信，牙齿的大小、形状、色泽及位置是迷人微笑的重要组成部分。尖牙替代正畸治疗因其形态、色泽、大小有别于正常侧切牙，对微笑美观可能会有所影响。因此，对上颌侧切牙先天缺失或畸形尖牙替代正畸治疗的患者微笑美观评价显得尤为重要。目前，国内外此类研究尚不多见，本研究就正畸医师与普通人对此类患者治疗后微笑美观评价进行分析，从而为正畸医师对上颌侧切牙先天缺失或畸形患者治疗方案的制定以及治疗效果的评价进行参考。

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[收稿日期]2015-01-15 [修回日期]2015-04-13