Good doctor consultation - Yu Chi - oral information

The first orthodontic process

2006-2007 year , Haishu Stomatological Hospital ：
①7 The No. 1 tooth was not included in the orthodontic program
② Pre orthodontic 7 The No. 1 tooth occludes normally , No protrusion
③ Pull out the two in the upper row , One in the lower row ( Eventually, the center line is uneven )
④ The day of orthodontic bracket removal , Inform the doctor that the second molars on both sides protrude , Doctor （ Resigned , I don't remember the name ） Original words ：“ Does not affect occlusion , Irrespective ”, Let's go home .
⑤ left 6 The gums of the No. 1 tooth atrophy 2-3mm, It's quite obvious .（ It is not suitable for secondary bracket orthodontics , Too much correction ）

because “ Teeth protrude ” It's hard to find professional terms on Baidu , I always believe what experts say “ It doesn't matter if your teeth protrude ”

2022 When looking for orthodontist Chen Lifang to fill her teeth in, she was rejected , Dr. chenlifang said there was no filling here , There is a lock on the upper jaw

Patient information

One 、 Die scanning

Ningbo Zhenhai children's Dental Hospital (2022-7-22)

https://3dscanner.cn/cnv2/index.html?id=2cc6205c

Two 、X light

Ningbo Haishu District Stomatological Hospital - Kaiming branch (2022-5-24)

3、 ... and 、 Surface layer (Panorama)

Four 、 Lateral cephalometric film

5、 ... and 、 Wide field of vision of mouth and jaw CT（cone beam computed tomography,CBCT）

Patient appeal

① Give up beauty

② Give up tidiness , Refuse slice cutting 、 Patches, etc

③ Give up perfection

④ Want a normal occlusal relationship

⑤ Don't pull out 8 Trumpet tooth

⑥ Don't want to use anchorage nails

⑦ I know that Periodontology and orthodontics belong to different directions of oral research , It is not the specialty of orthodontists ,

Gingival atrophy In orthodontic clinical statistics, almost 100% happen , Only try to control , There is no absolute guarantee that it will not shrink , And irreversible .

Inquired information - Patient notes

Hospital name	Doctor	The doctor's point of view （①② Indicates an alternative ）
Ningbo Haishu Stomatological Hospital （ Face consultation ）	Chenlifang	① Pull out 8 Number , Correction 7 Number ② Give up orthodontics , Drag it if you can .
Zhenhai children's Dental Hospital （ Face consultation ）	Zhang Zhongyi	① On the right side 7 Tooth extraction ,8 Substitute No left 8 Good tooth extraction ,7 No. correction Will use the anchorage nail ( There will be root injuries 、 Surgical risk of fracture and failure to pull out ) ② lock No problem , It doesn't matter to drag , Doctor Zhang said he 7 No. 1 also has a lock ---------------------------------------------------- Doctor Zhang thinks ： Incomprehensible 7 The No. 1 tooth appears in the first orthodontics , I think orthodontics can't have so much force , He thought it could only grow naturally , It doesn't match my memory . Unable to move canines out of the lip , Can cause bone cracking 、 Risk of bone fenestration . Unable to rotate wisdom teeth to provide dentition space , Rotate at most 2° Correction 7 Teeth can cause bone resorption problems （ Principle of osteoclasts and osteoblasts ）
Shanghai Ninth Hospital （ Good doctor online consultation ） （ At that time, I only uploaded X Light and mobile phone photos ）	Tang Guohua	① pull 8 Trumpet tooth Correction 7 Trumpet tooth --------------------------------------------------------- Dr. Tang's original words ： X X-ray film shows maxillary wisdom teeth Insufficient posterior alveolar bone , Cannot move far It is mainly the alveolar bone of the posterior segment in the late stage of growth Underdevelopment , It is manifested as wisdom teeth impaction , Dislocation of the second molar If no extraoral bow or implant nail is used for the first correction , It is impossible to move the molar back .（ I don't understand this sentence , Then the platform forced the end of the consultation ）

Add ：

One 、 Because some doctors Refuse to believe my description of the first orthodontics ,

What's the matter with locked teeth ？ Orthodontic failure may cause locking ！ - You know

In this note , The narration of Dr. Cao Tian of saide stomatology The situation is very similar to mine , Doctor Cao believes that the dental mold for bracket correction may be inaccurate , In this case , The first orthodontic plan did not put the second molar (7 Trumpet tooth ) Adding correction leads to lock , And The doctor refused to deal with .

Two 、 Yes From teeth to beautiful mouth , The doctor replied 3 Set of plans ：

① If it doesn't affect daily eating , Function oriented , Don't be mentally handicapped , Suggest giving up 7 Tooth correction .

② pull 8 Trumpet tooth 、 Correction 7 Trumpet tooth

③ Need to find a very patient doctor , Accurately calculate the dentition space , It is possible to expand the bow , But such a doctor is hard to find .

3、 ... and 、 From the description of Doctor Zhang Zhongyi , lock Belong to rare 、 Complex cases of difficult correction ,

In his more than ten years of career , Similar cases encountered are in single digits .

Four 、 Combined with the description of Private Hospital Dr. Cao Tian and Public Hospital Dr. Tang Guohua , The cause of jaw locking during orthodontics is ：

①7 No. 1 tooth did not join the orthodontic program , The dental mold is inaccurate （ Doctor Cao Tian's view ）

② The doctor didn't consider 8 The alveolar bone of the posterior segment of tooth No. 1 is underdeveloped , Manifested as 8 No. 1 tooth extrusion 、 Impaction 7 Trumpet tooth （ Dr. tangguohua's view ）

③ Sharp teeth are wider than extracted teeth 2mm about , Something unexpected happened to the doctor Grind your teeth far away effect .（ Personal view ）

comprehensive ①②③, Personal understanding ,

During the first orthodontics , front 5 Teeth and 8 Trumpet tooth , Join forces to attack 7 Trumpet tooth , Lead to 7 The trumpet protrudes , The performance is lock （ The problem was found at the end of Orthodontics ）