目的探讨手术联合牵引治疗上颌埋伏阻生中切牙的疗效。方法 66例单侧埋伏倒置阻生上颌中切牙患者分为前方牵引组和颌间牵引组各33例,前方牵引组行手术暴露联合前方牵引治疗,颌间牵引组行手术暴露联合颌间牵引治疗,2组牵引时间均为12个月,比较2组临床矫治效果。观察前方牵引组患牙治疗前、牵引即刻及治疗后1a时牙根及牙槽骨发育情况,并与对侧同名牙(对照牙)进行比较。结果前方牵引组正畸矫正成功率(100.0%)高于颌间牵引组(66.7%)(P<0.05);前方牵引组治疗前患牙根尖孔宽度[(2.43±1.35)mm]、牙根长度[(9.22±1.96)mm]与对照牙[(1.61±1.06)mm、(11.38±1.75)mm]比较差异有统计学意义(P<0.05);治疗后1a,前方牵引组患牙根管壁厚度[(1.75±0.23)mm]、牙根长度[(12.05±2.03)mm]和根尖孔宽度[(0.06±0.03)mm]与对照牙[(1.81±0.15)mm、(13.06±2.14)mm、(0.05±0.02)mm]比较差异无统计学意义(P>0.05);牵引结束即刻,患牙唇侧牙槽骨厚度[(0.35±0.25)mm]小于对照牙[(0.66±0.11)mm](P<0.05),唇侧牙槽骨水平[(2.78±0.92)mm]大于对照牙[(1.15±0.12)mm](P<0.05),腭侧牙槽骨水平及厚度[(0.60±0.26)、(1.18±0.56)mm]与对照牙[(0.56±0.16)、(1.22±0.40)mm]比较差异无统计学意义(P>0.05);治疗后1a,患牙唇侧牙槽骨厚度及水平[(0.33±0.18)、(3.44±0.55)mm]、腭侧牙槽骨厚度及水平[(2.87±0.22)、(0.73±0.42)mm]与对照牙[(0.38±0.24)、(3.23±0.34)mm,(2.76±0.24)、(0.65±0.35)mm]比较差异均无统计学意义(P>0.05)。结论外科手术联合前方牵引是矫正埋伏倒置阻生上中切牙的有效方法,与颌间牵引比较,更有助于促进牙根发育、牙槽骨改建,疗效稳定。 Objective To investigate the effect of surgical combined traction on incisors with impacted maxillary impacted incisors. Methods One hundred and sixty-six cases of unilateral maxillary central incisors with unilateral impacted upper incisors were divided into anterior traction group and intermaxillary traction group, 33 cases in each group. The anterior traction group underwent surgical exposure with anterior traction. The intermaxillary traction group underwent surgical exposure combined with intermaxillary traction Treatment, traction time of two groups were 12 months, comparing two groups of clinical effect. The development of root and alveolar bone immediately before and immediately after traction was observed in the traction group before and after treatment, and compared with the contralateral teeth (control teeth). Results The success rate of orthodontic correction in front traction group (100.0%) was higher than that in intermaxillary traction group (66.7%) (P <0.05). The width of apical foramen in front traction group was (2.43 ± 1.35) mm, (9.22 ± 1.96) mm] was significantly different from that of control teeth [(1.61 ± 1.06) mm, (11.38 ± 1.75) mm] (P <0.05). After treatment, the thickness of root canal in front traction group (1.75 ± 0.23) mm], root length (12.05 ± 2.03) mm and apical foramen width [(0.06 ± 0.03) mm] were significantly higher than those in control teeth [(1.81 ± 0.15) mm, (13.06 ± 2.14) mm, (0.05 ± 0.02) mm] (P> 0.05). At the end of traction, the thickness of the alveolar bone on the labial side [(0.35 ± 0.25) mm] was smaller than that of the control teeth [(0.66 ± 0.11) mm] (2.78 ± 0.92) mm] in control group were significantly higher than those in control group [(1.15 ± 0.12) mm] (P <0.05). The level and thickness of alveolar bone in palatal side [(0.60 ± 0.26 ), (1.18 ± 0.56) mm] had no significant difference with the control teeth [(0.56 ± 0.16), (1.22 ± 0.40) mm] (P> 0.05) And (0.33 ± 0.18) and (3.44 ± 0.55) mm respectively. The thickness and level of the alveolar bone in the palatal face were significantly higher than those in the control tooth [(0.38 ± 0.24), 3.23 ± 0.34 ) mm, (2.76 ± 0.24), (0.65 ± 0.35) mm] respectively. There was no significant difference between the two groups (P> 0.05). Conclusion Surgical operation combined with anterior traction is an effective method to correct incised upper incisors. It is more effective in promoting root development and alveolar bone reconstruction with stable curative effect than intermaxillary traction.