成人骨性Ⅲ类错下前牙区牙槽骨厚度的测量分析  

Measurement of alveolar bone thickness of adult skeletal ClassⅢ patients in mandibular anterior region

作　　者：王博[1] 房兵[1] 樊林峰[1] 毛丽霞[1] 夏韫晖[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面外科,上海市口腔医学重点实验室,上海200011

出　　处：《上海口腔医学》2012年第4期422-426,共5页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(10972142);上海市科学技术委员会资助项目(08411961600);上海市高校创新团队发展计划~~

摘　　要：目的:借助锥形束CT(cone-beam computed tomography,CBCT),结合计算机辅助测量技术,测量分析不同垂直骨面型的骨性Ⅲ类错患者下前牙区的牙槽骨厚度,为此类患者的临床治疗提供指导。方法:从2008年1月至2011年3月间于上海交通大学医学院附属第九人民医院口腔颌面外科正颌正畸联合门诊求治的成人连续病例中,选取诊断为骨性I类错畸形的患者64例,骨性Ⅲ类错畸形患者66例(以下分别简称为I类组及Ⅲ类组),进一步按照垂直骨面型将两组患者分类。选取左侧下中切牙进行测量,以I类组为对照组,运用CBCT比较评估不同垂直骨面型的骨性Ⅲ类错下前牙区的牙槽骨厚度。使用SAS8.02软件包对数据进行统计学处理。结果:Ⅲ类组患者前牙区唇侧(P<0.05)、舌侧(P<0.01)及总的牙槽骨厚度(P<0.01)均较I类组狭窄。前牙区唇侧牙槽骨厚度高角Ⅲ类组患者较均角及低角狭窄(P<0.01);舌侧牙槽骨厚度低角>均角(P<0.01),均角>高角(P<0.05);总的牙槽骨厚度低角>均角>高角(P<0.01)。不同垂直骨面型的Ⅲ类组患者唇侧牙槽骨厚度<舌侧(P<0.01)。结论:骨性Ⅲ类错畸形下前牙区牙槽骨厚度较I类狭窄,且低角骨面型>均角骨面型>高角骨面型;不同垂直骨面型的骨性Ⅲ类错前牙区唇侧牙槽骨厚度较舌侧狭窄。提示骨性Ⅲ类错治疗前,有必要对其下前牙区牙槽骨厚度进行评估,以确保治疗安全有效;掩饰性治疗骨性Ⅲ类错牙移动中,医源性牙根及牙周组织损害发生的风险更大。PURPOSE： To describe alveolar bone thickness in mandibular anterior region of skeletal Class Ⅲmalocclusion with the help of Cone-beam CT.METHODS： The subjects were selected from consecutive adult patients seeking orthodontic treatment in Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2008 to March 2011,which included 64 patients diagnosed to be skeletal Class I malocclusion（Class I group） and 66 patients diagnosed to be skeletal Class Ⅲ malocclusion（Class Ⅲ group）.Both Class I and Class Ⅲ groups were divided into 3 divisions respectively according to different vertical facial types.Mandibular left central incisor of each subject was chosen for measurement.The labial（L1）,lingual（L2） and total（L0）alveolar bone thickness of skeletal Class Ⅲ patients in mandibular anterior region were assessed using a CBCT analyzing method with Class I group as the control group.Data was processed with SAS8.02 software package.RESULTS： L1（P〈0.05）,L2（P〈0.01）and L0（P〈0.01）of Class Ⅲ group were thinner than those of Class I group.L1 of high-angle Class Ⅲ malocclusion was thinner than that of average-angle（P〈0.01）and low-angle（P〈0.01）ones;L2 of average-angle Class Ⅲ malocclusion was thinner than that of low-angle ones（P〈0.01）and thicker than that of high-angle ones（P〈0.05）;L0 of low-angle Class Ⅲ malocclusion was thicker than that of average-angle ones（P〈0.01）,which was thicker than that of high-angle ones（P〈0.01）.L1 of Class Ⅲ group with different vertical facial types was thicker than L2（P〈0.01）.CONCLUSIONS： Skeletal Class Ⅲ malocclusion exhibits thinner alveolus around the mandibular incisor apices compared with Class I malocclusion,which shows strong connection with different vertical facial types.Root apices of mandibular anterior teeth of skeletal Class Ⅲ malocclusion situated closer to labial cortical bone than lingual cortical bone.It is necessary to access

关 键 词：骨性Ⅲ类错 成人 牙槽骨厚度 锥形束CT 垂直骨面型 

分 类 号：R783.5[医药卫生—口腔医学]