上前牙牙冠、牙槽嵴顶骨缘和牙龈形态的比较研究  

Comparative study on the morphology of crown, alveolar ridge crest and gingivai in maxillary anterior region

作　　者：周芷萱[1] 沈铭[1] 陆胜男[1] 李俊[1] 陈宁[1] 

机构地区：[1]南京医科大学口腔医学研究所南京医科大学附属口腔医院口腔种植科,210029

出　　处：《中华口腔医学杂志》2013年第4期211-215,共5页Chinese Journal of Stomatology

基　　金：国家自然科学基金（81271109）;江苏高校优势学科建设工程（2011）

摘　　要：目的通过锥形束CT图像分析与石膏模型测量，研究成人上前牙牙冠、牙槽嵴顶骨缘、牙龈形态的相关性，为临床种植美学提供解剖依据。方法选取平均年龄为（23．08±6．30）岁的60名牙周健康且无明显错[牙合]畸形的汉族成人锥形束CT三维重建图像，测量上前牙唇侧牙槽嵴顶骨缘弧度、牙间骨板宽度和高度，在石膏模型上测量唇侧游离龈缘弧度及牙龈乳头、中切牙牙冠宽高度进行比较。按牙冠宽／高比值分为两组，取比值最高的10名纳入短宽型牙冠组；取比值最低的10名纳入长窄型牙冠组；并分别比较两组上前牙游离龈缘弧度、牙龈乳头形态的差异。结果①上前牙区中切牙、侧切牙、尖牙对应的唇侧牙槽嵴顶骨缘弧度分别为（2．33±0．16）、（2．29±0．22）、（2．06±0．15），游离龈缘弧度分别为（1．65±0．14）、（1．57±0．17）、（1．49±0．13），不同牙位对应的骨缘弧度间、龈缘弧度间均有差异，相同牙位对应的骨缘弧度和龈缘弧度显著相关（P〈0．05）；②除中切牙与侧切牙之间外，其余牙间区骨板外形与对应牙龈乳头外形显著相关（P〈0．01）；③与短宽型牙冠相比，长窄型牙冠瞬侧游离龈缘弧度较小（1．52±0．10）、更为弯曲（P：0．002），牙龈乳头更加细长（牙龈乳头宽高比值（2．16±0．33）（P=0．000）。结论中国汉族成人上前牙游离龈缘弧度、牙龈乳头形态与牙冠彤态、牙槽嵴顶骨缘彤态显著相关；牙冠呈长窄型、唇侧游离龈缘弧度小、牙龈乳头细长者种植修复的美学风险更大。Objective To investigate the correlation among the ,Morphology of crown, alveolar ridge crest and gingiva in maxillary anterior region of adults and to provide anatomical basis for clinical implant esthetics. Methods Sixty HaM-Chinese with heahhy peridontium were selected in this study. The curvature of labial alveolar crest, the length and height of inter-proximal bone were measured on 3-D model reconstructed from cone-beam CT（CBCT） images, and the curvature of free gingiva, the width and height of inter-dental papilla and central incisor crown were evaluated on easts. The ratio of crown width to height was ranked and the 10 ranked highest were categorized as group Short-Wide （SW）, the 10 ranked lowest were selected as group Long-Narrow （ LN ）. Results In maxillary anterior region, the curvature angle of both alveolar crest and marginal gingiva were significantly different among different tooth regions, but the alveolar and gingival curvature was significantly correlated in the same region （ P 〈 0. 05 ） . The morphology of inter-proximal bone and papilla was significantly correlated （ P 〈 0. 01 ） , except the region between central and lateral incisors （P = 0. 625, P 〉 0.05 ） . Compared to group SW, group LN formed a pronounced scalloped contour of gingival margin（ P =0. 002） and slender inter-dental papilla（ P =0. 000）. Conclusions The free gingival curvature and inter-dental papillary morphology are significantly correlated with the morphology of crown and alveolar ridge crest in maxillary anterior region of Hart-Chinese. Individuals with long-narrow crown, pronounced scalloped marginal gingiva and slender inter-dental papilla are susceptible to risk implant esthetics.

关 键 词：牙种植 解剖学 局部 锥形束CT 

分 类 号：R783[医药卫生—口腔医学]