不同骨性错[牙合]类型成年患者中切牙冠根形态的锥形束CT分析  

Analysis of the discrepancy of crown-root morphology of central incisors among different skeletal malocclusion using cone-beam CT

作　　者：王小明 王晶 邹敏[1] 郑军[1,2] 薛慧 Wang Xiaoming;Wang Jing;Zou Min;Zheng Jun;Xue Hui(Department of Orthodontics,College of Stomatology,Xi'an fiaotong University,Xi'an 710004,China;working on the Myour Dental Clinic,Suzhou 215006,China;Department of Stomatology,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215006, China)

机构地区：[1]西安交通大学口腔医学院正畸科,710004 [2]苏州美奥口腔姑苏机构,215006 [3]南京医科大学附属苏州医院口腔科,215006

出　　处：《中华口腔医学杂志》2019年第2期101-106,共6页Chinese Journal of Stomatology

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2016033).

摘　　要：目的通过锥形束CT影像比较不同骨性错[牙合]成年患者上下颌中切牙的冠根形态,为预防正畸骨开裂和骨开窗提供依据。方法采用回顾性病例-对照设计,筛选2015年1月至2017年12月就诊于西安交通大学口腔医学院正畸科的108例骨性错[牙合]患者,其中男性52例,女性56例,平均25.8岁(18~30岁)。根据锥形束CT数据进行头影测量,获得均角患者66例并进行矢状骨面型分组,其中骨性Ⅰ类组24例,骨性Ⅱ类组20例,骨性Ⅲ类组22例;获得骨性Ⅰ类患者66例并进行垂直骨面型分组,其中低角组21例,均角组24例(即矢状骨面型分组的骨性Ⅰ类组患者),高角组21例。用Invivo 5软件对锥形束CT影像进行三维定位,获得上下颌右侧中切牙正中唇舌向断面,以Auto CAD 2007软件测量牙冠长轴根方延长线与牙根长轴的夹角(Collum角),测量通过牙冠唇面中心点的唇面切线与牙冠长轴的夹角(牙冠唇面角)。单因素方差分析及Scheff法分析矢状骨面型组间或垂直骨面型组间Collum角或牙冠唇面角的差异,并对同牙位中切牙Collum角与牙冠唇面角进行Pearson相关性分析。结果不同矢状骨面型分组间上颌或下颌中切牙Collum角或牙冠唇面角差异均有统计学意义(P<0.05);其中骨性Ⅱ类组上颌中切牙Collum角为5.18°±4.97°,牙冠唇面角为17.78°±3.74°,均显著大于骨性Ⅰ类和Ⅲ类组相同测量项目(P<0.05);骨性Ⅲ类下颌中切牙Collum角为5.59°±5.64°,牙冠唇面角为15.32°±3.05°,均显著大于骨性Ⅰ类和Ⅱ类组相同测量项目(P<0.05)。不同垂直骨面型分组间上颌或下颌中切牙Collum角或牙冠唇面角差异均无统计学意义(P>0.05)。上颌或下颌中切牙Collum角与牙冠唇面角均显著正相关(上颌:r=0.723,P<0.001;下颌:r=0.752,P<0.001)。 结论骨性Ⅱ类错[牙合]患者上颌中切牙、骨性Ⅲ类错[牙合]患者下颌中切牙牙冠长轴相对牙根长轴明显偏舌侧,且对应有更大的牙冠唇面�ObjectiveTo investigate the discrepancy of crown-root morphology of upper and lower central incisors in adult patients with different skeletal malocclusions using cone-beam CT (CBCT).MethodsPatients visiting the Department of Orthodontics, College of Stomatology, Xi′an Jiaotong University from January 2015 to December 2017 were selected, including 108 cases (52 males, 56 females, aged from 18 to 30 years, mean age 25.8 years). According to CBCT data and cephalometric analysis, 66 patients with average angle were selected as the sagittal skeletal group, including 24 Class Ⅰ patients, 20 Class Ⅱ and 22 Class Ⅲ patients. In the other selected 66 skeletal Class Ⅰ patients including 21 low angle patients, 24 average angle patients (from the sagittal skeletal Class Ⅰ subgroup) and 21 high angle patients. Invivo 5 software was used to locate the CBCT image three dimensionally and then obtain the middle labio-lingual section of right central incisor. Auto CAD 2007 software was applied to measure the angle formed by the long axis of root and the extension line of the long axis of crown (Collum angle), and the angle between the long axis of crown and the lip tangent line passing through the center of the labial surface of crown (labial surface angle). One-way ANOVA and Scheff were used to analyze the discrepancies among classifications and Pearson correlation analysis was used to determine the correlation between the Collum angles and labial surface angles.ResultsSignificant differences were found in Collum angles and labial surface angles among different sagittal skeletal patterns (P<0.05). The Collum angle of maxillary central incisors in Class Ⅱ patients was 5.18°±4.97° and the average labial surface angle was 17.78°±3.74°, which were both significantly higher than that of maxillary central incisors in Class Ⅰ and Ⅲ subgroups (P<0.05). Similarly, the above two angles of mandibular central incisors in Class Ⅲ were 5.59°±5.64° and 15.32°±3.05°, which were significantly higher than that of m

关 键 词：错[牙合] 切牙 锥束计算机体层摄影术 Collum角 牙冠唇面角 

分 类 号：R783.5[医药卫生—口腔医学]