不同骨龄患者上颌快速扩弓后腭部形态变化的三维测量分析  

Three dimensional reconstruction measurement study of palatal contour changes in different bone ages after rapid maxillary expansion

作　　者：熊再道 柯杰[1] 赵桂芝[1] 林清华[1] 杨鑫铭 肖依寒 Xiong Zaidao Ke Jie Zhao Guizhi Lin Qinghua Yang Xinming Xiao Yihan(Department of Orthodontics, Air Force General Hospital of Chinese PLA, Beijing 100142, China)

机构地区：[1]解放军空军总医院口腔正畸科,北京100142

出　　处：《中华口腔医学杂志》2016年第12期734-738,共5页Chinese Journal of Stomatology

摘　　要：目的 评价不同椎骨骨龄患者上颌快速扩弓前后腭部形态变化的差异,探讨扩弓后上颌牙性及骨性变化与骨龄的关系.方法 选取2013年12月至2016年3月于解放军空军总医院口腔正畸科就诊的处于不同生长发育期需行上颌快速扩弓治疗的患者37例,按不同颈椎骨龄分组,分为生长加速组（13例）、生长高峰组（13例）和生长减速组（11例）,于扩弓前后分别拍摄锥形束CT影像,使用Mimics软件进行三维重建,获取腭部三维模型并测量.使用SPSS 17.0软件,对各组扩弓前后结果进行配对样本t检验,扩弓前后变化量的组间比较采用方差分析.结果 生长加速、生长高峰及生长减速组患者扩弓后均发生了牙齿和牙槽骨的倾斜及腭中缝的打开.第一磨牙角扩弓前后变化上,生长加速、生长高峰及生长减速组分别减小2.66°±1.04°、3.53°±0.81°和12.32°±1.64°,生长加速组与生长高峰组差异无统计学意义（P＞0.05）,两组均显著小于生长减速组（P＜0.05）.腭穹窿角扩弓前后变化上,3组分别增大6.01°±2.06°、4.79°±1.31°、6.73°±1.7l°,生长加速组与生长减速组差异无统计学意义（P＞0.05）,两组均显著大于生长高峰组（P＜0.05）.腭侧釉质牙骨质界宽度扩弓前后变化上,3组分别增大（7.37±1.31）、（6.68±0.72）、（5.13±1.42） mm,生长加速组与生长高峰组差异无统计学意义（P＞0.05）,两组均显著大于生长减速组（P＜0.05）.腭中部宽度扩弓前后变化上,3组分别增大（5.72±1.68）、（4.82±1.66）、（3.42±1.15） mm,生长加速组与生长高峰组差异无统计学意义（P＞0.05）,两组均显著大于生长减速组（P＜0.05）.腭中缝宽度扩弓前后变化上,3组分别增大（3.14±0.45）、（2.98±0.51）、（0.96±0.83） mm,生长加速组与生长高峰组差异无统计学意义（P＞0.05）,两组均显著大于生长减速组（P＜0.05）.结论 不同骨龄的青少年均可Objective To compare dental and skeletal changes after rapid maxillary expansion in patients with different bone ages.Methods Thirty-seven patients in different growth period were divided into three groups according to cervical vertebral maturation （CVM）.There were 13 patients in the growth acceleration group,13 patients in growth peak group,and 11 patients in growth deceleration group.Conebeam computed tomography（CBCT） images were segmented and reconstructed using Mimics image processing software to assess the change of palatal morphology before and after treatment.Statistical analysis was carried out using SPSS 17.0 software.Results After the expansion the posterior teeth and alveolar bone were tilted and the mid-palatal suture was opened in all three groups.The first molar angle in the three groups decreased by 2.66°±1.04°,3.53°±0.81° and 12.32°± 1.64°,respectively and no significant difference was found between the acceleration group and the peak group （P 〉 0.05）,but the changes in the acceleration group and the peak groups were significantly less than that in the deceleration group （P〈0.05）.The palatal angle in the three groups increased by 6.01°±2.06°,4.79°± 1.31° and 6.73°± 1.71°,respectively and no significant difference was found between the acceleration group and the deceleration group （P 〉 0.05）,but the changes in the acceleration group and the deceleration group were significantly greater than that in the peak group （P 〈 0.05）.The palatal cemento-enamel junction （CEJ） width,the middle palate width and the mid-palatal suture width in the three groups increased by （7.37± 1.31）,（6.68± 0.72） and （5.13± 1.42） mm;（5.72±1.68）,（4.82± 1.66） and （3.42± 1.15） mm;（3.14±0.45）,（2.98±0.51） and （0.96±0.83） mm,respectively and no significant difference was found between the acceleration group and the peak group （P 〉 0.05）,but the changes in the acceleration group and the peak group were significantly greater than t

关 键 词：腭扩张术 年龄测定 骨骼 锥束计算机体层摄影术 

分 类 号：R783.5[医药卫生—口腔医学]