CBCT初步评价Invisalign矫治器在牙周炎患者正畸中对牙槽骨改建的影响  

A preliminary assesment of Invisalign appliance on alveolar bone remodeling during orthodontic treatment in patients with periodontitis

作　　者：孙英媛 周光辉[1] 陈莉[1] 

机构地区：[1]首都医科大学附属北京口腔医院正畸科,100050

出　　处：《中华口腔正畸学杂志》2017年第3期137-141,共5页Chinese Journal of Orthodontics

基　　金：“首都临床特色应用研究”专项基金（z131107002213047）

摘　　要：目的 采用CBCT（Cone Beam CT）三维体素配准评估Invisalign矫治器在牙周炎正畸中对牙槽骨改建产生的影响.方法 选取唇向伸长展开的48颗前牙（来自6名成人慢性牙周炎患者）.采用Invisalign矫治器对前牙进行压入内收.采用Analyze12.0软件,上颌以双颧部为基准区域对治疗前后的CBCT图像进行体素重叠,下颌以下颌下缘及颏前部为基准区域建立测量参考平面,测量上下切牙根尖及切缘位置和唇倾度的变化、牙槽骨高度的变化以及牙槽骨密度的变化.结果 双颧部重叠分析显示,上前牙平均压入（0.82±0.31） mm（P＜0.05）,唇倾度减小（10.59±6.77）°（P＜0.05）,平均骨高度增加（0.41±0.15） mm（P＜0.05）.下颌重叠分析显示,下前牙平均压入（0.68±0.41） mm（P＜0.05）,唇倾度减小（6.84±3.77）°（P＜0.05）,平均骨高度增加（0.26±0.27） mm（P＜0.05）.治疗后上下颌各测量区域的密度均降低,在牙槽嵴顶的舌侧差异具有显著性（P＜0.05）.结论 Invisalign矫治器应用于成人牙周病正畸,能有效实现前牙的压入内收.牙槽骨高度较治疗前有一定程度的恢复.Objective The purpose of this study was to investigate the effects of Invisalign appliance on alveolar bone remodeling during orthodontic treatment in patients with periodontitis,based on voxel registration of cone beam computed tomography （CBCT） data.Methods 48 flared and elongated anterior teeth from six adult patients with aggressive periodontitis were selected,These teeth were retracted and intruded with Invisalign appliance.Analyze12.0 was used to superimpose the pre-and post-treatment CBCT data based on voxel registration.The bilateral-zygomatic bone was used as maxillary registration reference,and the inferior border of mandible and anterior chin were used to set up reference planes.The apical point and midpoint of the incisor edge,the proclination of the teeth,alveolar bone height,as well as the alveolar bone density of the upper and lower incisors were measured.Results The maxillary superimposition showed the mean intrusion of upper anterior teeth were （0.82±0.31） mm （P〈0.05）.The proclination of teeth were reduced by （10.59±6.77）°（P〈0.05）,and the bone density were increased by （0.41 ± 0.15） rnm （P〈0.05）.The mandible superimposition showed that the lower anterior teeth were intruded by （0.68±0.41） mm （P〈0.05）.The proclination were reduced by （6.84±3.77）° （P〈0.05）,and the bone density were increased by （0.26±0.27） mm （P〈0.05）.The density of alveolar bone were decreased after treatment,especially in the lingual side of alveolar crest （P〈0.05） Conclusions Invisalign appliance could effectively retract and intrude the migrated anterior teeth in adult orthodontic patient with periodontitis.The alveolar bone height could be restored in some extent comparing to pretreatment.

关 键 词：成人牙周病 隐形矫治器 CBCT 体素配准 牙槽骨改建 

分 类 号：R783.5[医药卫生—口腔医学]