伴宽度不调的成人骨性Ⅲ类畸形掩饰性治疗后横向代偿的锥形束CT分析  

The effect of transverse dental compensation of camouflaged treatment in adult skeletal Class Ⅲ patients with width discrepancy using cone-beam CT

作　　者：谷妍[1] 王华[1] 王林[1] GU Yan;WANG Hua;WANG Lin(Department of Orthodontics,AffiliatedHospital of Stomatology,Jiangsu Key Laboratory of Oral Diseases,Nanjing Medical University. Nanjing 210029,JiangsuProvince,China)

机构地区：[1]南京医科大学附属口腔医院正畸科南京医科大学口腔疾病研究江苏省重点实验室,江苏南京210029

出　　处：《上海口腔医学》2019年第1期36-40,共5页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(81830031);江苏省科教强卫口腔正畸学(ZDXKA2016026);江苏省高校优势学科建设工程项目(PAPD-2018-87)

摘　　要：目的:应用锥形束CT(cone-beam computed tomography,CBCT)探讨掩饰性治疗对伴宽度不调的骨性Ⅲ类畸形患者的磨牙颊舌向倾斜度、宽度及颊舌侧牙槽嵴的影响。方法:选取2014—2015年在南京医科大学附属口腔医院正畸科就诊的轻中度骨性Ⅲ类成人患者16例,其中男5例,女11例。治疗前、后均行CBCT扫描,应用Simplant 16.0软件进行校准及重建,对59个标记点及2个参考平面进行三维定位及测量分析。采用SPSS 17.0软件包对数据进行统计学分析。结果:治疗后,上颌磨牙颊舌侧倾斜角度增大,下颌磨牙倾斜角度减小。上颌磨牙间宽度增大,下颌磨牙间宽度略减小。上颌磨牙的颊侧牙槽嵴顶较治疗前有所降低(P<0.05),舌侧牙槽嵴顶及下颌磨牙的颊舌侧牙槽嵴顶高度无显著差异。结论:掩饰性治疗会继续加大伴宽度不调的骨性Ⅲ类患者的牙性横向代偿,并伴随上颌磨牙区的颊侧牙槽骨吸收。进行掩饰性治疗时,应明确磨牙横向代偿的潜力,选择合适的预置矫治器或者辅助手术扩弓,以避免牙周风险的发生。PURPOSE: To investigate the effect of buccolingual inclination and width of molars and their alveolar ridge height in skeletal Class III patients with width discrepancy by camouflaged treatment using cone-beam CT(CBCT).METHODS: Sixteen adult patients(5 males, 11 females) with mild to moderate skeletal Class III were treated with camouflaged method in the Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University from 2014 to 2015. CBCT scans were performed before and after treatment. Dicom data were calibrated and reconstructed using the software Simplant 16.0. Fifty-nine landmarks and two reference planes were located and measured in three coordinated dimensions. The data was processed using SPSS 17.0 software package. RESULTS: The buccolingual inclination of the maxillary first and second molars were increased, while the mandibular ones were decreased significantly after treatment(P<0.05). The inter-molar width was increased in the upper arch while decreased in the lower arch. The buccal alveolar ridge height of maxillary molars was decreased significantly(P<0.05). No significant difference of alveolar ridge height was found in the lingual side of maxillary molars or either side of mandibular molars. CONCLUSIONS:Camouflaged treatment deteriorated the transverse compensation in skeletal Class Ⅲ patients with width discrepancy,accompanied with maxillary buccal alveolar bone resorption. When camouflaged treatment is planned, the potential of molar compensation in transverse dimension should be clearly defined. Appropriate pre-adjusted appliance or surgery-assisted expansion should be considered to avoid periodontal risks.

关 键 词：骨性Ⅲ类错(牙合)畸形 掩饰性治疗 横向代偿 牙槽嵴顶高度 

分 类 号：R783.5[医药卫生—口腔医学]