上颌中切牙垂直埋伏阻生矫治疗效的锥形束CT分析  

Cone-beam CT analysis on the treatment efficacy in the vertically impacted maxillary central incisors

作　　者：王笑辰 王林[1] 谷妍[1] 王玉华 赵春洋[1] Wang Xiaochen;Wang Lin;Gu Yan;Wang Yuhua;Zhao Chunyang(Department of Orthodontics,Affiliated Hospital of Stomatology,Nanjing Medical University&Institute of Stomatology,Nanjing Medical University,Nanjing 210029,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医学研究所,210029

出　　处：《中华口腔医学杂志》2019年第11期739-744,共6页Chinese Journal of Stomatology

基　　金：国家自然科学基金(81830031);江苏省高校优势学科建设工程项目(2018-87);江苏省医学重点学科项目(ZDXKA2016026)。

摘　　要：目的通过锥形束CT分析上颌中切牙垂直埋伏阻生的矫治疗效,探讨替牙期上颌中切牙垂直埋伏阻生的矫治时机及正畸牵引对牙根发育及牙槽骨附着的影响。方法选择2012年12月至2017年12月于南京医科大学附属口腔医院正畸科就诊的单颗上颌中切牙垂直埋伏阻生患者22例,男性12例,女性10例,年龄(9.2±0.9)岁。按牙龄分为早期治疗组(牙根形成1/3~2/3,12例)和晚期治疗组(牙根接近形成或已形成,10例),以患者对侧同名牙为对照。对治疗前后及随访时(治疗后1年)的锥形束CT进行三维重建,测量分析埋伏牙和对照牙的牙根长度、牙体表面积及体积、唇舌侧根尖牙槽骨厚度、唇侧牙槽骨丧失高度及骨内根占比,于口内测量临床冠长度,计算分析埋伏牙与对照牙各测量项目差值(对照牙测量值-埋伏牙测量值)。结果治疗后早期治疗组、晚期治疗组的埋伏牙与对照牙牙根长度差值[分别为(1.58±1.56)和(2.57±1.00)mm]均显著小于各组治疗前[分别为(3.47±1.40)和(3.36±0.79)mm](P<0.05),治疗后早期治疗组埋伏牙与对照牙牙体表面积差值及体积差值[分别为(0±34)mm2和(-10±44)mm3]均显著小于治疗前[分别为(38±31)mm2和(55±70)mm3](P<0.05)。治疗后早期治疗组埋伏牙与对照牙各测量项目差值与晚期治疗组的差异均无统计学意义(P>0.05)。治疗后两组埋伏牙的牙根长度及骨内根占比均显著小于对照牙(P<0.05),临床冠长度、唇侧牙槽骨丧失高度均显著大于对照牙(P<0.05)。结论正畸牵引可加速垂直埋伏阻生上颌中切牙牙根的生长发育,但治疗后牙根长度及牙槽骨附着仍不能达到正常水平,替牙期矫治时机对垂直埋伏阻生上颌中切牙的牙根发育和牙槽骨附着无影响。Objective To analyze the treatment efficacy in the vertically impacted maxillary central incisors using cone-beam CT(CBCT)and explore the treatment timing and the influence of orthodontic traction on the root development and alveolar bone height in the mixed dentition.Methods Twenty-two patients with vertically impacted maxillary central incisor who were admitted to the Department of Orthodontics,Stomatological Hospital affiliated to Nanjing Medical University from December 2012 to December 2017 were selected[12 males and 10 females,(9.2±0.9)years].Based on the dental age,patients were classified as early treatment group(teeth ranging from a third to two thirds of root formation,n=12)and late treatment group(teeth with nearly or fully complete root formation,n=10).The contralateral maxillary central incisor was used as the control.Three-dimensional reconstruction of CBCT before treatment,after treatment and one year after treatment was carried out to measure root length,tooth surface area,tooth volume,labial and lingual apical alveolar bone thickness,the loss of labial alveolar bone height and intraosseous root ratio.The clinical crown length was measured in the mouth.The difference values of the measurement variables between the impacted teeth and the control teeth were calculated and analyzed(measurement values of impacted teeth were subtracted from control values).Results The values of root length difference beween the impacted teeth and the control teeth in the early and late treatment group were(1.58±1.56)mm and(2.57±1.00)mm,respectively after the treatment and the values were significantly less than those corresponding values before treatment[(3.47±1.40)and(3.36±0.79)mm](P<0.05).After the treatment,the values of the surface area and volume difference between the impacted teeth and the control teeth in the early treatment group[(0±34)mm2 and(-10±44)mm3]were significantly less than those corresponding values before treatment[(38±31)mm2 and(55±70)mm3](P<0.05).The value differences of any measurement v

关 键 词：切牙 牙 阻生 锥束计算机体层摄影术 牙正畸牵引 

分 类 号：R78[医药卫生—口腔医学]