正畸牵引术在下颌第三磨牙低位近中阻生拔除中的应用  

Application of Orthodontic Traction in Extraction of Impacted Mandibular Third Molar

作　　者：王留宏 程刚[2] 娄新田[1] 杨惠[1] 王一霖[1] WANG Liuhong;CHENG Gang;LOU Xintian;YANG Hui;WANG Yilin(Department of Stomatology,Shanghai Punan Hospital of Pudong New District,Shanghai 200125;Department of Stomatology,Zhejiang Provincial People's Hospital,Hangzhou 310014,Zhejiang Province,China)

机构地区：[1]上海市浦东新区浦南医院口腔科,上海200125 [2]浙江省人民医院口腔科,浙江杭州310014

出　　处：《口腔颌面外科杂志》2020年第1期36-41,共6页Journal of Oral and Maxillofacial Surgery

基　　金：上海市浦东新区卫生和计划生育委员会科技发展专项基金资助项目(PW2016A-25)

摘　　要：目的 :研究正畸牵引拔除下颌近中阻生第三磨牙对改善邻牙牙槽骨缺损的作用。方法 :选取2016-07—2018-01期间,我院收治的单侧或双侧有第二磨牙远中牙槽骨缺损的下颌第三磨牙近中阻生患者60例,按照随机数字表法将所有患者分为对照组(30例)和正畸牵引组(30例)。对照组患者常规拔除下颌第三磨牙,正畸牵引组患者经正畸牵引1~6个月后拔除下颌第三磨牙。检测患者正畸牵引治疗前(T0)、拔牙前(T1)、拔牙后3个月(T2)、拔牙后6个月(T3)这几个时间点,下颌第二磨牙近中及远中牙槽嵴顶至釉牙骨质界高度、下颌第二磨牙近中及远中牙槽骨密度、张口受限情况。结果:正畸牵引组患者在T1、T2、T3节点时,下颌第二磨牙近中牙槽嵴顶至釉牙骨质界高度分别为5.16、3.98、2.12 mm,均低于对照组的7.16、4.57、3.16 mm,差异有统计学意义(t/P=12.250/0.001、8.963/0.001、56.680/0.001)。正畸牵引组患者在T1、T2、T3节点时,下颌第二磨牙远中牙槽嵴顶至釉牙骨质界高度分别为5.24、3.15、2.34 mm,低于对照组的8.12、5.49、3.16 mm,差异有统计学意义(t/P=17.670/0.001、43.280/0.001、15.110/0.001)。正畸牵引组患者在T1、T2、T3节点时,张口受限评分分别为2.10、1.25、0.68分,均低于对照组的2.56、2.00、1.69分,差异有统计学意义(t/P=9.690/0.001、30.530/0.001、41.120/0.001)。结论:正畸牵引拔除下颌近中阻生第三磨牙可有效改善邻牙牙槽骨缺损现象,增大牙槽骨密度。Objective:To study the effect of orthodontic traction in the extraction of impacted mandibular third molar especially its effects on the alveolar bone defect of adjacent teeth.Methods:From July 2016 to January 2018,60 cases of impacted mandibular third molars with unilateral or bilateral distal alveolar bone defect of the second molar were selected.All patients were divided into control group(n=30)and orthodontic traction group(n=30)according to the random number table method.The control group received conventional minimally invasive tooth extraction of mandibular third molars,while the orthodontic traction group received 1-6 months of orthodontic traction,and minimally invasive tooth extraction of mandibular third molars.The height of the alveolar bone from the crest of the proximal and distal mandibular second molars to the enamel bone boundary,the height and density of the alveolar bone around the mandibular second molars,and the limitation of month opening at 4 time points,were recorded.The 4 time pionts including before orthodontic traction treatment(T0),before tooth extraction(T1),three months after tooth extraction(T2)and six months after tooth extraction(T3).Results:In the orthodontic traction group,the height of the mandibular second molars(from the alveolar crest to the enamel cementum boundary)at time points of T1,T2 and T3(5.16,3.98 and 2.12 mm respectively)were lower than those of the control group(7.16,4.57 and 3.16 mm),with t/P=12.250/0.001,8.963/0.001,56.680/0.001.In the orthodontic traction group,the height from the distal alveolar crest to the enamel bone boundary of the mandibular second molars at T1,T2 and T3 time points(5.24,3.15 and 2.34 mm),were lower than those of the control group(8.12,5.49 and 3.16 mm),with t/P=17.670/0.001,43.280/0.001 and 15.110/0.001 respectively.In the orthodontic traction group,the scores of limited mouth opening at T1,T2 and T3 time points,were 2.10,1.25,0.68 respectively,which were lower than those in the control group(2.56,2.00,1.69),with t/P=9.690/0.001,30.530/0

关 键 词：下颌第三磨牙 近中阻生 正畸牵引 牙拔除术 邻牙牙槽骨缺损 

分 类 号：R782.1[医药卫生—口腔医学]