锥形束CT评价伴安氏Ⅱ类错[牙合]畸形正畸史牙周炎患者牙槽骨缺损特点的研究  

Characteristics of the alveolar bone defects evaluated by cone-beam CT in periodontitis patients with orthodontic treatment history of Angle class Ⅱ malocclusion

作　　者：殷冉 赵海礁[1] 李玉超 潘亚萍[1] Yin Ran;Zhao Haijiao;Li Yuchao;Pan Yaping(Department of Periodontics,School and Hospital of Stomatology,China Medical University,Liaoning Provincial Key Laboratory of Oral Diseases,Shenyang 110002,China)

机构地区：[1]中国医科大学口腔医学院·附属口腔医院牙周病科,辽宁省口腔疾病重点实验,沈阳110002

出　　处：《中华口腔医学杂志》2021年第8期769-776,共8页Chinese Journal of Stomatology

基　　金：辽宁省“兴辽英才计划”项目(XLYC1802129)。

摘　　要：目的应用锥形束CT检测伴正畸史牙周炎患者牙槽骨缺损高度,分析其牙位、位点及牙周炎分期特异性,以期指导临床个性化诊疗方案的制定。方法选取2009年1月至2019年6月于中国医科大学口腔医学院·附属口腔医院牙周病科就诊的牙周炎伴安氏Ⅱ类错[牙合]畸形正畸史(曾接受唇侧固定矫治且已矫治完成)的患者30例(正畸组),年龄(27.0±5.4)岁(18~41岁),按照年龄、性别及牙周炎严重程度配对,同时选取60例无正畸史牙周炎患者作为对照(非正畸组),年龄(26.7±5.2)岁(18~41岁)。应用锥形束CT测量纳入患者全口牙齿各位点的牙槽骨缺损高度,比较正畸组与非正畸组在上下颌同一牙位的牙槽骨缺损高度差异,分析正畸组牙槽骨缺损高度在上下颌不同牙位及同一牙位不同位点的特异性,并比较正畸组各牙周炎分期的牙槽骨缺损高度的牙位特异性。结果正畸组患者上颌尖牙区和磨牙区、下颌切牙区、尖牙区和前磨牙区的牙槽骨缺损高度均显著大于非正畸组(P<0.05)。正畸组患者上下颌牙槽骨高度缺损最重牙位均为尖牙区[分别为(3.75±1.00)、(3.83±1.10)mm],其次上颌牙槽骨高度缺损较重牙位依次为磨牙区[(3.67±0.84)mm]及切牙区[(3.39±0.83)mm],下颌牙槽骨高度缺损较重牙位依次为切牙区[(3.73±1.42)mm]及磨牙区[(3.54±0.81)mm],且下颌切牙区骨缺损高度显著大于上颌切牙区(P<0.05),上颌磨牙区骨缺损高度显著大于下颌磨牙区(P<0.05);除上颌切牙区外,上下颌其他牙位颊舌侧牙槽骨缺损高度均显著大于近远中侧(P<0.05)。牙周炎分期不同,上下颌牙槽骨缺损高度最重牙位发生改变,牙周炎Ⅰ期上颌最重牙位为磨牙区[(3.26±0.63)mm],下颌最重牙位为切牙区[(3.14±1.04)mm],牙周炎Ⅱ期上颌牙槽骨缺损高度最重牙位为尖牙区,Ⅲ、Ⅳ期各期上下颌同颌内4个不同牙位区域,牙槽骨缺损高度最重牙位均为尖牙区(P<0.05)。�Objective To evaluate the levels of alveolar bone defects by using cone-beam CT in periodontitis patients with history of orthodontic treatment and to find the special tooth positions,sites and periodontitis stages of alveolar bone defects,so as to provide reference for the formulation of clinical personalized diagnosis and treatment plans.Methods Thirty patients who were diagnosed as Angle classⅡmalocclusion,treated by using labial fixed orthodontic appliances and also diagnosed as periodontitis(orthodontic group)were recuited from January 2009 to June 2019 at the School and Hospital of Stomatology,China Medical University in the present study.They were aged(27.0±5.4)years old(ranged 18-41 years old).Another 60 periodontitis patients without a history of orthodontic treatment matched according to age,gender and severity of periodontitis were selected as control group(non-orthodontic group).They were aged(26.7±5.2)years old(ranged 18-41 years old).Cone-beam CT images were used to measure the heights of the alveolar bone defects at each tooth position of the patients.The difference in the heights of the alveolar bone defects between the orthodontic group and the non-orthodontic group at the same position of the maxillary and mandibular alveolar bones were compared.The specificities of the defect heights in different positions of the maxillary and mandibular alveolar bones and different sites of the same tooth position were analyzed among orthodontic group.The specificities of the different tooth positions of the maxillary and mandibular alveolar bones of the different periodontitis stages among orthodontic group were compared.Results The heights of the alveolar bone defects in the maxillary canine area and molar area,the mandibular incisor area,the canine area and the premolar area in the orthodontic group were higher than that in the non-orthodontic group,and the differences were statistically significant(P<0.05).In orthodontic group,the most severe teeth in the maxillary and mandibular alveolar bone defects

关 键 词：牙周炎 锥束计算机体层摄影术 错[牙合] 安氏Ⅱ类 牙槽骨质丢失 

分 类 号：R783.5[医药卫生—口腔医学] R781.42[医药卫生—临床医学]