不同部位微种植体支抗钉矫治成人露龈笑的临床对比研究  

Clinical Comparative of Mini-implants in Different Parts for Treatment of Adult with Gummy Smile

作　　者：吴彬 黎伟 覃李玲 陈瑶森 杨艳[2] WU Bin;LI Wei;QIN Li-ling;CHEN Yao-sen;YANG Yan(Department of Stomatology,the Third Clinical Medical College of the Three Gorges University,Gezhouba Central Hospital of Sinopharm,Yichang 443000,Hubei,China;Department of Stomatology,Zhongnan Hospital of Wuhan University,Wuhan 430070,Hubei,China)

机构地区：[1]三峡大学第三临床医学院·国药葛洲坝中心医院口腔科,湖北宜昌443000 [2]武汉大学中南医院口腔科,湖北武汉430070

出　　处：《中国美容医学》2021年第10期153-157,共5页Chinese Journal of Aesthetic Medicine

基　　金：三峡大学青年科学基金项目(编号:KJ2017A009);三峡大学教学研究项目(编号:J2019052)。

摘　　要：目的:研究微种植体支抗钉在不同部位植入对上前牙压低以治疗成人露龈笑效果的差异。方法:选取因上颌前部牙槽骨垂直向发育过度的露龈笑成人患者30例,根据微种植体支抗钉植入部位不同分为三组。A组:在上颌中切牙间颊侧牙槽骨植入1枚微种植体支抗钉;B组:在两侧尖牙与侧切牙间颊侧牙槽骨各植入1枚微种植体支抗钉;C组:对照组,采用摇椅弓压低上前牙。植入后2周用橡皮链牵引以压低上前牙,垂直牵引力为100g。通过对比压低前后露龈笑改善情况及头影测量数据的变化,观察不同方法压低上前牙改善露龈笑的效果。结果:2枚微种植体支抗钉在治疗期间松动/脱落,初期稳定率为93.3%。三组的垂直露龈量变化值分别为:A组(2.4±0.6)mm、B组(2.7±0.7)mm、C组(1.2±0.7)mm。三组总体变化趋势为:垂直露龈量降低、∠U1-SN增大、U1-PP距减小、UL-U1距减小、Overjet增大、Overbite减小,且差异具有统计学意义(P<0.05);另外,C组的U6-PP距增大具有统计学差异。相比C组,A、B组的垂直露龈量、U1-PP距、UL-U1距、Overbite的减小量更显著,而C组的∠U1-SN、U6-PP距、Overjet增大量更显著。与A组比较,B组的U1-PP与Overbite的减小更大,同时侧切牙的根吸收也更大。结论:两种不同部位植入微种植体支抗压低上前牙矫治露龈笑的效果整体相似,均能达到满意效果,值得临床推广使用。Objective To evaluate the difference in the effect of Mini-Implants on the intrusion anterior in different parts of the maxillary alveolar bone.Methods Thirty patients with Gummy smile were selected and divided into 3 groups according to the Mini-Implants sites.In group A,mini-implant was placed into the alveolar bone between the roots of maxillary central incisors.In group B,mini-implant was placed into the alveolar bone between the roots of maxillary canine and the lateral incisor in both side.In group C,Reverse Curve of Spee was used as control group.The rubber chain was used to intrusion the upper anterior after 2 weeks,the vertical force was 100g.Cephalometric measurements,external apical root resorption,and gingival exposure were used to evaluate the changes of the skeletal and dental.Results Two mini-implants lost during the treatment period,the initial stability rate was 93.3%.The average reduction of gingival exposure was(2.4±0.6)mm(group A),(2.7±0.7)mm(group B),(1.2±0.7)mm(group C)respectively.It showed similar significant change in all groups:the reduction of gingival exposure,U1-PP,UL-U1 and Overbite,as well as increase of∠U1-SN and Overjet.Compared to group C,the deduction of gingival exposure,U1-PP,UL-U1 and Overbite was more significant in group A and B,while the increase of∠U1-SN,U6-PP and Overjet was more significant(P<0.05).compared to group A,the decrease of U1-PP and Overbite was more significant in group B.Conclusion Two different parts of mini-implants used as orthodontic anchorage showed effectively intrude maxillary incisors in gummy smile correction and are worthy of clinical use,although there are slight differences in the efficacy and indication.

关 键 词：微种植体支抗钉 露龈笑 压低上前牙 支抗 摇椅弓 

分 类 号：R782.12[医药卫生—口腔医学]