两种方法压低下前牙的效果及牙根吸收状况的临床研究  

Clinical Study on the Effect of Two Methods to Depress Anterior Teeth and Root Absorption

作　　者：郑琳琳 何丹青[2] 范海霞 耿海霞[1] ZHENG Linlin;HE Danqing;FAN Haixia;GENG Haixia(Department of Orthodontics,Affi liated Hospital of Shandong Jining Medical College,Jining 272000,Shandong,China;Department of Orthodontics,Peking University Stomatological Hospital,Beijing 100034,China;School of Stomatology,Shandong Jining Medical College,Jining 272000,Shandong,China)

机构地区：[1]山东济宁医学院附属医院口腔正畸科,山东济宁272000 [2]北京大学口腔医院口腔正畸科,北京100034 [3]山东济宁医学院口腔学院,山东济宁272000

出　　处：《中国美容医学》2022年第4期125-129,共5页Chinese Journal of Aesthetic Medicine

基　　金：济宁医学院附属医院“苗圃”科研计划项目(编号:MP-2016-008);济宁医学院科研扶持基金项目(编号:JYFC2019FKJ168)。

摘　　要：目的:比较使用微种植钉支抗和平面导板两种方法压低下前牙打开咬合的矫治效果以及下前牙牙根吸收的差异。方法:选取济宁医学院附属医院正畸科深覆牙合患者40例,随机分为两组。A组采用微种植钉支抗,B组采用平面导板压低下前牙。将A、B两组患者压低前,压低后CBCT图像资料导入Dolphin三维重建软件进行三维重建,评估下前牙的压低效果,并测量两组患者牙根根尖外吸收量。结果:两组患者均达到了正常覆牙合,A、B组覆牙合分别平均减小了3.4 mm、3.2 mm(P<0.001),组间比较差异无统计学意义(P>0.05);下切牙的阻抗中心点分别降低了3.1 mm、2.8 mm(P<0.001),组间比较差异无统计学意义(P>0.05)。两组的下切牙分别唇倾了5.2°、6°(P<0.05),组间比较差异无统计学意义(P>0.05)。A组垂直向骨性测量指标MP-SN、FMA值未发生显著性改变(P>0.05),B组MP-SN、FMA值分别增加了0.7°和0.8°(P<0.05)。B组中切牙、侧切牙的牙根吸收分别为(0.98±0.30) mm、(0.94±0.20) mm,均高于A组中切牙、侧切牙的牙根吸收量(0.71±0.30) mm、(0.69±0.20) mm(P<0.05)。尖牙牙根吸收量两组比较差异无统计学意义(P>0.05)。结论:针对下前牙过长型的深覆牙合,微种植钉压低下前牙可达到良好的矫治效果。平面导板作为一种传统的活动矫治器压低前牙及打开咬合可以达到与微种植钉压低前牙类似的矫治效果。然而,平面导板组可能导致下颌平面角增加及较多的牙根吸收量。在临床工作中,医生需综合考虑选择合适的压低方法。Objective To compare the intrusion effect and root resorption of lower incisors by using mini-screw and bite plate.Methods 40 cases with deep over bite from orthodontic departments of affiliated hospital of Ji Ning Medical college were randomly divided into two groups. group A were treated by using mini-screw, whereas group B by using bite plate. CBCT image data were obtained before and after intrusion and imported into Dolphin 3d reconstruction software for reconstruction.The intrusion effect of lower incisor was evaluated, and the amount of root resorption was measured in patients in the two groups. Results Normal overbite was achieved in both groups, with an average reduction of 3.4 mm and 3.2 mm in group A and group B respectively(P<0.001), and no significant difference was observed between the two groups. The center of resistance of the lower incisors decreased 3.1 mm and 2.8 mm in group A and group B, respectively(P<0.001), and no significant difference was observed between the two groups. Lower incisors in the two groups had protruded of 5.2°and 6°, respectively(P<0.05), and no significant difference was observed between the two groups. The MP-SN and FMA values of the vertical bone measurement indexes in group A did not change significantly(P>0.05), while the MP-SN and FMA values in group B increased by 0.7° and 0.8°, respectively(P<0.05). Root resorption of central incisors and lateral incisors in group B were(0.98±0.30) mm and(0.94±0.20) mm, respectively, which were higher than that of group A(0.71±0.30) mm and(0.69±0.20) mm(P<0.05).No significant difference in canine root absorption between the two groups(P>0.05). Conclusion In respect to the deep overbite which caused by overeruption of the lower anterior teeth,the mini-screw can effectively intrude the lower anterior teeth.As a traditional movable orthodontic appliance, the bite plate can achieve comparable effect as the miniscrew in intrusion of the lower anterior teeth and solving the deep overbite. However,the bite plate may lead to an incr

关 键 词：深覆牙合 牙根吸收 微种植钉 平面导板 

分 类 号：R783.5[医药卫生—口腔医学]