后牙种植患者上前牙牙龈形态与牙槽骨形态相关性的数字化测量分析  

Digitalized analysis of the gingival and bone morphology in the maxillary anterior teeth in patient with posterior dental implant

作　　者：张薇[1] 李颖 刘冰 洪涛[3] 龙云婧 刘利鹏 安维康 马楚凡 Zhang Wei;Li Ying;Liu Bing;Hong Tao;Long Yunjing;Liu Lipeng;An Weikang;Ma Chufan(Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University&State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Key Laboratory of Stomatology,Xi'an 710032,China;Department of Stomatology,Air Force Medical Center,The Fourth Military Medical University,Beijing 100142,China;Department of Digital Dentistry Center,School of Stomatology,The Fourth Military Medical University&State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Clinical Research Center for Oral Diseases,Xi'an 710032,China)

机构地区：[1]第四军医大学口腔医学院口腔修复科,军事口腔医学国家重点实验室,口腔疾病国家临床医学研究中心,陕西省口腔医学重点实验室,西安710032 [2]空军军医大学特色医学中心口腔科,北京100142 [3]第四军医大学口腔医学院数字化口腔医学中心,军事口腔医学国家重点实验室,口腔疾病国家临床医学研究中心,陕西省口腔疾病临床医学研究中心,西安710032

出　　处：《中华口腔医学杂志》2022年第4期340-345,共6页Chinese Journal of Stomatology

基　　金：国家自然科学基金(81970971)。

摘　　要：目的通过数字化方法探讨后牙种植患者上前牙唇侧牙龈形态和牙槽骨形态的相关性,为前牙修复设计和美学重建提供参考。方法前瞻性选取2020年5月至2021年5月于第四军医大学口腔医学院口腔修复科行种植修复的后牙缺失患者64例,其中男性24例,女性40例,年龄(25.6±3.3)岁;按牙周表型分为薄龈型(29例)和厚龈型(35例)。采用口内扫描仪进行口内扫描,并拍摄锥形束CT,利用Geomagic和Mimics软件进行测量并记录上前牙唇侧牙冠宽度和高度、龈乳头高度、龈缘角度、骨乳头高度、骨缘角度。结果所有患者上颌中切牙、侧切牙、尖牙牙冠宽长比为0.85±0.08、0.80±0.08和0.86±0.09(F=10.71,P<0.01);上颌中切牙间、中切牙与侧切牙间、侧切牙与尖牙间龈乳头高度分别为(3.93±0.86)、(3.47±0.84)和(3.38±0.91)mm(F=7.44,P<0.01),其下骨乳头高度分别为(3.44±0.88)、(3.12±0.75)和(2.72±0.63)mm(F=14.26,P<0.01);上颌中切牙、侧切牙、尖牙龈缘角度分别为88.3°±7.7°、84.7°±8.9°和81.2°±6.6°(F=13.15,P<0.01),骨缘角度分别为103.2°±13.1°、99.5°±11.2°和110.6°±13.0°(F=13.25,P<0.01)。薄龈型受试者牙冠宽长比(0.81±0.08)、龈缘角度(82.2°±7.4°)、骨缘角度(99.4°±12.9°)均显著小于厚龈型受试者(分别为0.85±0.09、86.5°±8.6°、108.5°±11.4°)(t=-2.79、3.63、5.20,P<0.01);龈乳头高度[(3.93±0.81)mm]和骨乳头高度[(3.43±0.80)mm]显著大于厚龈型受试者[分别为(3.34±0.84)和(2.85±0.71)mm](t=-4.89、-5.36,P<0.01)。上前牙龈乳头高度与骨乳头高度呈中等程度正相关(r=0.66,P<0.01);牙冠宽长比与骨缘角度呈中等程度正相关(r=0.42,P<0.01);上前牙龈乳头高度与骨缘角度呈中等程度负相关(r=-0.58,P<0.01),骨乳头高度与骨缘角度呈高度负相关(r=-0.82,P<0.01)。结论上前牙不同牙位的牙冠形态、牙龈形态与牙槽骨形态各不相同;不同牙周表型患者上前牙牙冠宽长比、龈乳头高度、�Objective To explore and analyze the correlation between labial gingival morphology and alveolar bone morphology of maxillary anterior teeth in patients with posterior dental implant,so as to provide reference basis for restoration design and esthetic reconstruction of anterior teeth.Methods Sixty-four patients[24 males,40 females(25.6±3.3)years old]who planned to receive posterior dental implant restoration were recruited randomly with the inclusion and exclusion criteria in Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University from May 2020 to May 2021.According to the visibility of periodontal probe through gingival margin,the subjects were divided into thin and thick gingival biotypes,including 29 cases of thin biotype and 35 cases of thick biotype.The 3Shape software was used to perform oral scanning,and cone beam CT(CBCT)was taken for each patient.Geomagic and Mimics software were used to measure and record the labial crown width and length,gingival papilla height,gingival angle,bone papilla height and bone margin angle of maxillary anterior teeth.Results The crown width length ratios of maxillary central incisors,lateral incisors and canines were 0.85±0.08,0.80±0.08 and 0.86±0.09(F=10.71,P<0.01).The height of gingival papilla between maxillary central incisors,between central incisors and lateral incisors,between lateral incisors and canines were(3.93±0.86),(3.47±0.84)and(3.38±0.91)mm respectively(F=7.44,P<0.01),and the height of corresponding bone papilla were(3.44±0.88),(3.12±0.75)and(2.72±0.63)mm respectively(F=14.26,P<0.01).The gingival margin angles of maxillary central incisors,lateral incisors and canines were 88.3°±7.7°,84.7°±8.9°and 81.2°±6.6°(F=13.15,P<0.01),and the bone margin angles were 103.2°±13.1°,99.5°±11.2°and 110.6°±13.0°(F=13.25,P<0.01).The crown width length ratio(0.81±0.08),gingival margin angle(82.2°±7.4°)and bone margin angle(99.4°±12.9°)of thin gingival subjects were significantly lower than those of thick gingiv

关 键 词：美学 牙科 计算机辅助设计 牙槽突 牙龈 龈乳头 牙周表型 

分 类 号：R783.6[医药卫生—口腔医学]