两种矫治设计在下颌近中唇侧阻生异位尖牙治疗中对邻近切牙牙根吸收的对比研究  

Comparative study of mandibular adjacent incisor root resorption following orthodontic management of mandibular mesial-labial impacted ectopic canines between two correction designs

作　　者：杜建东[1] 韩保迪[1] 李芳兰 张颖杰[1] DU Jiandong;HAN Baodi;LI Fanglan;ZHANG Yingjie(The Second Hospital of Lanzhou University,China,Lanzhou 730030)

机构地区：[1]兰州大学第二医院,730030

出　　处：《实用口腔医学杂志》2022年第4期471-478,共8页Journal of Practical Stomatology

基　　金：甘肃省自然科学基金(编号:21JR1RA120)。

摘　　要：目的:对比研究三维虚拟矫治设计和常规矫治设计在下颌近中唇侧阻生异位尖牙治疗中对邻近切牙牙根吸收的影响。方法:24例下颌单侧近中唇侧阻生异位尖牙患者随机分为2组(n=12)。所有患者矫治前(T0)行下颌牙颌CBCT扫描,在三维方向上测量邻近切牙牙根长度及面积。研究组口内数字化模型与CBCT 3D模型进行配准融合建立三维整合牙颌模型,确定阻生异位尖牙牵引方向和定位牵引钩位置,并3D打印牵引钩导板,根据牵引钩导板制作改良舌弓牵引钩。对照组参照CBCT及口腔检查设计制作改良舌弓牵引钩。对24例24颗下颌近中唇侧阻生异位尖牙进行正畸治疗,尖牙牙冠牵引至侧切牙牙根远中时(T1)行CBCT复查,复测下颌切牙牙根长度及面积并与初始数据比较,并记录牵引用时。结果:24颗近中唇侧阻生异位尖牙均成功牵引至侧切牙牙根远中,牙髓和牙周情况良好。牵引前后比较异位侧下颌切牙牙根长度及面积,研究组在三维方向上均无统计学意义(P>0.05),对照组有不同程度减小(P<0.05)。T0-T1用时研究组平均6.05个月,对照组8.25个月(P<0.01)。结论:口内数字化模型与CBCT 3D模型进行配准融合,三维虚拟矫治设计,设计个性化牵引装置可有效矫治下颌近中唇侧阻生异位尖牙,防止邻近切牙牙根进一步吸收。Objective:To compare mandibular incisor root resorption following orthodontic management of mandibular mesia-labialy impacted ectopic canines between 3D virtual correction design and convention correction design.Methods:24 patients with mandibular unilateral mesial-labial impacted ectopic canine were randomly divided into 2 groups(n=12).Befort treatment(T0),the mandibular dentognathic relationship of all patients was scaned with CBCT,the length and area of mandibular incisor roots were measured in 3 dimensions.In the study group,the CBCT-based mandibular dental model was integrated with laser-scanned dental model,virtual direction and the point of traction were determined based on integrated digital mandibular dental model,3D virtual traction hook guide was designed and printed according to the virtual correction plan,traction hook of modified lingual arch was fabricated according to 3D virtual traction hook guides.In control group,traction hook of modified lingual arch was fabricated according to the CBCT and oral examination.The 24 mesial-labial ectopic mandibular canines were orthodenticlly treated,as crowns of the canines were pulled to distal of the adjacent lateral incisor roots(T1),the teeth were scaned with CBCT again,the length and area of mandibular incisor roots were measured in 3 dimensions again and compared with the previous data,the traction time was recorded.Results:All of the 24 impacted ectopic canines were drawn to distal of the adjacent lateral incisors successfully.Their pulp and periodontal attachment were normal.Before and after traction,the length and area of ectopic side mandibular incisor roots showed no significant difference on 3D orientation in the study group(P>0.05),and all decreased in control group(P<0.05).From T0 to T1,It took 6.05 months in study group and 8.25 months in control group(P<0.01).Conclusion:3D virtual correction plan and individual traction device is effective in the treatment of mandibular mesia-labialy impacted ectopic canines and may avoid the root resorption of

关 键 词：下颌阻生异位尖牙 三维整合牙颌模型 CBCT 虚拟矫治 牙根吸收 

分 类 号：R783.5[医药卫生—口腔医学]