骨皮质微钻孔术辅助压低磨牙在修复前正畸中应用的临床研究  

The clinical study on micro-osteoperforations aiding to depress molars in orthodontic treatment before restoration

作　　者：陆建锋 郭海波 邱憬[1] LU Jianfeng;GUO Haibo;QIU Jing(Department of Oral Implantology,The Affiliated Stomatological Hospital,Jiangsu Province Key Laboratory of Oral Diseases,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属口腔医院种植科,江苏省口腔疾病研究重点实验室,江苏省口腔转化医学工程研究中心,江苏南京210029 [2]南通市口腔医院正畸科,江苏南通226001

出　　处：《口腔医学》2022年第11期1000-1005,共6页Stomatology

基　　金：国家自然科学基金面上项目(81870799);江苏省重点研发计划(社会发展)项目(BE2019728);江苏高校“青蓝工程”中青年学术带头人项目。

摘　　要：目的研究骨皮质微钻孔对伸长牙压入速度的影响并评价骨皮质微钻孔加速压低伸长牙的安全稳定性。方法收集44例下颌单侧第一磨牙缺失,对颌磨牙伸长,需在修复前压低上颌磨牙的患者,随机分为两组,每组22例。对照组患者经局部麻醉后,在目标牙的颊侧和腭侧分别植入微种植支抗钉,术后即刻用链状橡皮圈横跨牙齿牙合面加力,压至目标牙与邻牙边缘嵴相平齐为止,随后修复缺失的下颌磨牙。研究组也进行如上操作,并分别在目标牙颊侧和腭侧的近中、远中四个区域,用手动工具助攻丝锥钻孔,穿透皮质骨,深度达骨皮质下2 mm。每个区域钻3个孔,孔间距3 mm。观察两组患者的压低距离、压入时间、术后疼痛程度、牙根吸收情况及稳定性。结果对照组的平均压低距离为2.37 mm,研究组为2.36 mm,两组之间无显著性差异。对照组平均压入时间6.2个月,研究组平均压入时间5.0个月,明显缩短治疗时间。两组的术后疼痛比较无显著性差异。牙根吸收情况观察显示,对照组的牙根吸收率大于研究组。结论骨皮质微钻孔术可加速牙齿压入速度,进而缩短疗程,使患者能尽早进行义齿修复,还可降低牙根吸收风险,且不增加疼痛感。Objective To study the influence of micro-osteoperforations on the pressing speed of elongated teeth and evaluate the safety and stability of its application to accelerate depressing elongated teeth.Methods Forty-four patients,who had missing mandibular unilateral first molars with elongated antagonist molars and needed to depress maxillary molars before restoration,were collected and randomly divided into two groups with 22 patients in each group.After local anesthesia,patients in the control group were implanted with micro-implant anchorage nails in buccal and palatal sides of the target teeth.Immediately after the operation,a chain rubber band was used to apply force across occlusal surfaces of the teeth,which was pressed until the target teeth were flush with marginal ridges of adjacent teeth.Subsequently,their missing mandibular molars were restored.The above operation was also carried out in the experimental group.Using manual tools to assist taps,holes were drilled in mesio and distal areas of buccal and palatal sides of the target teeth,respectively,to penetrate the cortical bone with a depth of 2 mm below the bone cortex.Three holes were drilled in each area with a spacing of 3 mm.The depression distance,pressing time,postoperative pain degree,root resorption degree and root stability of the two groups were observed.Results Average depression distance of the control group was 2.37 mm,while that of the experimental group was 2.36 mm,with no significant difference.Average pressing time in the control group was 6.2 months,while that in the experimental group was 5.0 months,which indicated that the course of treatment was significantly shortened.There was no significant difference in postoperative pain between the two groups.Observation of root resorption showed that the root resorption rate of the control group was higher than that of the experimental group.Conclusion Micro-osteoperforations can accelerate the speed of tooth depression,thus shorten the course of treatment,enabling patients to make denture r

关 键 词：骨皮质微钻孔 微种植支抗 磨牙压低 

分 类 号：R783.5[医药卫生—口腔医学]