骨性Ⅱ类高角错[牙合]患者术前正畸下前牙去代偿效果及牙槽骨改建分析  

Decompensation effectiveness and alveolar bone remodeling analysis of mandibular anterior teeth after preoperative orthodontic treatment in high-angle patients with skeletal classⅡmalocclusion

作　　者：付玉[1] 胡鑫浓 崔圣洁 施捷[2] FU Yu;HU Xin-nong;CUI Sheng-jie;SHI Jie(Fourth Clinical Division,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology&NHC Research Center of Engineering and Technology for Computerized Dentistry&NMPA Key Laboratory for Dental Materials,Beijing 100081,China;Department of Orthodontics,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology&NHC Research Center of Engineering and Technology for Computerized Dentistry&NMPA Key Laboratory for Dental Materials,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院第四门诊部,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京100081 [2]北京大学口腔医学院·口腔医院正畸科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2023年第1期62-69,共8页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(81901053);北京大学口腔医院新技术新疗法项目(PKUSSNCT-20G02,PKUSSNCT-22A05)。

摘　　要：目的:应用头颅侧位片和锥形束计算机体层摄影术(cone-beam computed tomography,CBCT)评价骨性Ⅱ类高角错[牙合]患者术前正畸的下前牙去代偿效果和牙槽骨改建情况。方法:从2017年1月至2022年8月在北京大学口腔医院完成术前正畸及正颌手术的骨性Ⅱ类高角错[牙合]患者中,筛选出30例术前正畸前后拍摄了头颅侧位片和CBCT的患者。测量术前正畸前后与下前牙角度及线距相关的头影测量项目,包括:下中切牙(L1)长轴-眶耳平面角(L1-Frankfort horizontal plane angle,L1-FH)、L1长轴-下颌平面角(L1-mandibular plane angle,L1-MP)、L1长轴-鼻根点-下齿槽座点连线交角(L1-nasion-supramental angle,L1-NB)、L1切缘到鼻根点-下齿槽座点连线的垂直距离(L1-NB线距)等。利用CBCT测量并评估术前正畸前后下前牙唇/舌侧骨开裂长度(d-La/d-Li)及骨开裂/骨开窗发生情况的变化。采用Pearson相关性分析,评价L1的d-Li变化量与年龄、术前正畸疗程及治疗前头影测量项目之间的相关性,筛选出与术前正畸牙周风险相关的因素。结果:经过术前正畸治疗,L1-FH、L1-MP、L1-NB、L1-NB线距分别变化了11.56°±5.62°、-11.13°±5.53°、-11.57°±5.43°、(-4.99±1.89)mm,差异均具有统计学意义(P<0.05)。180个测量牙位中,45个术前正畸前(T0)唇侧存在骨开裂/骨开窗,而术前正畸后(T1)不再骨开裂/骨开窗;142个T0时舌侧不存在骨开裂/骨开窗,而T1时出现了骨开裂/骨开窗。术前正畸后下侧切牙(L2)、下尖牙(L3)及下前牙(L1+L2+L3)的d-La分别减小了(0.95±2.22)mm、(1.20±3.23)mm及(0.68±2.50)mm,且差异均具有统计学意义(P<0.05);术前正畸后L1、L2、L3及L1+L2+L3的d-Li分别增加了(4.43±1.94)mm、(4.53±2.35)mm、(3.19±2.80)mm及(4.05±2.46)mm,差异均具有统计学意义(P<0.05)。L1的d-Li变化量与治疗前的L1-FH值成正相关(r=0.373,P=0.042)。结论:骨性Ⅱ类高角错[牙合]患者在减数双侧下颌第一前磨牙后经过完�Objective:To evaluate the decompensation effectiveness and alveolar bone remodeling of mandibular anterior teeth after preoperative orthodontic treatment in high-angle patients with skeletal classⅡmalocclusion using lateral cephalogram and cone-beam computed tomography(CBCT).Methods:Thirty high-angle patients with skeletal classⅡmalocclusion who had received preoperative orthodontic treatment and orthognathic surgery in Peking University School and Hospital of Stomatology between Ja-nuary 2017 and August 2022 and had taken lateral cephalogram and CBCT before and after preoperative orthodontic treatment were selected.Items were measured with lateral cephalogram including:The lower central incisor(L1)-Frankfort plane angle(L1-FH),the L1-mandibular plane angle(L1-MP),the L1-nasion-supramental angle(L1-NB)and the vertical distance from the incisal edge of lower central incisor to NB line(L1-NB distance),etc.The incidence of dehiscence/fenestration and the length of dehiscence at labial side(d-La)and lingual side(d-Li)were measured using CBCT.Pearson correlation analysis was used to evaluate the correlation between the changes of d-Li of L1 and age,duration of preoperative orthodontic treatment and the cephalometric measurements before preoperative orthodontic treatment to screen out risk factors affecting the periodontal risk of preoperative orthodontic treatment in high-angle patients with skeletal classⅡmalocclusions.Results:After preoperative orthodontic treatment,L1-FH,L1-MP,L1-NB and L1-NB distances changed by 11.56°±5.62°,-11.13°±5.53°,-11.57°±5.43°and(-4.99±1.89)mm,respectively,and the differences were all statistically significant(P<0.05).Among the 180 measured mandibular anterior teeth,45 cases with labial dehiscence/fenestration before preoperative orthodontic treatment(T0)had no longer labial dehiscence/fenestration after preope-rative orthodontic treatment(T1);142 cases without lingual dehiscence/fenestration at T0 had lingual dehiscence/fenestration at T1.After preoperative orthodontic tr

关 键 词：骨性Ⅱ类错[牙合] 锥形束计算机体层摄影术 骨开裂 骨开窗 

分 类 号：R783.5[医药卫生—口腔医学]