成年双颌前突患者减数矫治后前牙区牙槽骨变化的锥形束CT分析  

Analysis of morphometric changes in the anterior alveolar bone in bimaxillary protrusion adult patients after retraction with cone-beam CT

作　　者：王宇 谢飘 沈涛 刘剑[1] Wang Yu;Xie Piao;Shen Tao;Liu Jian(Department of Orthodontics,The Affiliated Stomatological Hospital of Nanchang University&The Key Laboratory of Oral Biomedicine,Jiangxi Province&Jiangxi Province Clinical Research Center for Oral Diseases,Nanchang 330006,China)

机构地区：[1]南昌大学附属口腔医院正畸科、江西省口腔生物医学重点实验室、江西省口腔疾病临床医学研究中心,南昌330006

出　　处：《中华口腔医学杂志》2023年第2期143-150,共8页Chinese Journal of Stomatology

基　　金：江西省卫生健康委科技计划(202130520)。

摘　　要：目的:分析减数矫治的成年双颌前突患者矫治前后及保持阶段的前牙牙槽骨形态的变化,为临床安全内收前牙提供参考。方法:选取2016年1月至2018年12月于南昌大学附属口腔医院正畸科完成正畸治疗,并且减数4颗第一前磨牙强支抗内收前牙的成年患者15例,其中男性4例,女性11例,年龄(22.2±3.1)岁(19~28岁),对全部患者进行回访追踪,拍摄锥形束CT,分别于矫治前(T1期)、矫诊结束时(T2期)及随访时(保持期2年以上,T3期)测量患者上下前牙唇腭侧牙槽骨高度,以及根颈部、根中部、根尖部的牙槽骨厚度,通过单因素重复测量方差分析比较不同阶段牙槽骨形态的差异,对矫治前后(T1-T2)牙槽骨变化量、治疗结束至随访时(T2-T3)牙槽骨变化量进行Pearson相关性分析。结果:T1、T2、T3期上前牙腭侧、上颌侧切牙及尖牙唇侧、下前牙唇舌侧牙槽骨高度总体差异均有统计学意义(P<0.05)。T1-T2期前牙腭侧牙槽骨高度变化量差异有统计学意义(P<0.05),其中上下中切牙腭侧牙槽骨高度分别降低(1.52±0.32)和(4.96±0.46)mm;T2-T3期,前牙腭侧牙槽骨高度变化量差异均有统计学意义(P<0.05),其中上下中切牙腭侧牙槽骨高度分别增加(1.20±0.27)和(3.14±0.35)mm;T1-T3期前牙腭侧牙槽骨高度差异均有统计学意义(P<0.05),其中上下中切牙腭侧牙槽骨高度分别降低(0.33±0.11)和(1.82±0.39)mm。上、下前牙根颈部及根中部牙槽骨厚度的3个时间点总体差异均有统计学意义(P<0.05)。T1-T2期前牙根颈部及根中部牙槽骨厚度差异均有统计学意义(P<0.05),其中上、下侧切牙根颈部的牙槽骨厚度分别减少(0.63±0.10)和(0.67±0.09)mm。T2-T3期,下前牙根颈部牙槽骨厚度差异均有统计学意义(P<0.05),下颌中切牙根颈部牙槽骨厚度增加(0.09±0.03)mm。T1-T3期上下切牙根颈部及根中部牙槽骨厚度差异均有统计学意义(P<0.05),其中根中部分别减少(0.38±0.16)和(0.63±0Objective To measure and analyze the morphometric changes in the anterior alveolar bone during treatment and retention stage after retraction in bimaxillary adults using cone-beam CT(CBCT).Methods Fifteen adult patients,four males and 11 females,aged 19 to 28 years[(22.2±3.1)years],who have completed orthodontic treatment and extracted four first premolar teeth for retraction in the Department of Orthodontics,The Affiliated Stomatological Hospital of Nanchang University from January 2016 to December 2018 were selected.CBCT was taken to assess the labial and palatal vertical bone level,total bone thickness at crest area,middle root area and apical area in pre-treatment(T1),post-treatment(T2)and at follow-up(maintained for more than two years)(T3).The differences in alveolar bone morphology at different stages were compared by single factor repeated measure ANOVA,and Pearson correlation analysis was performed on the amount of alveolar bone change in treatment stage and retention stage.Results There were statistically significant differences in the alveolar bone height of the palatal side of maxillary anterior teeth,the labial side of maxillary lateral incisors and canine among three time points(P<0.05).The height difference of palatal alveolar bone of anterior teeth in T1-T2 stage was statistically significant(P<0.05).Palatal alveolar bone of upper and lower central incisors decreased by(1.52±0.32)and(4.96±0.46)mm,respectively.The height difference of anterior palatal alveolar bone was statistically significant in T2-T3 stage(P<0.05),the palatal alveolar bone height of central incisors increased by(1.20±0.27)and(3.14±0.35)mm respectively.The height difference of palatal alveolar bone in the anterior teeth of T1-T3 stage was statistically significant(P<0.05),and the height of palatal alveolar bone of central incisors was decreased(0.33±0.11)and(1.82±0.39)mm,respectively.There were statistically significant differences in the thickness of the cervical and middle root alveolar bone of anterior teeth among three

关 键 词：锥束计算机体层摄影术 正畸学 矫正 双颌前突 牙槽骨改建 保持阶段 

分 类 号：R782.11[医药卫生—口腔医学]