下前牙拥挤非拔牙患者正畸治疗后牙龈黑三角发生的影响因素研究  

Analysis of contributing factors for gingivial black trangle after non⁃extraction orthodontic treatment of crowded mandibular anterior teeth

作　　者：张柯佳 史学明 胡丹艳 钱心瑶 刘璐玮 曹丹[1] 严斌[1] ZHANG Kejia;SHI Xueming;HU Danyan;QIAN Xinyao;LIU Luwei;CAO Dan;YAN Bin(Department of Orthodontics,The Affiliated Stomatological Hospital of Nanjing Medical University,Jiangsu Province Key Laboratory of Oral Diseases,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine,Nanjing 210029,China)

机构地区：[1]南京医科大学附属口腔医院正畸科,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

出　　处：《口腔医学》2023年第6期518-523,共6页Stomatology

基　　金：国家自然科学基金(82071143);江苏省重点研发计划项目(BE2022795);江苏省卫健委重点医学科研项目(ZDA2020003);江苏高校优势学科建设工程项目(2018⁃87)。

摘　　要：目的探究下前牙拥挤的非拔牙患者正畸治疗后下前牙牙龈黑三角发生的危险因素。方法选择2017年1月—2021年12月在南京医科大学附属口腔医院正畸科完成正畸矫治的151例患者为研究对象,根据矫治结束即刻时正面口内照中下颌前牙区黑三角的有无,将患者分为正常组和黑三角组。根据治疗前后的口内照、数字化模型、锥形束CT等临床资料,测量患者下前牙拥挤度、牙齿排列情况、矫治前后牙齿移动量等指标并进行分析。结果下前牙拥挤的非拔牙患者中,矫治结束后下颌中切牙间黑三角的发生率为23.2%。正常组和黑三角组在年龄、拥挤度、近中切角间前后向和横向距离、切缘间角度、CEJ⁃CEJ距离上存在统计学差异。回归分析显示,年龄、近中切角间前后向距离、ICP⁃CEJ距离、CEJ⁃CEJ距离与黑三角的发生显著相关。结论下前牙拥挤非拔牙患者的黑三角发生率较低,但成人正畸患者且下颌中切牙唇舌侧错位严重或龈楔状隙大的患者较易出现黑三角。Objective To identify risk factors for the occurrence of black triangle of lower anterior teeth after orthodontic treatment in non⁃extraction patients with crowded lower anterior teeth.Methods A total of 151 orthodontic patients who completed orthodontic treatment in Orthodontic Department of the Affiliated Stomatological Hospital of Nanjing Medical University from January 2017 to De⁃cember 2021 were selected as research subjects.The patients were divided into normal group and black triangle group according to whether there was a black triangle between mandibular central incisor teeth after the treatment.According to the clinical data of intraoral photos,digital models and CBCT,parameters related to tooth alignment and tooth movement before and after treatment were measured and analyzed.Results The incidence of black triangle between mandibular central incisor teeth was 23.2%in non⁃extractive patients with crowded lower anterior teeth.There were statistical differences between the normal group and the black triangle group in age,crow⁃ding degree,antero⁃posterior and transverse overlap of the two central incisors,angle formed by the incisal edges of the two central in⁃cisors,and CEJ⁃CEJ distance.Regression analysis showed that age,antero⁃posterior overlap,ICP⁃CEJ distance and CEJ⁃CEJ distance were significantly correlated with the occurrence of black triangle.Conclusion The incidence of black triangle is low in patients with crowded lower anterior teeth without tooth extraction,but it is more likely to occur in adult orthodontic patients and patients with severe labial⁃lingual dislocation of mandibular central incisor teeth or large gingival interproximal space.

关 键 词：黑三角 下中切牙 正畸治疗 开放性龈楔状隙 

分 类 号：R783.5[医药卫生—口腔医学]