上颌全牙列种植固定修复前后上唇轮廓美学变化的锥形束CT分析  

Esthetic analysis of upper lip morphology variation after the cross-arch fixed restoration of maxillary implant-supported prostheses via radiographic methods

作　　者：袁珊珊 高姗[1] 李国情 蔡坤展 汤春波[1] Yuan Shanshan;Gao Shan;Li Guoqing;Cai Kunzhan;Tang Chunbo(Department of Dental Implantology,The Affiliated Stomatological Hospital of Nanjing Medical University&State Key Laboratory Cultivation Base of Research,Prevention and Treatment for Oral Diseases(Nanjing Medical University)&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口腔种植科,口腔疾病研究与防治国家级重点实验室培育建设点(南京医科大学)江苏省口腔转化医学工程研究中心,南京210029

出　　处：《中华口腔医学杂志》2024年第6期559-564,共6页Chinese Journal of Stomatology

基　　金：国家自然科学基金(82170993)。

摘　　要：目的分析评估上颌全牙列种植固定修复对锥形束CT上唇轮廓的影响,为上颌牙列缺失患者种植修复美学治疗提供参考。方法回顾性收集2010年1月至2023年12月于南京医科大学附属口腔医院口腔种植科行上颌全牙列种植固定修复的32例上颌牙列缺失患者的种植治疗前(T0)、戴入放射导板时(T1)及最终修复后(T2)锥形束CT资料。对患者各时间点上唇长度和厚度等指标进行测量分析,对上唇轮廓数据及面部美学参数进行相关性分析。结果与种植治疗前相比,最终修复后上唇总长度由(21.72±2.84)mm增加至(24.98±2.93)mm(t=-8.13,P<0.001);上唇中部厚度和上唇唇红厚度分别由(13.24±1.41)和(12.81±1.67)mm下降至(11.36±1.67)和(10.21±1.69)mm(t=7.79,P<0001;t=9.37,P<0.001),患者面下部高度从(54.52±4.95)mm增加至(58.70±4.42)mm(t=-11.05,P<0.001);而鼻唇角则由(95.35°±7.70°)减小至(90.53°±7.28°)(t=7.68,P<0.001)。最终修复后上唇中部厚度比戴入放射导板时[(10.94±1.24)mm]显著增加(t=-0.76,P<0.05)。最终修复后上唇侧面轮廓形态分类为直形(19例;59%)和凹形(13例;41%)。相关性分析显示,治疗前后鼻唇角变化量与剩余牙槽嵴高度占前鼻棘点至上中切牙切点距离的比例呈中等弱相关(r=-0.37,P=0.049)。结论上颌全牙列种植固定修复后患者上唇长度增长、厚度变薄,上颌全牙列种植固定义齿能恢复上唇支撑,改善患者侧貌。ObjectiveTo measure and analyze upper lip morphology variation before and after the cross-arch fixed restoration of the maxillary implant-supported prostheses using cone-beam CT(CBCT)to provide an esthetic objective reference for maxillary edentulous patients.MethodsThere were 32 maxillary edentulous patients selected in the Department of Dental Implantology,The Affiliated Stomatological Hospital of Nanjing Medical University from January 2010 to December 2023.The CBCT data of patients with maxillary full-arch implant-supported fixed prostheses were retrospectively collected before implantation(T0),at the time of radio-guide insertion(T1),and after final repair(T2).The length and thickness of the upper lip were measured and analyzed at each time point,and the correlation between the upper lip contour data and facial esthetic parameters was analyzed.ResultsAfter the final prosthodontic treatment,the length of the upper lip was significantly increased from(21.72±2.84)mm to(24.98±2.93)mm(t=-8.13,P<0.001)compared with that before implant treatment.The widths of the middle and vermilion of the upper lip(Sm-Hm/Ls-UP),were reduced from(13.24±1.41),(12.81±1.67)mm to(11.36±1.67),(10.21±1.69)mm,with significant differences(t=7.79,P<0001;t=9.37,P<0.001).The lower face height(Sn-Gn)was increased from(54.52±4.95)mm to(58.70±4.42)mm,with significant differences(t=-11.05,P<0.001).However,the nasolabial angle reduced significantly from 95.35°±7.70°to 90.53°±7.28°(t=7.68,P<0.001).The width of the middle of the upper lip with a radiation guide was(10.94±1.24)mm,and it increased significantly compared with that after the final prosthesis treatment(t=-0.76,P<0.05).The proportion of straight upper lip profiles accounted for 59%(19/32),and the proportion of concave upper lip profiles accounted for 41%(13/32)after the final prosthesis treatment.In addition,the results of correlation analysis showed that the nasolabial angle variation was weak and negatively correlated with residual bone height(r=-0.37,P=0.490).Conclusion

关 键 词：美学 牙科 颌 无牙 牙种植 锥束计算机体层摄影术 唇 

分 类 号：R783.6[医药卫生—口腔医学]