成人骨性Ⅲ类偏颌牙齿倾斜度的三维测量分析  

Three-dimensional measurement and analysis of dental inclination in skeletal class Ⅲ adults with facial asymmetry

作　　者：莫朝伦 张军梅 付雪飞 宋明慧 MO Chaolun;ZHANG Junmei;FU Xuefei;SONG Minghui(Department of Orthodontics DivisionⅡ,Stomatological Hospital Affiliated of Guizhou Medial University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属口腔医院正畸二科,贵州贵阳550004

出　　处：《贵州医科大学学报》2024年第8期1198-1204,共7页Journal of Guizhou Medical University

基　　金：贵州省卫生健康委科学技术基金项目(gzwkj2024-448)。

摘　　要：目的研究成人骨性Ⅲ类偏颌畸形的牙齿三维位置特征。方法收集骨性Ⅲ类错[牙合]畸形患者锥形束CT(CBCT)资料、导入Invivo 5.2图像处理软件,以头影测量ANB角(上-下牙槽座角,由上齿槽座点A.subspinale、鼻根点N.nasion和下齿槽座点B.supramental构成的角)小于0°、上下第一磨牙至少一侧呈近中关系以及颏下点至正中矢状面的距离﹥2 mm作为骨性Ⅲ类偏颌畸形标准筛选出偏颌患者38例,偏颌牙弓的左右两侧以颏下点偏向的一侧为偏斜侧(作为偏斜侧组,S组),另一侧为非偏斜侧(作为非偏斜侧组,NS组),筛选非偏颌患者34例作为对照组(N组)。测量各组被检者的牙齿颊舌向、近远中向倾斜角以及牙冠垂直向高度。结果S组上颌第一前磨牙、第一磨牙较N组颊倾(P<0.05),下颌尖牙、第一前磨牙、第一磨牙较N组舌倾(P<0.05),上颌的尖牙、第一前磨牙、第一磨牙较NS组颊倾(P<0.05),下颌较NS组舌倾(P<0.01);S组上颌第一磨牙近远中向倾斜角小于N组(P<0.05)、大于NS组(P<0.05);S组上下颌第一前磨牙、上颌第一磨牙牙冠垂直高度小于N组(P<0.05),上颌的尖牙、第一前磨牙、第一磨牙牙冠垂直高度小于NS组(P<0.05)。结论骨性Ⅲ类偏颌畸形患者偏斜侧牙齿在三维方向上都发生了代偿,偏斜侧上颌牙相对颊向倾斜、下颌牙相对舌向倾斜、上颌磨牙相对直立、上颌牙冠垂直高度相对偏低。Objective To study three-dimensional positional characteristics of teeth in adults with skeletal Class Ⅲ mandibular deviation.Methods Data were collected from cone-beam computed tomography(CBCT)of patients with skeletal class Ⅲ malocclusion and imported into Invivo 5.2 image software.A total of 38 patients with mandibular deviation were selected based on ANB angle(between the subspinale point A,nasion point N,and supramentale point B)<0°by cephalometric measurement,at least one side of the upper and lower first molars in a mesial relationship and the distance from the submental point to the mid sagittal plane>2 mm.The side to which the pogonion was biased towards was considered the tilted side(S group),and the opposite side was the non-titled side(NS group).A control group(N group)of 34 patients with non-tilted pogonion was selected.Buccolingual and mesiodistal inclinations as well as the vertical crown heights of the teeth were measured in each group.Results The buccolingual inclinations of maxillary first premolar and the first molar in S group were higher than those in N group(P<0.05),and the lingual inclinations of mandibular canines,the first premolar and the first molar in S group were higher than those in NS group(P<0.05).The mesial and distal inclination angles of the maxillary first molar in S group were smaller than those in N group(P<0.05),but larger than those in NS group.The vertical heights of the first premolar and maxillary first molar crown in S group were lower than those in N group(P<0.05),and the vertical heights of maxillary canine,first premolar and first molar crown in S group were lower than those in NS group(P<0.05).Conclusions Teeth in the tilted side of skeletal Class Ⅲ patients with facial asymmetry have compensation in the three-dimensional directions.On the tilted side,the maxillary teeth are inclined to the buccal direction,and the mandibular teeth are inclined to the lingual direction,with relatively upright maxillary molars and small vertical height of the maxillary crown.

关 键 词：锥形束CT 骨性Ⅲ类错[牙合]畸形 偏颌 牙齿倾斜度 

分 类 号：R781.5[医药卫生—口腔医学]