根尖型致密骨岛影响正畸牙齿移动的临床观察  

Clinical observation on the influence of apical dense bone islands on orthodontic tooth movement

作　　者：梁叶 申龙朵 曹芳 戴静桃 LIANG Ye;SHEN Longduo;CAO Fang;DAI Jingtao(Department of Orthodontics,Huizhou Stomatological Hospital,Huizhou 516001,China;Special Clinic,Huizhou Stomatological Hospital,Huizhou 516001,China;Department of Orthodontics,Stomatological Hospital,School of Stomatology,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]惠州口腔医院正畸科,广东惠州516001 [2]惠州口腔医院特诊科,广东惠州516001 [3]南方医科大学口腔医院(口腔医学院)正畸科,广东广州510280

出　　处：《口腔疾病防治》2024年第10期780-788,共9页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省医学科研基金项目(A2023369);惠州市科技计划(医疗卫生项目)(2023CZ010212)。

摘　　要：目的探讨根尖型致密骨岛对正畸治疗牙齿移动的影响及其并发症,为正畸临床治疗提供参考。方法本研究获医院伦理委员会批准。回顾性分析2018~2022年于惠州口腔医院正畸科接受全口固定正畸治疗的33例根尖型致密骨岛患者。应用锥形束CT(cone-beam CT,CBCT)分析治疗前根尖型致密骨岛的位置分布和包裹程度;分析治疗前、治疗后以及治疗后12个月位于根尖型致密骨岛的牙齿松动度、牙齿根尖区牙根外吸收的情况和吸收程度。结果33例正畸患者,年龄11~42岁,平均年龄16.7岁,中位数年龄15岁;根尖型致密骨岛均波及单个牙齿,均位于下颌,主要位于前磨牙-磨牙区,男12例(36.4%),女21例(63.6%),差异无统计学意义(P>0.05)。根尖型致密骨岛轻度包裹23例(69.7%),中度包裹10例(30.3%),无重度包裹。不同包裹程度的根尖型致密骨岛在正畸治疗中均未发现牙齿移动困难以及拔牙间隙关闭不全。位于根尖型致密骨岛的牙齿在治疗前牙齿松动患者1例(3.0%),治疗后牙齿松动患者6例(18.2%),治疗后12个月牙齿松动患者2例(6.1%)。治疗后以及治疗后12个月的牙齿松动患者均增加,为I度松动,其中治疗前和治疗后牙齿松动数量差异有统计学意义(P<0.05),治疗前和治疗后12个月牙齿松动数量差异无统计学意义(P>0.05),治疗后和治疗后12个月牙齿松动数量差异无统计学意义(P>0.05)。治疗后位于根尖型致密骨岛的牙齿吸收表现出轻度吸收26例(78.8%),中度吸收7例(21.2%),无重度吸收。治疗后12个月位于根尖型致密骨岛的牙齿吸收表现出轻度吸收25例(75.8%),中度吸收8例(24.2%),无重度吸收。牙根吸收的严重程度在治疗前和治疗后间差异具有统计学意义(P<0.05),在治疗前和治疗后12个月间差异具有统计学意义(P<0.05),在治疗后和治疗后12个月间差异不具有统计学意义(P>0.05)。结论根尖型致密骨岛在正畸治疗中未发现影响牙齿Objective To explore the influence of apical dense bone islands on tooth movement during orthodontic treatment and its complications,and to provide a reference for orthodontic clinical treatment.Methods This study ob-tained approval from the hospital ethics committee.A retrospective analysis was conducted on 33 patients with apical dense bone islands who received full-mouth fixed orthodontic treatment in the Orthodontics Department of Huizhou Sto-matological Hospital from 2018 to 2022.Cone-beam CT(CBCT)was used to determine the location,distribution,and wrapping severity of the apical dense bone islands before treatment.The number of loose teeth located in the apical dense bone islands and the degree of external apical root resorption in the apical area of teeth were analyzed before treatment,immediately after treatment,and 12 months after treatment.Results There were 33 orthodontic patients(aged 11 to 42 years,with an average age of 16.7 years and a median age of 15 years)included in this study,including 12 males(36.4%)and 21 females(63.6%).All apical dense bone islands involved a single tooth located in the mandi-ble,mainly in the premolar-molar area.No gender differences were present in the location of the dense bone islands(P>0.05).The apical dense bone islands were mildly wrapped in 23 cases(69.7%),moderately wrapped in 10 cases(30.3%),and severely wrapped in no cases.No difficulty in tooth movement or incomplete closure of extraction space was found in the apical dense bone islands with different degrees of wrapping during orthodontic treatment.For teeth lo-cated in apical dense bone islands,1 patient(3.0%)had loose teeth before treatment,6 patients(18.2%)had loose teeth after treatment,and 2 patients(6.1%)had loose teeth 12 months after treatment.The number of patients with grade I loose teeth increased after treatment and 12 months after treatment.There was a statistically significant difference in the number of loose teeth before and after treatment(P<0.05),no statistically significant difference in the

关 键 词：根尖型致密骨岛 正畸 牙齿移动 锥形束CT 根尖区牙根外吸收 包裹程度 牙齿松动 吸收程度 

分 类 号：R78[医药卫生—口腔医学]