应用CBCT评价开放式与闭合式牵引矫治上颌埋伏倒置弯根中切牙的临床疗效  

Application of CBCT to Evaluate the Clinical Effect of Open and Closed Traction Correction for Maxillary Buried Inverted Curved Central Incisors

作　　者：尹志刚 郭强 齐建华 YIN Zhigang;GUO Qiang;QI Jianhua(Department of Orthodontics,Handan Stomatological Hospital,Handan 056001,Hebei,China;Department of Prosthetics,Handan Stomatological Hospital,Handan 056001,Hebei,China;Department of Radiology,Handan Stomatological Hospital,Handan 056001,Hebei,China)

机构地区：[1]邯郸市口腔医院正畸科,河北邯郸056001 [2]邯郸市口腔医院修复科,河北邯郸056001 [3]邯郸市口腔医院放射科,河北邯郸056001

出　　处：《中国美容医学》2024年第12期64-67,共4页Chinese Journal of Aesthetic Medicine

基　　金：邯郸市科学技术研究与发展计划项目(编号:21422083091)。

摘　　要：目的:分析开放式与闭合式牵引矫治上颌埋伏倒置弯根中切牙的临床效果,并采取锥形束CT(Cone beam computed tomography,CBCT)评价两种方法的优劣。方法:选取2017年2月-2022年2月来笔者医院诊治的60例上颌埋伏倒置弯根中切牙患者为研究对象,按随机数字表法分为开放组和闭合组,各30例,分别采取开放式、闭合式牵引矫治方法进行正畸治疗。比较两组治疗效果,使用CBCT检测治疗前后的牙根长度、冠根比及根管壁厚度,记录其咀嚼效率、咀嚼疼痛感以及牙齿美学效果变化,统计术后感染率。结果:两组总有效率比较差异无统计学意义(P>0.05)。治疗后,两组牙根长度、根管壁厚度增加,冠根比减小(均P<0.05);两组咀嚼效率增高,视觉模拟评分(Visual analogue score,VAS)、红色美学评分(Pink esthetic score,PES)均降低,且以闭合组优于开放组(均P<0.05),白色美学评分(White esthetic score,WES)比较差异无统计学意义(P>0.05)。两组术后感染率比较差异无统计学意义(P>0.05)。结论:开放式与闭合式牵引矫治上颌埋伏倒置弯根中切牙的临床效果相当,其中闭合式牵引矫治方法在增加牙根长度、减小冠根比和根管壁厚度,恢复咀嚼功能以及牙齿美学上更具优势。Objective To analyze the clinical effects of open and closed traction correction for maxillary buried inverted curved central incisors,and evaluate the advantages and disadvantages of the two methods using cone beam CT(CBCT).Methods A total of 60 patients with maxillary embedded inverted curved central incisors who were treated in our hospital from February 2017 to February 2022 were selected as the study subjects.They were randomly divided into an open group and a closed group with 30 cases each,using open and closed traction orthodontic methods for orthodontic treatment.Compare the treatment effects of two groups,using CBCT to detect the root length,crown root ratio,heel wall thickness,and root wall thickness before and after treatment,and record the changes in chewing efficiency,chewing pain,and dental aesthetic effects,and calculate postoperative infection rate.Results There was no statistically significant difference in the total effective rate between the open group and the closed group(P>0.05).After treatment,the root length and heel wall thickness of the two groups increased,the crown root ratio decreased,and the chewing efficiency increased.VAS score and PES score both decreased,with the closed group showing the most significant changes(all P<0.05),and there was no statistically significant difference in the WES score(P>0.05).There was no significant difference in postoperative infection rate between the two groups(P>0.05).Conclusion The clinical effects of open and closed traction in the treatment of maxillary embedded inverted curved central incisors are comparable,with closed traction being more advantageous in increasing root length,reducing crown root ratio and heel wall thickness,restoring chewing function,and improving dental aesthetics.

关 键 词：锥形束CT 开放式 闭合式 牵引矫治 上颌埋伏倒置弯根中切牙 咀嚼效率 美学效果 

分 类 号：R783.5[医药卫生—口腔医学]