34例骨性Ⅱ类成人患者上颌后牙区微种植体支抗植入部位及角度的CBCT研究  

Evaluation of micro-implant anchorage insertion site and angle in the maxillary posterior region of 34 adult patients with skeletal classⅡ:A cone-beam computed tomography study

作　　者：郭玥 周守恒[1] GUO Yue;ZHOU Shouheng(Department of Stomatology,the Second Affiliated Hospital of Dalian Medical University,Dalian 116027)

机构地区：[1]大连医科大学附属第二医院口腔科,116027

出　　处：《现代口腔医学杂志》2024年第6期419-424,共6页Journal of Modern Stomatology

摘　　要：目的分析骨性Ⅱ类不同垂直骨面型患者上颌后牙根间区不同高度,不同角度下的颊侧骨皮质厚度,有效骨质和根间距离,为临床微种植体支抗的植入部位提供参考。方法选取34例骨性Ⅱ类成人患者,根据下颌平面角分为高角、均角和低角组,使用CBCT测量上颌第二前磨牙与第一磨牙根间区距牙槽嵴顶3 mm、5 mm、7 mm高度下的根间距离,以及分别与牙槽嵴顶成0°、45°、60°植入时的颊侧骨皮质厚度和有效骨质,对数据进行统计学分析。结果高角组在5 mm高度以0°植入时的有效骨质小于低角组,差异有统计学意义(P<0.05)。三组在相同高度下,MIA与牙槽嵴顶所成角度越大,所得颊侧骨皮质厚度越大;在7 mm高度以0°植入时的颊侧骨皮质厚度大于在3 mm高度以相同角度植入,差异有统计学意义(P<0.05)。三组在7 mm高度以60°植入时的有效骨质小于以0°植入,差异有统计学意义(P<0.05);以45°和60°植入时,距牙槽嵴顶7 mm高度处的有效骨质小于3 mm,差异有统计学意义(P<0.05)。高角组和均角组在距牙槽嵴顶7 mm高度处的根间距离大于在3 mm高度处的根间距离,差异有统计学意义(P<0.05)。结论当骨性Ⅱ类成人患者在上颌第二前磨牙和第一磨牙颊侧之间植入微种植体支抗时,选择距牙槽嵴顶5 mm,并与冠状位上的牙槽嵴顶成45°植入支抗钉较佳,无需过分考虑垂直骨面型。Objective To provide reference for the selection of implant site by evaluating the thickness of buccal cortical bone and buccolingual bone as well as the interradicular distance of maxillary posterior area in patients with different vertical facial patterns.Methods 34 cases of skeletal class II adult patients were divided into three groups according to mandibular plane angle:hyperdivergent,normodivergent and hypodivergent.CBCT was used to measure the interradicular distance of the maxillary second premolar and the first molar at the height of 3 mm,5 mm and 7 mm from the alveolar crest,the thickness of buccal cortical bone and buccolingual bone at the angles of 0°,45°and 60°,respectively.Results The thickness of the buccolingual bone in hyperdivergent group with 0°insertion at the height of 5mm was smaller than that in the hypodivergent group(P<0.05).The greater the implantation angle made with the alveolar crest,the greater buccal cortical thickness we can get.In addition,the buccal cortical thickness with 0°insertion at 7 mm in three groups was greater than 3 mm with the same insertion(P<0.05).In three groups,the buccolingual bone with 60°insertion at 7 mm was thinner than 0°at the same height(P<0.05).What’s more,the buccolingual bone at 7 mm was thinner than 3mm with 45°and 60°insertion(P<0.05).The interradicular distance at the height of 7 mm from the alveolar crest was greater than the height of 3 mm both in the hyperdivergent and normodivergent group(P<0.05).Conclusion When a skeletal class II adult patient choses to insert MIA between the maxillary second premolar and the first molar buccally,it should be inserted at the height of 5 mm from the alveolar crest with 45°angulation on the coronal plane and it is not necessary to pay much attention to the different vertical facial patterns.

关 键 词：锥形束CT 微种植体支抗 垂直骨面型 

分 类 号：R782.12[医药卫生—口腔医学]