成人轻中度牙弓狭窄患者上颌慢速牙槽扩展效果的CBCT研究  

Study on the Clinical Efficacy after Slow Maxillary Alveolar Expansion in Adults by Cone-beam Computerized Tomography

作　　者：张婧 周思颖 冯玉霞 陈曦[3] ZHANG Jing;ZHOU Siying;FENG Yuxia;CHEN Xi(Department of Stomatology,the 940th Hospital of Joint Logistics Support Force of PLA,Lanzhou 730000,Gansu,China;Department of Orthodontics,the First Affilicated Hospital of Xinjiang Medical University,Affilicated Stomatological Hospital,Urumqi 830011,Xinjiang,China;Department of Stomatology,the First Affiliated Hospital,Medical School of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]联勤保障部队第九四零医院口腔科,甘肃兰州730000 [2]新疆医科大学第一附属医院(附属口腔医院)口腔正畸科,新疆乌鲁木齐830011 [3]西安交通大学医学院第一附属医院口腔科,陕西西安710061

出　　处：《中国美容医学》2025年第3期56-60,共5页Chinese Journal of Aesthetic Medicine

基　　金：陕西省高校联合项目(编号:2020GXLH-Y-014);甘肃省自然科学基金(编号:24JRRA004)。

摘　　要：目的:探讨成人轻中度牙弓狭窄患者慢速牙槽扩展后的牙齿、牙槽骨变化,旨在为成人手术临界病例寻求一种满足临床治疗需求量及组织反应小的非手术方法和加力频率。方法:选择2016年1月-2017年12月西安交通大学第一附属医院口腔科20例成人轻中度牙弓狭窄病例,以每5天1/4圈的频率扩展。在慢速牙槽扩展前、扩展保持后拍摄CBCT,分别测量牙弓宽度、牙齿倾斜度、腭侧牙槽骨宽度和倾斜度、颊腭侧牙槽骨高度和厚度,对测量结果进行统计学分析,评价牙槽扩展的效果。结果:慢速牙槽扩展使上颌第一磨牙牙冠宽度扩宽(4.60±1.77)mm,腭根间距离增加(2.83±2.83)mm,左右侧颊向倾斜(4.19±2.26)°、(4.38±2.77)°;上颌第一前磨牙牙冠宽度扩宽(4.75±1.35)mm,腭根间距离增加(2.68±1.91)mm,左右侧颊向倾斜(5.50±3.51)°、(5.49±1.74)°,测量结果表明后牙牙冠牙根宽度前后变化均具有统计学意义(P<0.05);第一前磨牙、第二前磨牙、第一磨牙牙根与牙冠移动距离比值依次为:55.37%、42.40%、61.84%;慢速牙槽扩展使第一前磨牙到第一磨牙处腭侧牙槽骨颊倾交角分别增加(9.33±3.83)°、(7.23±2.46)°、(6.87±2.97)°,测量结果表明后牙牙槽骨倾斜度前后变化均具有统计学意义(P<0.05);第一前磨牙腭中部宽度及釉牙骨质界宽度平均增加(1.54±1.55)mm、(1.94±1.53)mm,测量结果表明腭部宽度前后变化均具有统计学意义(P<0.05);后牙区牙槽骨厚度颊侧平均减少0.32~0.54?mm,腭侧平均增宽0.43~0.96?mm,颊侧牙槽嵴顶高度平均降低0.28~0.44?mm,测量结果表明后牙牙槽骨厚度和高度前后变化均具有统计学意义(P<0.05);牙根未见有明显吸收。结论:慢速牙槽扩展可以有效扩宽轻中度牙弓狭窄成人患者牙弓,不会引起明显的牙槽骨吸收,副作用小,在适应证范围内慢速牙槽扩展是安全的。Objective To explore the effect of slow alveolar expansion on the teeth and alveolar bone in adults with mild to moderate arch deficiency.Methods Choose 20 Cases who with mild to moderate arch deficiency from the Department of Stomatology,the First Affiliated Hospital,Medical School of Xi'an Jiaotong University,from January 2016 to December 2017,and expanded at a frequency of 1/4 turn every 5 days.Measure the arch width,tooth inclination,l alveolar bone width,alveolar bone inclination,alveolar bone height and thickness before and after slow alveolar expansion.The results are statistically analyzed.Results The slow alveolar expansion increase the width of the first molar by (4.60±1.77)mm,the distance between the roots increased by (2.83±2.83)mm,and the left and right teeth are buccally inclined by (4.19±2.26)°and (4.38±2.77)°.The crown width of the first premolar increases by (4.75±1.35)mm,the distance between the roots increases by (2.68±1.91)mm,and the left and right teeth are buccally inclined by (5.50±3.51) and (5.49±1.74),the measurement results showed that the changes in the width of the posterior tooth crown and root were statistically significant (P<0.05),the ratio of root to the crown in the first premolar,the second premolar,and the first molar movement distance respectively were:55.37%,42.40%,61.84%.The slow alveolar expansion increase the inclination angle of the alveolar bone of the first premolar to the first molar by (9.33±3.83)°(7.23±2.46)°and (6.87±2.97)°,the measurement results showed that the changes in inclination of the posterior alveolar bone before and after treatment were statistically significant (P<0.05).The width of the middle of the first premolar and the width of the enamel bone boundary increased by (1.54±1.55)mm and (1.94±1.53)mm,the measurement results showed that the changes in palatal width before and after were statistically significant (P<0.05).The average thickness of the alveolar bone in the posterior region decrease by 0.32-0.54 mm.The average width of the p

关 键 词：牙弓狭窄 成人 慢速牙槽扩展 锥体束CT(CBCT) 

分 类 号：R782.1[医药卫生—口腔医学]