个性化口外牵引面弓牵引上颌埋伏中切牙疗效的研究  

Study on the effectiveness of personalized extraoral traction headgear for the traction of impacted maxillary central incisors

作　　者：高琳清 何丹青 张宝明 赵晶晶 葛东占 高林成 马永平[1] Gao Linqing;He Danqing;Zhang Baoming;Zhao Jingjing;Ge Dongzhan;Gao Lincheng;Ma Yongping(Department of Orthodontics,Baoding Second Hospital,Baoding 071051,China;Department of Orthodontics,Peking University School of Stomatology,National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology,Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]保定市第二医院口腔正畸科,保定071051 [2]北京大学口腔医学院·口腔医院正畸科,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京100081

出　　处：《中华口腔正畸学杂志》2025年第1期24-30,共7页Chinese Journal of Orthodontics

基　　金：保定市科学技术局项目(2441ZF010);北京市自然科学基金资助项目(L242130);京津冀基础研究合作专题项目(H2023104901)。

摘　　要：目的探讨使用个性化口外牵引面弓牵引不同牙龄分期的上颌埋伏中切牙对其牙根发育的影响。方法选择诺拉(Nolla)牙龄分期7期和8期的上颌埋伏中切牙作为早期牙龄组(n=8),选择Nolla牙龄分期9期和10期的上颌埋伏中切牙作为晚期牙龄组(n=8),选择对侧同名牙作为对照组。利用锥形束CT测量分析牙根长度,冠根角度,牙体体积和表面积指标。使用配对t检验比较早期牙龄组和晚期牙龄组埋伏牙牵引前后以及埋伏牙治疗后与对侧同名牙之间的差异,使用独立样本t检验比较早期牙龄组与晚期牙龄组埋伏牙牵引后牙根生长量的差异以及埋伏牙牵引后和对侧同名牙的差异。结果经过牵引治疗后早期牙龄组的上颌埋伏阻生中切牙牙根长度、牙体体积和表面积分别从牵引前(6.26±0.83)mm,(361.51±34.20)mm^(3),(418.51±28.90)mm^(2)的增加至牵引后的(10.06±0.96)mm(P<0.001),(439.11±62.05)mm^(3)(P=0.003),(486.45±52.81)mm^(2)(P<0.001),晚期牙龄组的牙根长度从牵引前的(8.78±0.76)mm增加至牵引后的(9.21±0.90)mm(P=0.022)。牵引后早期牙龄组的牙根长度生长量(3.80±1.26)mm、牙体体积生长量(77.60±48.11)mm^(3)和牙体表面积生长量(67.95±34.28)mm^(2)比晚期牙龄组[(0.43±0.41)mm,P<0.001;(8.34±16.11)mm^(3),P=0.004;(6.46±13.02)mm^(2),P<0.001]增加的更多。此外,早期牙龄组牵引后的牙根长度,牙体表面积与对侧同名牙之间的差异[(0.96±0.48)mm,(17.85±32.00)mm^(2)]比晚期牙龄组小[(2.10±0.77)mm,P=0.003;(58.46±39.46)mm^(2),P=0.040]。结论早期诊断并使用个性化口外牵引面弓牵引上颌埋伏中切牙有利于其牙根长度,牙体体积和表面积增加,引导其牙根发育接近正常水平;本研究为上颌埋伏牙,特别是垂直或冠朝唇侧的水平埋伏中切牙提供一种支抗设计的选择。Objective To explore the effects of personalized extraoral traction headgear on the root development of maxillary impacted central incisors at different dental age stages.Methods Maxillary impacted central incisors at Nolla dental age stages 7 and 8 were selected as the early dental age group(n=8),and those at Nolla dental age stages 9 and 10 were selected as the late dental age group(n=8).Contralateral teeth were selected as the control group.Cone beam computed tomography(CBCT)was used to measure and analyze root length,crown-root angle,tooth volume,and surface area.Paired t-tests were used to compare differences before and after traction for the early and late dental age groups,as well as the differences between the impacted teeth after treatment and the contralateral teeth.Independent samples t-tests were used to compare the differences in root growth between the early and late dental age groups after traction,as well as the differences between the impacted teeth after traction and the contralateral teeth.Results After traction treatment,the root length,tooth volume,and surface area of impacted maxillary central incisors in the early dental age group increased from(6.26±0.83)mm,(361.51±34.20)mm^(3),and(418.51±28.90)mm^(2) before traction to(10.06±0.96)mm(P<0.001),(439.11±62.05)mm^(3)(P=0.003),and(486.45±52.81)mm^(2)(P<0.001)after traction.In the late dental age group,the root length increased from(8.78±0.76)mm before traction to(9.21±0.90)mm after traction(P=0.022).The root length growth(3.80±1.26)mm,tooth volume growth(77.60±48.11)mm^(3),and surface area growth(67.95±34.28)mm^(2) in the early dental age group were greater than those in the late dental age group[(0.43±0.41)mm,P<0.001,(8.34±16.11)mm^(3),P=0.004,(6.46±13.02)mm^(2),P<0.001].Furthermore,the differences in root length and surface area between the treated teeth and the contralateral teeth were smaller in the early dental age group[(0.96±0.48)mm,(17.85±32.00)mm^(2)]compared to the late dental age group[(2.10±0.77)mm,P=0.003,(58.46±3

关 键 词：埋伏牙 上颌中切牙 个性化口外牵引面弓 牵引 锥形束CT 

分 类 号：R78[医药卫生—口腔医学]