骨性Ⅱ类成年患者上中切牙根尖区牙槽骨量的CBCT研究
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摘要
目的采用CBCT评估骨性Ⅱ类成年患者正畸术前上中切牙根尖区唇、腭侧牙槽骨量,分析影响上中切牙唇、腭侧牙槽骨量的相关因素。方法根尖平面(LA),根尖到唇、腭侧骨壁的长度分别为l_1、l_2,l_1与l_2之和为l_(T1)。根尖上平面(LU),牙体长轴延长线与LU平面的交点到唇、腭侧骨壁的长度分别为l_3、l_4,l_3与l_4之和为l_(T2)。根尖下平面(LL)与牙根唇侧交点到唇侧骨壁的长度为l_5,与牙根腭侧交点到腭侧骨壁的长度为l_6,与牙槽嵴唇、腭侧骨壁交点连线的长度为l_(T3)。牙体长轴与腭平面的夹角为θ_1,牙槽嵴与腭平面的夹角为θ_2。结果θ_1与l_1、l_3、l_5呈显著正相关;θ_2与l_1、l_3呈显著负相关,与l_2、l_(T1)、l_4、l_(T2)、l_6、l_(T3)呈显著正相关;SN-MP与l_1、l_(T1)、l_3、l_(T2)呈显著负相关;SNA与l_2、l_4、l_6、l_(T3)呈显著正相关。结论该研究结果表明骨性Ⅱ类上中切牙唇、腭侧牙槽骨厚度与上中切牙唇倾度、牙槽嵴倾斜度以及垂直骨面型有着密切的关系,其中上中切牙的唇倾度及垂直骨面型对上中切牙根尖区牙槽骨厚度的影响最大。
Objective Using CBCT to evaluate the amount of labial and palatal alveolar in the maxillary central incisor root apex area of the skeletal Class Ⅱ adults before orthodontic treatment, and analyze the related factors of the labial and palatal alveolar of the maxillary central incisors. Methods In the LA plane, the distances from the apex to the labial and palatal alveolar were l_1 and l_2 respectively and l_(T1) was sum of l_1 and l_2. In the LU plane, the distances from the intersection of the long axial of the incisor and the LU plane to the labial and palatal alveolar were l_3 and l_4 respectively and l_(T2) was sum of l_3 and l_4. In the LL plane, the distance from the intersection point of the LL plane and the labial side to the labial alveolar was l_5, the distance from the intersection point of the LL plane and the palatal side to the palatal alveolar was l_6, and the distance from the intersection point of the LL plane to the labial and palatal alveolar was l_(T3). θ_1 was the angle between the palatal plane and the axis of the incisor, and θ_2 was the angle between the palatal plane and the alveolar crest. Results θ_1 was positively correlated with l_1, l_3 and l_5. θ2 was positively correlated with l_2, l_(T1), l_4,以l_(T2), l_6, l_(T3) and negatively correlated with l_1, l_3 and l_5. SN-MP was negatively correlated with l_1, l_(T1), l_3 and l_(T2). SNA was positively correlated with l_2, l_4, l_6 and l_(T3). Conclusion The results showed that the thickness of maxillary central incisors labial and palatal alveolar in skeletal Class II adults was closely correlated with the inclination of maxillary central incisors,the inclination of alveolar crest and the vertical dimension, among which the inclination of maxillary central incisors and the vertical dimension had the greatest influence on the thickness of maxillary central incisors labial alveolar bone.
Objective Using CBCT to evaluate the amount of labial and palatal alveolar in the maxillary central incisor root apex area of the skeletal Class Ⅱ adults before orthodontic treatment, and analyze the related factors of the labial and palatal alveolar of the maxillary central incisors. Methods In the LA plane, the distances from the apex to the labial and palatal alveolar were l_1 and l_2 respectively and l_(T1) was sum of l_1 and l_2. In the LU plane, the distances from the intersection of the long axial of the incisor and the LU plane to the labial and palatal alveolar were l_3 and l_4 respectively and l_(T2) was sum of l_3 and l_4. In the LL plane, the distance from the intersection point of the LL plane and the labial side to the labial alveolar was l_5, the distance from the intersection point of the LL plane and the palatal side to the palatal alveolar was l_6, and the distance from the intersection point of the LL plane to the labial and palatal alveolar was l_(T3). θ_1 was the angle between the palatal plane and the axis of the incisor, and θ_2 was the angle between the palatal plane and the alveolar crest. Results θ_1 was positively correlated with l_1, l_3 and l_5. θ2 was positively correlated with l_2, l_(T1), l_4,以l_(T2), l_6, l_(T3) and negatively correlated with l_1, l_3 and l_5. SN-MP was negatively correlated with l_1, l_(T1), l_3 and l_(T2). SNA was positively correlated with l_2, l_4, l_6 and l_(T3). Conclusion The results showed that the thickness of maxillary central incisors labial and palatal alveolar in skeletal Class II adults was closely correlated with the inclination of maxillary central incisors,the inclination of alveolar crest and the vertical dimension, among which the inclination of maxillary central incisors and the vertical dimension had the greatest influence on the thickness of maxillary central incisors labial alveolar bone.
引文
[1] 陈香,陈婷婷,程敏,等.成人正畸治疗相关因素的回顾性分析[J].现代口腔医学杂志,2014,28(6):351-354.
[2] Cedro MK,Moles DR,Hodges SJ.Adult orthodontics—who’s doing what[J].Br J Orthod,2010,37(2):107-117.
[3] 陈扬熙.口腔正畸学基础、技术与临床[M].3版.北京:人民卫生出版社,2017:658-661.
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[5] 马宁,李巍然.不同支抗控制下上颌前突矫治结果的三维模型研究[J].华西口腔医学杂志,2015,33(1):63-66.
[6] 于红伟,韩红娟,吴浩,等.微螺钉型种植支抗矫治成人双颌前突的价值[J].现代口腔医学杂志,2016,30(3):147-150.
[7] Xu TM,Liu Y,Yang MZ,et al.Comparison of extraction versus nonextraction orthodontic treatment outcomes for borderline Chinese patients[J].Am J of Orthod Dentofacial Orthop,2006,129(5):672-677.徐海洋,等.骨性Ⅱ类成年患者上中切牙根尖区牙槽骨量的CBCT研究
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[10] Yagci A,Veli I,Uysal T,et al.Dehiscence and fenestration in skeletal Class Ⅰ,Ⅱ,and Ⅲ malocclusions assessed with cone-beam computed tomography[J].The Angle Orthod,2012,82(1):67-74.
[11] Kim JH,Lee JG,Han DH,et al.Morphometric analysis of the anterior region of the maxillary bone for immediate implant placement using micro-CT[J].Clinical Anatomy,2011,24(4):462-468.
[12] Nahás-Scocate AC,de Siqueira Brand?o A,Patel MP,et al.Bone tissue amount related to upper incisors inclination[J].Angle Orthod,2014,84(2):279-285.
[13] Kaley J,Phillips C.Factors related to root resorption in edgewise practice[J].Angle Orthod,1991,61(2):125.
[14] 夏文倩,顾永佳,高美琴.安氏Ⅱ类1分类和2分类错牙合畸形患者上中切牙区牙槽骨的三维形态分析[J].上海口腔医学,2016,25(1):68-71.
[15] Thongudomporn U,Charoemratrote C,Jearapongpakorn S.Chan-ges of anterior maxillary alveolar bone thickness following incisor proclination and extrusion[J].Angle Orthod,2015,85(4):549-554.
[16] Gracco A,Lombardo L,Mancuso G,et al.Upper incisor position and bony support in untreated patients as seen on CBCT[J].Angle Orthod,2009,79(4):692-702.
[17] Ahn HW,Moon SC,Baek SH.Morphometric evaluation of changes in the alveolar bone and roots of the maxillary anterior teeth before and after en masse retraction using cone-beam computed tomography[J].Angle Orthod,2013,83(2):212-221.
[18] Handelman CS.The anterior alveolus:its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae[J].Angle Orthod,1996,66(2):109-110.
[19] Bae SM,Kim HJ,Kyung HM.Long-term changes of the anterior palatal alveolar bone after treatment with bialveolar protrusion,evaluated with computed tomography[J].Am J Orthod Dentofacial Orthop,2018,153(1):108-117.
[20] 廖妮,周诺,莫水学,等.骨性Ⅱ类不同垂直骨面型患者切牙牙槽骨形态特征的CBCT研究[J].实用口腔医学杂志,2015,(4):556-559.
[2] Cedro MK,Moles DR,Hodges SJ.Adult orthodontics—who’s doing what[J].Br J Orthod,2010,37(2):107-117.
[3] 陈扬熙.口腔正畸学基础、技术与临床[M].3版.北京:人民卫生出版社,2017:658-661.
[4] Xu Y,Xie J.Comparison of the effects of mini-implant and traditional anchorage on patients with maxillary dentoalveolar protrusion[J].Angle Orthod,2017,87(2):320-327.
[5] 马宁,李巍然.不同支抗控制下上颌前突矫治结果的三维模型研究[J].华西口腔医学杂志,2015,33(1):63-66.
[6] 于红伟,韩红娟,吴浩,等.微螺钉型种植支抗矫治成人双颌前突的价值[J].现代口腔医学杂志,2016,30(3):147-150.
[7] Xu TM,Liu Y,Yang MZ,et al.Comparison of extraction versus nonextraction orthodontic treatment outcomes for borderline Chinese patients[J].Am J of Orthod Dentofacial Orthop,2006,129(5):672-677.徐海洋,等.骨性Ⅱ类成年患者上中切牙根尖区牙槽骨量的CBCT研究
[8] Ackerman JL,Proffit WR.Soft tissue limitations in orthodontics:treatment planning guidelines[J].Angle Orthod,1997,67(5):327-336.
[9] Graber LW,Vanarsdall RL,Vig KWL,et al.Orthodontics:Current principles and techniques[M].6th ed.St Louis:Elsevier,2018:208-215.
[10] Yagci A,Veli I,Uysal T,et al.Dehiscence and fenestration in skeletal Class Ⅰ,Ⅱ,and Ⅲ malocclusions assessed with cone-beam computed tomography[J].The Angle Orthod,2012,82(1):67-74.
[11] Kim JH,Lee JG,Han DH,et al.Morphometric analysis of the anterior region of the maxillary bone for immediate implant placement using micro-CT[J].Clinical Anatomy,2011,24(4):462-468.
[12] Nahás-Scocate AC,de Siqueira Brand?o A,Patel MP,et al.Bone tissue amount related to upper incisors inclination[J].Angle Orthod,2014,84(2):279-285.
[13] Kaley J,Phillips C.Factors related to root resorption in edgewise practice[J].Angle Orthod,1991,61(2):125.
[14] 夏文倩,顾永佳,高美琴.安氏Ⅱ类1分类和2分类错牙合畸形患者上中切牙区牙槽骨的三维形态分析[J].上海口腔医学,2016,25(1):68-71.
[15] Thongudomporn U,Charoemratrote C,Jearapongpakorn S.Chan-ges of anterior maxillary alveolar bone thickness following incisor proclination and extrusion[J].Angle Orthod,2015,85(4):549-554.
[16] Gracco A,Lombardo L,Mancuso G,et al.Upper incisor position and bony support in untreated patients as seen on CBCT[J].Angle Orthod,2009,79(4):692-702.
[17] Ahn HW,Moon SC,Baek SH.Morphometric evaluation of changes in the alveolar bone and roots of the maxillary anterior teeth before and after en masse retraction using cone-beam computed tomography[J].Angle Orthod,2013,83(2):212-221.
[18] Handelman CS.The anterior alveolus:its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae[J].Angle Orthod,1996,66(2):109-110.
[19] Bae SM,Kim HJ,Kyung HM.Long-term changes of the anterior palatal alveolar bone after treatment with bialveolar protrusion,evaluated with computed tomography[J].Am J Orthod Dentofacial Orthop,2018,153(1):108-117.
[20] 廖妮,周诺,莫水学,等.骨性Ⅱ类不同垂直骨面型患者切牙牙槽骨形态特征的CBCT研究[J].实用口腔医学杂志,2015,(4):556-559.
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