成人双颌前突内收后前牙区牙根长度及牙槽骨变化研究

Changes of root length and alveolar bone of anterior teeth after retraction in adult patients with bimaxillary protrusion

  • 摘要:
      目的  采用三维锥形束计算机断层扫描(CBCT)观察成人双颌前突患者辅助种植钉内收后前牙区牙根长度及牙槽骨的变化。
      方法  选取35例成人安氏Ⅰ类双颌前突患者,拔除4颗第一前磨牙后使用种植钉支抗内收前牙。治疗前后采用CBCT三维成像观察前牙区牙根长度、骨开窗及骨开裂变化情况。
      结果  矫治后,上颌尖牙、下颌侧切牙、下颌尖牙唇侧骨开窗率降低,差异有统计学意义(P < 0.05);矫治前后舌侧骨开窗情况比较,差异无统计学意义(P>0.05)。矫治后,上颌前牙、下颌中切牙、下颌侧切牙唇侧骨开裂率均增高,差异有统计学意义(P < 0.05)。除下颌中切牙外,其余前牙舌侧骨开裂率均增高,差异有统计学意义(P < 0.05)。矫治后,上颌中切牙、上颌侧切牙、下颌前牙牙根长度较治疗前缩短,差异有统计学意义(P < 0.05);矫治前后上颌尖牙牙根长度比较,差异无统计学意义(P>0.05)。
      结论  成人安氏Ⅰ类双颌前突拔牙患者采用辅助种植钉内收前牙的过程中存在牙根吸收及骨缺损风险,因此矫治过程中需注意转矩控制并进行风险评估。

     

    Abstract:
      Objective  To observe changes in alveolar bone and length of tooth root treated by maxillary and mandibular incisor retraction via planting nail in patients with bimaxillary protrusion by means of using three-dimensional conical beam computed tomography (CBCT).
      Methods  A total of 35 adult patients with class Ⅰ bimaxillary protrusions were selected. After extraction of four first premolars, we used micro-implant anchorage to strengthen anchorage. The CBCT were used before and after orthodontic treatment to observe changes of dehiscence and fenestration of alveolar bone and root length.
      Results  The labial side fenestration rates of maxillary canines, mandibular lateral incisors and mandibular canines were decreased after treatment, and the differences were statistically significant(P < 0.05). The lingual side fenestration rates of all anterior teeth showed no significant differences (P>0.05). The labial side dehiscence rates of maxillary anterior teeth, mandibular central incisors and mandibular lateral incisors were increased after treatment, and the differences were statistically significant (P < 0.05). The lingual side dehiscence rates of all anterior teeth except mandibular central incisors were increased after treatment, and the differences were statistically significant (P < 0.05). The root lengths of maxillary central incisors, maxillary lateral incisors and mandibular anterior teeth were significantly shorter than that before treatment (P < 0.05). The root length of the maxillary canines had no significant change after the treatment(P>0.05).
      Conclusion  Risk of tooth resorption and bone defect occur in class Ⅰ bimaxillary protrusion patients when incisors are retracted by using micro-implant anchorage. Thus, torque control and risk assessment should be paid attention during the correction process.

     

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