替牙期上颌唇侧倒置埋伏中切牙治疗后牙周状况分析
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摘要
目的 :分析替牙期上颌唇侧倒置埋伏中切牙治疗结束后切牙的牙周状况。方法 :采用导杆式矫治器联合固定正畸,矫治16例替牙期上颌唇侧倒置埋伏中切牙,在治疗结束约2年后进行随访牙周检查并拍摄锥形束CT(conebeam CT,CBCT)。中切牙分为埋伏牙组和同名牙组,临床检查项目包括菌斑指数(PLI)、牙龈指数(GI)、牙周探诊深度(PD)、附着龈宽度(AW)及临床牙冠长度(CL);应用Mimics16.0系统测量中切牙唇、腭侧牙槽骨高度(ha及fc),唇、腭侧牙槽嵴顶至相应釉-牙骨质界(CEJ)的距离(ab及cd)和牙根唇、腭侧骨支持比例(LBP)、(PBP)及中切牙的唇倾度(U1-SN)。采用SPSS 17.0软件包对数据进行配对t检验。结果:埋伏侧牙组与同名牙组间PLI、GI、PD、U1-SN差异无统计学意义;埋伏组AW、ha、fc、LBP及PBP较小(P<0.01);埋伏组CL、ab及cd较大(P<0.01)。结论:替牙期上颌唇侧倒置埋伏中切牙矫治后牙周支持情况虽较对侧同名牙稍差,牙龈形态不对称,但总体情况良好,无松动,无感染。不对称的牙龈形态提示需后期植骨及牙龈形态修整。
PURPOSE: To study the periodontal status of labially inversely impacted maxillary central incisor in mixed dentition after orthodontic treatment. METHODS: Sixteen patients with labially inversely impacted maxillary central incisor in mixed dentition and treated by guided rod appliance and conventional fixed appliance were enrolled in this study.Periodontal examinations were performed and cone-beam CT(CBCT) was taken approximately 2 years post treatment. Central incisors were divided into impacted and contralateral incisor groups. Clinical examinations included plaque index(PLI),gingival index(GI), probing depth(PD), width of attached gingiva(AW) and clinical crown length(CL); Mimics 16.0 software was used to measure the length of alveolar bone around the root(ha and fc), the length from the alveolar bone crest to cementoenamel junction(CEJ)(ab and cd) on both the labial and palatal side of the central incisors as well as the labial and palatal bone support proportion(LBP and PBP) of the root and tipping of central incisor(U1-SN). The data were analyzed using paired sample t tests with SPSS 17.0 software package. RESULTS: There was no significant difference in PLI, GI, PD, U1-SN; the value of AW, ha,fc, LBP, PBP was significantly smaller in impacted groups(P<0.01); the value of CL, ab and cd was significantly larger in impacted groups(P<0.01). CONCLUSIONS: The periodontal status of the impacted central incisor was on good condition without teeth mobility and inflammation, although a little worse than the contralateral homonymous teeth. There may be a need for periodontal bone grafting and gingival surgery in the future for the asymmetric morphology of gingiva.
PURPOSE: To study the periodontal status of labially inversely impacted maxillary central incisor in mixed dentition after orthodontic treatment. METHODS: Sixteen patients with labially inversely impacted maxillary central incisor in mixed dentition and treated by guided rod appliance and conventional fixed appliance were enrolled in this study.Periodontal examinations were performed and cone-beam CT(CBCT) was taken approximately 2 years post treatment. Central incisors were divided into impacted and contralateral incisor groups. Clinical examinations included plaque index(PLI),gingival index(GI), probing depth(PD), width of attached gingiva(AW) and clinical crown length(CL); Mimics 16.0 software was used to measure the length of alveolar bone around the root(ha and fc), the length from the alveolar bone crest to cementoenamel junction(CEJ)(ab and cd) on both the labial and palatal side of the central incisors as well as the labial and palatal bone support proportion(LBP and PBP) of the root and tipping of central incisor(U1-SN). The data were analyzed using paired sample t tests with SPSS 17.0 software package. RESULTS: There was no significant difference in PLI, GI, PD, U1-SN; the value of AW, ha,fc, LBP, PBP was significantly smaller in impacted groups(P<0.01); the value of CL, ab and cd was significantly larger in impacted groups(P<0.01). CONCLUSIONS: The periodontal status of the impacted central incisor was on good condition without teeth mobility and inflammation, although a little worse than the contralateral homonymous teeth. There may be a need for periodontal bone grafting and gingival surgery in the future for the asymmetric morphology of gingiva.
引文
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[12]王秀颖,孙浩,戴微微,等.导杆式矫治器治疗上颌唇侧倒置埋伏中切牙[J].口腔医学研究,2014,30(12):1149-1152.
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[14]孙超凡,孙浩,郑志伟,等.替牙期上颌埋伏中切牙正畸疗效的锥形束CT观察[J].中华口腔医学杂志,2012,47(9):528-533.
[15]Vermette ME,Kokich VG,Kennedy DB.Uncovering labially impacted teeth:apically positioned flap and closed-eruption techniques[J].Angle Orthod,1995,65(1):23-32.
[16]Sarikaya S,Haydar B,Ciǐg er S,et al.Changes in alveolar bone thickness due to retraction of anterior teeth[J].Am J Orthod Dentofacial Orthop,2002,122(1):15-26.
[17]Vardimon AD,Oren E,Ben-Bassat Y.Cortical bone remodeling/tooth movement ratio during maxillary incisor retraction with tip versus torque movements[J].Am J Orthod Dentofacial Orthop,1998,114(5):520-529.
[2]步捷,王旭霞,张君,等.恒牙埋伏阻生的临床分析[J].临床口腔医学杂志,2007,23(6):363-366.
[3]刘晓君,范群,姚霜,等.上颌中切牙埋伏阻生的临床统计分析[J].广东牙病防治,2000,8(4):279.
[4]张耀国,赵春洋.上颌中切牙埋伏阻生的病因与诊断[J].广东牙病防治,2001,9(1):34-35.
[5]王镶珊,胡荣党.上颌埋伏阻生中切牙的影像学分类[J].上海口腔医学,2012,21(2):185-189.
[6]吴平,张海滨,韩立赤,等.上颌倒置弯根阻生中切牙的分类及正畸牵引适应证探讨[J].口腔医学研究,2014,30(6):575-572.
[7]黄吉娜,郭慧芬.上颌埋伏中切牙82例临床治疗和分析[J].浙江医科大学学报(医学版),1994,23(5):210-213.
[8]Sun H,Hu R,Ren M,et al.The treatment timing of labial inversely impacted maxillary central incisors:a prospective study[J].Angle Orthod,2016,86(5):768-774.
[9]Becker A,Brin I,Ben-Bassat Y,et al.Closed-eruption surgical technique for impacted maxillary incisors:a postorthodontic periodontal evaluation[J].Am J Orthod Dentofacial Orthop,2002,122(1):9-14.
[10]Quirynen M,Op Heij DG,Adriansens A,et al.Periodontal health of orthodontically extruded impacted teeth.A split-mouth,longterm clinical evaluation[J].J Periodontol,2000,71(11):1708-1714.
[11]Chaushu S,Brin I,Ben-Bassat Y,et al.Periodontal status following surgical-orthodontic alignment of impacted central incisors with an open-eruption technique[J].Eur J Orthod,2003,25(6):579-584.
[12]王秀颖,孙浩,戴微微,等.导杆式矫治器治疗上颌唇侧倒置埋伏中切牙[J].口腔医学研究,2014,30(12):1149-1152.
[13]卞金有,胡德渝.预防口腔医学[M].第4版.北京:人民卫生出版社,2006:32-33.
[14]孙超凡,孙浩,郑志伟,等.替牙期上颌埋伏中切牙正畸疗效的锥形束CT观察[J].中华口腔医学杂志,2012,47(9):528-533.
[15]Vermette ME,Kokich VG,Kennedy DB.Uncovering labially impacted teeth:apically positioned flap and closed-eruption techniques[J].Angle Orthod,1995,65(1):23-32.
[16]Sarikaya S,Haydar B,Ciǐg er S,et al.Changes in alveolar bone thickness due to retraction of anterior teeth[J].Am J Orthod Dentofacial Orthop,2002,122(1):15-26.
[17]Vardimon AD,Oren E,Ben-Bassat Y.Cortical bone remodeling/tooth movement ratio during maxillary incisor retraction with tip versus torque movements[J].Am J Orthod Dentofacial Orthop,1998,114(5):520-529.