轻度骨性偏颌患者的牙及颌骨特征研究
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摘要
目的:通过对轻度骨性偏颌患者与颌面对称患者之间牙及颌骨形态特点的比较,研究轻度骨性偏颌患者牙、颌骨形态特点及其相关关系。方法 :选取恒牙期轻度骨性偏颌患者(实验组)以及面部基本对称的患者(对照组)各30例,采用X线及锥形束CT(CBCT)对所有患者进行头颅扫描,并对扫描数据进行测量。采用SPSS19.0软件包对测量结果进行统计学分析。结果:实验组左、右侧下颌骨,上、下颌第一磨牙及其周围牙槽骨在冠状面出现不对称现象,差异显著(P<0.05)。实验组与对照组在下颌牙列中线与面中线成角,前下颌平面倾斜角度,上、下颌第一磨牙倾斜角度,下颌第一磨牙区牙槽骨倾斜度、宽度方面均存在显著差异(P<0.05)。颏点偏斜的程度、第一磨牙倾斜度与其周围牙槽骨倾斜度和宽度之间存在一定的相关关系。结论:轻度骨性偏颌患者磨牙倾斜度、牙槽骨及颌骨在冠状面具有一定的特征性表现。轻度骨性偏颌患者颏点偏斜的程度、第一磨牙倾斜度与其周围牙槽骨倾斜度和宽度之间可能存在一定的相关关系。
PURPOSE: The purpose of this study was to investigate the dental and craniofacial morphological characteristics in patients with mild skeletal facial asymmetry, and to investigate the relationship between mild skeletal facial asymmetry and dental anomalies. METHODS: Thirty patients with mild skeletal facial asymmetry(experimental group) and 30 patients with normal faces(control group) were selected. All patients were scanned by cone-beam computed tomography(CBCT) and X-ray machine, Winceph software was used to measure the posteroanterior cephalometric radiographs, NNT software was used to measure the CBCT data. The results were analyzed by Chi-square test, paired t test and independent sample t test using SPSS 19.0 software package. RESULTS: There were significant differences between the left and right sides of faces, teeth and alveolar bone of the first molar in the experimental group. The angle of mandibular dental midline and facial midline, the inclination of the frontal mandibular plane, the inclination of the first molar, the inclination of alveolar bone of the mandibular first molar, the width of alveolar bone of the mandibular first molar showed significant differences between the experimental group and the control group(P <0.05). There are some correlations among menton deviation, inclination of the first molar and alveolar bone of the first molar. CONCLUSIONS:Patients with mild skeletal facial asymmetry showed some specific skeletal and dental characteristics. There could be some correlations between these features.
PURPOSE: The purpose of this study was to investigate the dental and craniofacial morphological characteristics in patients with mild skeletal facial asymmetry, and to investigate the relationship between mild skeletal facial asymmetry and dental anomalies. METHODS: Thirty patients with mild skeletal facial asymmetry(experimental group) and 30 patients with normal faces(control group) were selected. All patients were scanned by cone-beam computed tomography(CBCT) and X-ray machine, Winceph software was used to measure the posteroanterior cephalometric radiographs, NNT software was used to measure the CBCT data. The results were analyzed by Chi-square test, paired t test and independent sample t test using SPSS 19.0 software package. RESULTS: There were significant differences between the left and right sides of faces, teeth and alveolar bone of the first molar in the experimental group. The angle of mandibular dental midline and facial midline, the inclination of the frontal mandibular plane, the inclination of the first molar, the inclination of alveolar bone of the mandibular first molar, the width of alveolar bone of the mandibular first molar showed significant differences between the experimental group and the control group(P <0.05). There are some correlations among menton deviation, inclination of the first molar and alveolar bone of the first molar. CONCLUSIONS:Patients with mild skeletal facial asymmetry showed some specific skeletal and dental characteristics. There could be some correlations between these features.
引文
[1]丁寅.骨性错畸形临床诊治-骨性偏颌畸形诊断与治疗[J].中国实用口腔科杂志,2010,3(5):257-260.
[2]Buranastidporn B,Hisano M,Soma K.Temporomandibular joint internal derangement in mandibular asymmetry.What is the relationship?[J].Eur J Orthod,2006,28(1):83-88.
[3]周顺成,杨乐,章斌,等.成人骨性下颌偏斜与脊柱冠状面形态及躯干平衡性的相关性研究[J].中华口腔正畸学杂志,2011,18(2):68-71.
[4]Haraguchi S,Takada K,Yasuda Y.Facial asymmetry in subjects with skeletal ClassⅢdeformity[J].Angle Orthod,2002,72(1):28-35.
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[6]Kusayama M,Motohashi N,Kuroda T.Relationship between transverse dental anomalies and skeletal asymmetry[J].Am J Orthod Dentofacial Orthop,2003,123(3):329-337.
[7]孙婷婷,张苗苗,邵玶.掩饰性正畸治疗轻度骨性偏畸形的临床研究[J].北京口腔医学,2006,14(4):251-254.
[8]史建陆,陈晓迪,魏婷婷,等.错畸形患者牙颌对称性的CBCT研究[J].临床口腔医学杂志,2013,29(5):288-290.
[9]许一起,丁寅,彭勇,等.发育性偏颌畸形患者的下颌骨三维形态分析[J].医学争鸣,2008,29(14):1325-1327.
[10]Mulick JF.An investigation of craniofacial asymmetry using the serial twin-study method[J].Am J Orthod,1965,51:112-129.
[11]Shah SM,Joshi MR.An assessment of asymmetry in the normal craniofacial complex[J].Angle Orthod,1978,48(2):141-148.
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[13]马志贵,樊林峰,房兵.应用CBCT评价牙周病正畸治疗中牙槽骨状态的价值[J].上海口腔医学,2010,19(2):113-117.
[14]贾绮林,黄金芳.颜面不对称畸形的颅面骨骼结构及其生长发育的研究[J].中华口腔医学杂志,1994,29(1):34-37.
[15]惠元,林薇薇,丁寅,等.成人骨性下颌偏斜患者牙槽骨厚度的锥形束CT研究[J].实用口腔医学杂志,2013,29(3):403-407.
[16]贾海潮,孙新华.偏颌畸形患者的牙弓特征[J].华西口腔医学杂志,2005,23(5):412-414.
[17]Mongini F,Schmid W.Treatment of mandibular asymmetries during growth.A longitudinal study[J].Eur J Orthod,1987,9(1):51-67.
[18]张若芳,刘怡,张丁,等.下颌偏斜患者的牙特征及其与颅面形态的关系[J].中华口腔正畸学杂志,2010,17(4):201-203.
[19]段银钟,霍娜,陈磊,等.Ⅲ类错下颌偏斜正畸疗效的初步分析[J].中华口腔医学杂志,2008,43(12):723-726.
[2]Buranastidporn B,Hisano M,Soma K.Temporomandibular joint internal derangement in mandibular asymmetry.What is the relationship?[J].Eur J Orthod,2006,28(1):83-88.
[3]周顺成,杨乐,章斌,等.成人骨性下颌偏斜与脊柱冠状面形态及躯干平衡性的相关性研究[J].中华口腔正畸学杂志,2011,18(2):68-71.
[4]Haraguchi S,Takada K,Yasuda Y.Facial asymmetry in subjects with skeletal ClassⅢdeformity[J].Angle Orthod,2002,72(1):28-35.
[5]胡炜,周彦恒.骨性下颌前突伴偏斜畸形的牙弓和牙齿代偿分析[J].中华口腔医学杂志,2002,37(3):180-182.
[6]Kusayama M,Motohashi N,Kuroda T.Relationship between transverse dental anomalies and skeletal asymmetry[J].Am J Orthod Dentofacial Orthop,2003,123(3):329-337.
[7]孙婷婷,张苗苗,邵玶.掩饰性正畸治疗轻度骨性偏畸形的临床研究[J].北京口腔医学,2006,14(4):251-254.
[8]史建陆,陈晓迪,魏婷婷,等.错畸形患者牙颌对称性的CBCT研究[J].临床口腔医学杂志,2013,29(5):288-290.
[9]许一起,丁寅,彭勇,等.发育性偏颌畸形患者的下颌骨三维形态分析[J].医学争鸣,2008,29(14):1325-1327.
[10]Mulick JF.An investigation of craniofacial asymmetry using the serial twin-study method[J].Am J Orthod,1965,51:112-129.
[11]Shah SM,Joshi MR.An assessment of asymmetry in the normal craniofacial complex[J].Angle Orthod,1978,48(2):141-148.
[12]Ishizaki K,Suzuki K,Mito T.Morphologic,functional,and occlusal characterization of mandibular lateral displacement malocclusion[J].Am J Orthod Dentofacial Orthop,2010,137(4):454.e1-9.
[13]马志贵,樊林峰,房兵.应用CBCT评价牙周病正畸治疗中牙槽骨状态的价值[J].上海口腔医学,2010,19(2):113-117.
[14]贾绮林,黄金芳.颜面不对称畸形的颅面骨骼结构及其生长发育的研究[J].中华口腔医学杂志,1994,29(1):34-37.
[15]惠元,林薇薇,丁寅,等.成人骨性下颌偏斜患者牙槽骨厚度的锥形束CT研究[J].实用口腔医学杂志,2013,29(3):403-407.
[16]贾海潮,孙新华.偏颌畸形患者的牙弓特征[J].华西口腔医学杂志,2005,23(5):412-414.
[17]Mongini F,Schmid W.Treatment of mandibular asymmetries during growth.A longitudinal study[J].Eur J Orthod,1987,9(1):51-67.
[18]张若芳,刘怡,张丁,等.下颌偏斜患者的牙特征及其与颅面形态的关系[J].中华口腔正畸学杂志,2010,17(4):201-203.
[19]段银钟,霍娜,陈磊,等.Ⅲ类错下颌偏斜正畸疗效的初步分析[J].中华口腔医学杂志,2008,43(12):723-726.