正畸患者上颌侧切牙和尖牙区骨缺损影响因素的锥形束CT研究
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摘要
目的:利用锥形束CT(cone beam computed tomography,CBCT)研究上颌侧切牙和尖牙区骨开裂和骨开窗的危险因素。方法:实验对象选自2014~2016年就诊于中国医科大学附属口腔医院正畸一科患者治疗前的CBCT,存在骨开裂或骨开窗的上颌侧切牙44例和上颌尖牙43例为实验组,不存在骨开裂和骨开窗的上颌侧切牙43例和上颌尖牙41例为对照组。结果:牙体倾斜度、牙体长轴与牙槽突长轴的角度、牙槽骨曲度、牙槽骨宽度、牙根宽度与牙槽骨宽度差、牙齿在牙槽骨中的位置有统计学差异(P<0.05),牙根长度、根尖距牙槽骨最凹点的距离无统计学差异(P>0.05)。结论:牙齿舌倾、牙体长轴与牙槽突长轴角度大、牙槽骨薄、牙槽骨弯曲大、牙齿位置偏离牙槽骨中心(偏唇侧或舌侧)等是上颌侧切牙和尖牙区发生骨开裂与骨开窗的危险因素。
Objective:To investigate the risk factors with dehiscences and fenestrations of upper lateral incisors and canines using CBCT.Methods:CBCT images of untreated patients in China Medical University Hospital of Stomatology from 2014 to 2016 were selected.Forty-four upper lateral incisors and 43 upper canines with dehiscences or fenestrations were selected as test group,and 43 upper lateral incisors and 41 upper canines without alveolar defects were selected as control group.Results:There were significant differences on the tooth axis,the angle between tooth axis and alveolar bone axis,curvature angle of alveolar bone,alveolar bone width,differences between the root diameter and alveolar bone width,tooth position in the alveolar bone(P<0.05).There was no difference on the length of root and the distance from the root apical to the deepest point on the buccal bone(P>0.05).Conclusion:Tooth lingual inclination,larger angle between tooth axis and alveolar bone axis,thin alveolar,more curved alveolar buccal bone,and tooth position deviated from the alveolar bone(lateral or lingual)are risk factors of dehiscences and fenestrations in maxillary lateral incisors and canines.
Objective:To investigate the risk factors with dehiscences and fenestrations of upper lateral incisors and canines using CBCT.Methods:CBCT images of untreated patients in China Medical University Hospital of Stomatology from 2014 to 2016 were selected.Forty-four upper lateral incisors and 43 upper canines with dehiscences or fenestrations were selected as test group,and 43 upper lateral incisors and 41 upper canines without alveolar defects were selected as control group.Results:There were significant differences on the tooth axis,the angle between tooth axis and alveolar bone axis,curvature angle of alveolar bone,alveolar bone width,differences between the root diameter and alveolar bone width,tooth position in the alveolar bone(P<0.05).There was no difference on the length of root and the distance from the root apical to the deepest point on the buccal bone(P>0.05).Conclusion:Tooth lingual inclination,larger angle between tooth axis and alveolar bone axis,thin alveolar,more curved alveolar buccal bone,and tooth position deviated from the alveolar bone(lateral or lingual)are risk factors of dehiscences and fenestrations in maxillary lateral incisors and canines.
引文
[1]李明,逢爱慧,陈美玲,等.锥形束CT检测牙槽骨缺损的准确性研究[J].口腔医学研究,2013,29(8)∶760-763
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[7]Evangelista K,Vasconcelos KF,Bumann A,et al.Dehiscence and fenestration in patients with ClassⅠand ClassⅡDivision 1malocclusion assessed with cone-beam computed tomography[J].Am J Orthod Dentofacial Orthop,2010,138(2)∶133e1-133e7
[8]Agarwal V.Fenestration and dehiscence in a non vital Tooth-Acase report[J].J Clin Diagn Res,2010,4(4)∶2971-2973
[9]赵欢,刘琳牙槽骨缺损与正畸诊疗研究进展[J].中国实用口腔科杂志,2016,10(9)∶624-627
[10]Yu Q,Pan XG,Ji GP,et al.The association between lower incisal inclination and morphology of the supporting alveolar bone-a cone-beam CT study[J].Int J Oral Sci,2009,1(4)∶217-223
[11]Siriwat PP,Jarabak JR.Malocclusion and facial morphology:is there a relationship?An epidemiologic study[J].Angle Orthod,1985,55(2)∶127-138
[12]Ghassemian M,Nowzari H,Lajolo C,et al.The thickness of facial alveolar bone overlying healthy maxillary anterior teeth[J].JPeriodontol,2012,83(2)∶187-197
[13]Fuhrmann RAW.Three-dimensional evaluation of periodontal remodeling during orthodontic treatment[J].Semin Orthod,2002,8(1)∶23-28
[14]Wehrbein H,Bauer W,Diedrich P.Mandibular incisors,alveolar bone and symphysis after orthodontic treatment:A retrospective study[J].Am J Orthod Dentofacial Orthop,1996,110(3)∶239-246
[15]Vardimon AD,Graber TM,Voss LR,et al.Determinants controlling iatrogenic external root resorption and repair during and after palatal expansion[J].Angle Orthod,1991,61(2)∶113-124
[16]Asli B,Tancan U,Ilknur V,et al.Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography[J].Korean J Orthod,2013,43(2)∶83-95
[2]邓莉,史雪峰.锥形束CT在切牙区唇侧牙槽骨开窗及开裂诊断中的应用研究[J].口腔医学研究,2017,33(5)∶559-562
[3]周琳,李巍然.锥形束CT在评价双颌前突患者前牙区牙槽骨缺损中的应用[J].北京大学学报(医学版),2015,47(3)∶514-520
[4]Wehrbein H,Bauer W,Diedrich P,et al.Mandibular incisors,alveolar bone,and symphysis after orthodontic treatment.A retrospective study[J].Am J Orthod Dentofacial Orthop,1996,110(3)∶239-246
[5]Enhos S,Uysal T,Yagci A,et al.Dehiscence and fenestration in patients with different vertical growth patterns assessed with cone-beam computed tomography[J].Angle Orthod,2012,82(5)∶868-874
[6]王博,房兵,樊林峰.成人骨性Ⅲ类错牙合下前牙区牙槽骨厚度的测量分析[J].上海口腔医学,2012,21(4)∶422-426
[7]Evangelista K,Vasconcelos KF,Bumann A,et al.Dehiscence and fenestration in patients with ClassⅠand ClassⅡDivision 1malocclusion assessed with cone-beam computed tomography[J].Am J Orthod Dentofacial Orthop,2010,138(2)∶133e1-133e7
[8]Agarwal V.Fenestration and dehiscence in a non vital Tooth-Acase report[J].J Clin Diagn Res,2010,4(4)∶2971-2973
[9]赵欢,刘琳牙槽骨缺损与正畸诊疗研究进展[J].中国实用口腔科杂志,2016,10(9)∶624-627
[10]Yu Q,Pan XG,Ji GP,et al.The association between lower incisal inclination and morphology of the supporting alveolar bone-a cone-beam CT study[J].Int J Oral Sci,2009,1(4)∶217-223
[11]Siriwat PP,Jarabak JR.Malocclusion and facial morphology:is there a relationship?An epidemiologic study[J].Angle Orthod,1985,55(2)∶127-138
[12]Ghassemian M,Nowzari H,Lajolo C,et al.The thickness of facial alveolar bone overlying healthy maxillary anterior teeth[J].JPeriodontol,2012,83(2)∶187-197
[13]Fuhrmann RAW.Three-dimensional evaluation of periodontal remodeling during orthodontic treatment[J].Semin Orthod,2002,8(1)∶23-28
[14]Wehrbein H,Bauer W,Diedrich P.Mandibular incisors,alveolar bone and symphysis after orthodontic treatment:A retrospective study[J].Am J Orthod Dentofacial Orthop,1996,110(3)∶239-246
[15]Vardimon AD,Graber TM,Voss LR,et al.Determinants controlling iatrogenic external root resorption and repair during and after palatal expansion[J].Angle Orthod,1991,61(2)∶113-124
[16]Asli B,Tancan U,Ilknur V,et al.Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography[J].Korean J Orthod,2013,43(2)∶83-95