不同年龄骨性Ⅱ类高角患者切牙区牙槽骨的厚度及高度特征
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摘要
目的研究应用锥形束CT(CBCT)测量分析不同年龄组骨性Ⅱ类高角患者切牙区牙槽骨高度、厚度、骨开窗及骨开裂等根周牙槽骨特征,为临床治疗提供参考。方法选取符合纳入标准骨性Ⅱ类高角患者46例,其中青少年组26例,年龄(12.9±1.2)岁;成人组20例,年龄(22.3±3.2)岁。收集患者正畸治疗前拍摄的CBCT三维影像数据,独立t检验(正态分布)或Mann-Whitney U检验(偏态分布)比较两组患者右侧上下颌切牙区牙槽骨高度及厚度特征,卡方检验两组患者骨开窗、骨开裂发生率。结果骨性Ⅱ类高角成年患者切牙区唇舌(腭)侧牙槽骨附着高度低于青少年患者(P<0.05);成人组切牙区唇舌(腭)侧釉牙骨质界下2 mm处及根尖部牙槽骨厚度薄于青少年组(P<0.05);成人组切牙区唇舌(腭)侧牙槽骨面积少于青少年组(P<0.05)。骨性Ⅱ类高角成年患者正畸治疗前切牙区牙槽骨骨开窗、骨开裂发生率分别为10.00%和32.50%;青少年患者骨开窗、骨开裂发生率分别为3.37%和14.90%;成人组切牙区牙槽骨骨开窗、骨开裂发生率高于青少年组(χ~2_(骨开窗)=6.794,P_(骨开窗)=0.009;χ~2_(骨开裂)=16.030,P_(骨开裂)<0.001)。结论骨性Ⅱ类高角成年患者切牙区根周牙槽骨量少于青少年患者,骨开窗、骨开裂发生率高于青少年患者。
Objective This study aims to explore the height and thickness of the anterior alveolarbone of hyperdivergent skeletal ClassⅡmalocclusion between different ages and calculate the incidencerates of fenestration and dehiscence using cone-beam computed tomography(CBCT).Methods Thesample consisted of 46 persons of hyperdivergent skeletal ClassⅡmalocclusion who met the inclusioncriteria.They were divided into two groups,teenager group(26 cases,age:12.9±1.2 years)and adultgroup(20 cases,age:22.3±3.2 years).The CBCT images were collected to measure the height andthickness of the anterior alveolar bone of the upper right side and calculate the incidence rates offenestration and dehiscence.Independent t-test(normal distribution)or Mann-Whitney U-test(skeweddistribution)were used for the measurement of the height and thickness of the anterior alveolar bone.Chi-square test was used to compare the incidence rates of fenestration and dehiscence between the two groups.Results For the hyperdivergent skeletal ClassⅡmalocclusion,the alveolar bone attachment of theincisors of both jaws in the adult group were lower than those in the teenager group(P<0.05);Thealveolar bone thickness at 2 mm level from cemeto-enamel junction and the apical level of the incisors ofboth jaws in the adult group were lower than those in the teenager group(P<0.05);The alveolar bonearea of the incisors of both jaws in the adult group were smaller than those in the teenager group(P<0.05).In the adult group of the hyperdivergent skeletal ClassⅡmalocclusion,the incidence rates offenestration and dehiscence were 10.00% and 32.50% respectively and in the teenager group were 3.37% and 14.90% respectively before orthodontic treatment.Compared with teenagers,the incidence rates offenestration and dehiscence were much higher in adults(χ_(Fenestration)~2=6.794,P_(Fenestration)=0.009;χ_(Dehiscence)~2=16.030,P_(Dehiscence)<0.001).Conclusions For the hyperdivergent skeletal ClassⅡmalocclusion,thequantity of anterior alveolar bone in the adult group was less than that of the teenager group.Comparedwith the teenagers,the incidence rates of fenestration and dehiscence were much higher in adults.
Objective This study aims to explore the height and thickness of the anterior alveolarbone of hyperdivergent skeletal ClassⅡmalocclusion between different ages and calculate the incidencerates of fenestration and dehiscence using cone-beam computed tomography(CBCT).Methods Thesample consisted of 46 persons of hyperdivergent skeletal ClassⅡmalocclusion who met the inclusioncriteria.They were divided into two groups,teenager group(26 cases,age:12.9±1.2 years)and adultgroup(20 cases,age:22.3±3.2 years).The CBCT images were collected to measure the height andthickness of the anterior alveolar bone of the upper right side and calculate the incidence rates offenestration and dehiscence.Independent t-test(normal distribution)or Mann-Whitney U-test(skeweddistribution)were used for the measurement of the height and thickness of the anterior alveolar bone.Chi-square test was used to compare the incidence rates of fenestration and dehiscence between the two groups.Results For the hyperdivergent skeletal ClassⅡmalocclusion,the alveolar bone attachment of theincisors of both jaws in the adult group were lower than those in the teenager group(P<0.05);Thealveolar bone thickness at 2 mm level from cemeto-enamel junction and the apical level of the incisors ofboth jaws in the adult group were lower than those in the teenager group(P<0.05);The alveolar bonearea of the incisors of both jaws in the adult group were smaller than those in the teenager group(P<0.05).In the adult group of the hyperdivergent skeletal ClassⅡmalocclusion,the incidence rates offenestration and dehiscence were 10.00% and 32.50% respectively and in the teenager group were 3.37% and 14.90% respectively before orthodontic treatment.Compared with teenagers,the incidence rates offenestration and dehiscence were much higher in adults(χ_(Fenestration)~2=6.794,P_(Fenestration)=0.009;χ_(Dehiscence)~2=16.030,P_(Dehiscence)<0.001).Conclusions For the hyperdivergent skeletal ClassⅡmalocclusion,thequantity of anterior alveolar bone in the adult group was less than that of the teenager group.Comparedwith the teenagers,the incidence rates of fenestration and dehiscence were much higher in adults.
引文
[1]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):95-109.
[2]Koh KK,Tan JS,Nambiar P,et al.Age estimation from structural changes of teeth and buccal alveolar bone level[J].JForensic Leg Med,2017(48):15-21.DOI:10.1016/j.jflm.2017.03.004.
[3]Ren Y,Maltha JC,Stokroos L,et al.Age-related changes of periodontal ligament surface areas during force application[J].Angle Orthod,2008,78(6):1000-1005.DOI:10.2319/080107-357.1.
[4]孙良,王博,房兵.骨性Ⅲ类错牙合前牙区牙槽骨开裂和牙槽骨开窗发生率的锥形束CT研究[J].上海口腔医学,2013,22(4):418-422.
[5]Hwang SH,Park SG.Experience of Orthodontic Treatment and Symptoms of Temporomandibular Joint in South Korean Adults[J].Iran J Public Health,2018,47(1):13-17.
[6]Rodriguez Flores JM.Multidisciplinary orthodontic treatment in adult patients:the future of orthodontics[J].Int J Orthod Milwaukee,2010,21(3):11-21.
[7]于世凤.口腔组织病理学[M].北京:人民卫生出版社,2012:101-102.
[8]Varrela TM,Paunio K,Wouters FR,et al.The relation between tooth eruption and alveolar crest height in a human skeletal sample[J].Arch Oral Biol,1995,40(3):175-180.DOI:10.1016/0003-9969(95)98805-9.
[9]曹采方.临床牙周病学[M].北京:北京大学医学出版社,2006:18-19.
[10]Sun L,Zhang L,Shen G,et al.Accuracy of cone-beam computed tomography in detecting alveolar bone dehiscences and fenestrations[J].Am J Orthod Dentofacial Orthop,2015,147(3):313-323.
[11]Pilloni A,Rotundo R,Gambarini G,et al.Bone dehiscences and fenestrations of the anterior mandibular facial bone wall:a retrospective cone beam computed tomography study[J].Minerva Stomatol,2018,67(3):86-95.DOI:10.23736/S0026-4970.18.04099-2.
[12]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.DOI:10.2319/111211-702.1.
[13]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.DOI:10.3969/j.issn.1671-167X.2015.03.027.
[14]徐筱,徐莉,江久汇,等.锥形束CT评判安氏Ⅲ类错牙合上前牙骨开裂与骨开窗的准确性分析[J].北京大学学报(医学版),2018,50(1):104-109.DOI:10.3969/j.issn.1671-167X.2018.01.018.
[15]Nimigean VR,Nimigean V,Bencze MA,et al.Alveolar bone dehiscences and fenestrations:an anatomical study and review[J].Rom J Morphol Embryol,2009,50(3):391-397.
[16]赵岩,屈振宇,刘琳,等.锥形束CT用于骨性安氏Ⅱ类1分类错牙合畸形切牙区唇侧牙槽骨开窗及骨开裂的研究[J].中华口腔正畸学杂志,2016,23(1):2-7.DOI:10.3760/cma.j.issn.1674-5760.2016.01.001.
[17]Spray JR,Black CG,Morris HF,et al.The influence of bone thickness on facial marginal bone response:stage 1 placement through stage 2 uncovering[J].Ann Periodontol,2000,5(1):119-128.DOI:10.1902/annals.2000.5.1.119.
[18]Esfahanizadeh N,Daneshparvar N,Askarpour F,et al.Correlation Between Bone and Soft Tissue Thickness in Maxillary Anterior Teeth[J].J Dent(Tehran),2016,13(5):302-308.
[19]Farahamnd A,Sarlati F,Eslami S,et al.Evaluation of Impacting Factors on Facial Bone Thickness in the Anterior Maxillary Region[J].J Craniofac Surg,2017,28(3):700-705.DOI:10.1097/SCS.0000000000003643.
[20]田玉楼,赵震锦,韩坤,等.下颌中切牙唇倾度与牙槽骨厚度关系的锥形束CT分析[J].上海口腔医学,2015,24(2):210-214.2018-05-19
[2]Koh KK,Tan JS,Nambiar P,et al.Age estimation from structural changes of teeth and buccal alveolar bone level[J].JForensic Leg Med,2017(48):15-21.DOI:10.1016/j.jflm.2017.03.004.
[3]Ren Y,Maltha JC,Stokroos L,et al.Age-related changes of periodontal ligament surface areas during force application[J].Angle Orthod,2008,78(6):1000-1005.DOI:10.2319/080107-357.1.
[4]孙良,王博,房兵.骨性Ⅲ类错牙合前牙区牙槽骨开裂和牙槽骨开窗发生率的锥形束CT研究[J].上海口腔医学,2013,22(4):418-422.
[5]Hwang SH,Park SG.Experience of Orthodontic Treatment and Symptoms of Temporomandibular Joint in South Korean Adults[J].Iran J Public Health,2018,47(1):13-17.
[6]Rodriguez Flores JM.Multidisciplinary orthodontic treatment in adult patients:the future of orthodontics[J].Int J Orthod Milwaukee,2010,21(3):11-21.
[7]于世凤.口腔组织病理学[M].北京:人民卫生出版社,2012:101-102.
[8]Varrela TM,Paunio K,Wouters FR,et al.The relation between tooth eruption and alveolar crest height in a human skeletal sample[J].Arch Oral Biol,1995,40(3):175-180.DOI:10.1016/0003-9969(95)98805-9.
[9]曹采方.临床牙周病学[M].北京:北京大学医学出版社,2006:18-19.
[10]Sun L,Zhang L,Shen G,et al.Accuracy of cone-beam computed tomography in detecting alveolar bone dehiscences and fenestrations[J].Am J Orthod Dentofacial Orthop,2015,147(3):313-323.
[11]Pilloni A,Rotundo R,Gambarini G,et al.Bone dehiscences and fenestrations of the anterior mandibular facial bone wall:a retrospective cone beam computed tomography study[J].Minerva Stomatol,2018,67(3):86-95.DOI:10.23736/S0026-4970.18.04099-2.
[12]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.DOI:10.2319/111211-702.1.
[13]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.DOI:10.3969/j.issn.1671-167X.2015.03.027.
[14]徐筱,徐莉,江久汇,等.锥形束CT评判安氏Ⅲ类错牙合上前牙骨开裂与骨开窗的准确性分析[J].北京大学学报(医学版),2018,50(1):104-109.DOI:10.3969/j.issn.1671-167X.2018.01.018.
[15]Nimigean VR,Nimigean V,Bencze MA,et al.Alveolar bone dehiscences and fenestrations:an anatomical study and review[J].Rom J Morphol Embryol,2009,50(3):391-397.
[16]赵岩,屈振宇,刘琳,等.锥形束CT用于骨性安氏Ⅱ类1分类错牙合畸形切牙区唇侧牙槽骨开窗及骨开裂的研究[J].中华口腔正畸学杂志,2016,23(1):2-7.DOI:10.3760/cma.j.issn.1674-5760.2016.01.001.
[17]Spray JR,Black CG,Morris HF,et al.The influence of bone thickness on facial marginal bone response:stage 1 placement through stage 2 uncovering[J].Ann Periodontol,2000,5(1):119-128.DOI:10.1902/annals.2000.5.1.119.
[18]Esfahanizadeh N,Daneshparvar N,Askarpour F,et al.Correlation Between Bone and Soft Tissue Thickness in Maxillary Anterior Teeth[J].J Dent(Tehran),2016,13(5):302-308.
[19]Farahamnd A,Sarlati F,Eslami S,et al.Evaluation of Impacting Factors on Facial Bone Thickness in the Anterior Maxillary Region[J].J Craniofac Surg,2017,28(3):700-705.DOI:10.1097/SCS.0000000000003643.
[20]田玉楼,赵震锦,韩坤,等.下颌中切牙唇倾度与牙槽骨厚度关系的锥形束CT分析[J].上海口腔医学,2015,24(2):210-214.2018-05-19