微种植体支抗辅助内收上切牙后牙槽骨改建的锥形束CT研究

doi:10.19439/j.sjos.2018.02.008

上海口腔医学 ›› 2018, Vol. 27 ›› Issue (2): 150-155.doi: 10.19439/j.sjos.2018.02.008

微种植体支抗辅助内收上切牙后牙槽骨改建的锥形束CT研究

陈香¹, 张向凤², 黄倩倩², 张翼², 喻凤², 王华桥¹

1.重庆医科大学附属口腔医院正畸科,口腔疾病与生物医学重庆市重点实验室, 重庆市高校市级口腔生物医学工程重点实验室,重庆 401147;
2.重庆市协尔口腔,重庆 400042

收稿日期:2017-05-08 修回日期:2017-07-05 出版日期:2018-04-25 发布日期:2018-05-14
通讯作者: 王华桥,E-mail：muscle_tina@163.com
作者简介:陈香（1992-）,女,硕士,E-mail：418634302@qq.com
基金资助:
国家自然科学基金（81570979）; 重庆市卫生局面上项目( 2013-2-069, 2012-2-131,2015MSXM051)

Evaluation of the changes of alveolar bone around the upper incisors after retraction with mini implant anchorage using cone-beam CT

CHEN Xiang¹, ZHANG Xiang-feng², HUANG Qian-qian², ZHANG Yi², YU Feng², WANG Hua-qiao¹

1.Department of Orthodontics,The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education. Chongqing 401147;
2.Chongqing Sharedental Clinic. Chongqing 400042, China

Received:2017-05-08 Revised:2017-07-05 Online:2018-04-25 Published:2018-05-14

摘要/Abstract

摘要： 目的:探索运用微种植体支抗结合高位牵引钩大量内收上颌切牙后牙槽骨的改建情况。方法:以22例青少年上颌前突拔牙矫治患者,上颌切牙内收前、内收完成后的锥形束CT（cone-beam CT,CBCT）为研究样本,应用Mimics 15.0行CBCT影像三维重建,明确上颌切牙移动方式,利用Invivo5.0三维定点测量唇、腭侧牙槽骨厚度和高度变化。采用SPSS19.0 软件包对测量数据进行配对t 检验。结果:上颌切牙切缘与根尖均发生水平舌侧移动,但切缘的移动距离大于根尖;切缘点发生向下移动,根尖点出现明显的向上移动。上切牙腭侧牙槽骨厚度及唇腭侧总厚度在根颈1/3和根中1/3均显著减小（P<0.05）,而根尖1/3显著增加（P<0.05）,腭侧牙槽骨高度显著降低（P<0.05）。结论:青少年上颌前突患者微种植体支抗结合高位牵引钩可以实现受控制的倾斜移动。大量内收上颌切牙后,其腭侧牙槽骨吸收远大于唇侧增生,牙槽骨并没有完全跟随牙的移动而改建,提示正畸矫治时不宜过度内收前牙。

关键词: 切牙内收, 微种植体支抗, 锥形束CT, 牙槽骨改建

Abstract: PURPOSE: The aim of this clinical study was to evaluate the changes of alveolar bone morphology before and after upper incisors retraction with mini implant anchorage using cone-beam CT (CBCT). METHODS: Twenty-two young patients with dentoalveolar maxillary protrusion and extraction of 2 maxillary first premolars were evaluated with CBCT. CBCT scans were obtained before treatment and 3 months after retraction of the incisors. The movement patterns of the upper incisors were assessed with Mimics15.0. The labial and palatal alveolar plates at crest level, midroot level, and apical level for bone-thickness changes and labial and palatal vertical bone level during retraction of the maxillary anterior segments were assessed with Invivo5.0. Paired t tests were used to evaluate the changes. RESULTS: The edge of the maxillary incisor and the root apex appeared lingual movement horizontally, but the moving distance was larger than the root apex. The edge of the incisors was moved downward, and the root apex was moved upward obviously. The palatal thickness and total thickness of the alveolar bone showed significant decrease at the crest level and midroot level after retraction while the apical level showed significant increase(P<0.05). The palatal vertical bone level also showed great loss (P<0.05). CONCLUSIONS: After extensive retraction of the maxillary incisors, tilt movements are controlled with high traction hooks and microscrew implants. The decreases in palatal bone thickness are much more significant compared with the increases in labial bone thickness. Alveolar bone remodeling doesn't follow the movement of tooth, suggesting that the limitation of anterior teeth retraction should be taken into consideration.

Key words: Incisors retraction, Mini-screw implant anchorage, Cone-beam CT, Alveolar bone remodeling

中图分类号:

R783.5

陈香, 张向凤, 黄倩倩, 张翼, 喻凤, 王华桥. 微种植体支抗辅助内收上切牙后牙槽骨改建的锥形束CT研究[J]. 上海口腔医学, 2018, 27(2): 150-155.

CHEN Xiang, ZHANG Xiang-feng, HUANG Qian-qian, ZHANG Yi, YU Feng, WANG Hua-qiao. Evaluation of the changes of alveolar bone around the upper incisors after retraction with mini implant anchorage using cone-beam CT[J]. Shanghai Journal of Stomatology, 2018, 27(2): 150-155.

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微种植体支抗辅助内收上切牙后牙槽骨改建的锥形束CT研究

Evaluation of the changes of alveolar bone around the upper incisors after retraction with mini implant anchorage using cone-beam CT

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