Peridental bone changes after orthodontic tooth movement with fixed appliances: A cone-beam computed tomographic study

Objective:To quantify treatment-related changes in peridental bone height and thickness in orthodontic patients.Materials and Methods:Cone-beam computed tomographs (CBCTs) of 43 patients (24 female, 19 male; mean age: 25 years, 5 months) who underwent orthodontic treatment with multibracket appliances for at least 1 year were chosen for retrospective evaluation. Dehiscence depth and changes in bone width and tooth inclination were determined for 954 teeth.Results:There was a significant decrease in peridental bone height (dehiscence; −0.82 ± 1.47 mm) and bone thickness (−0.56 ± 0.7 and −0.69 ± 0.9 mm at 5 mm and 10 mm apical to the CEJ, respectively) during treatment (P < .001). A significantly greater dehiscence depth with increased vertical bone loss occurred in patients older than 30 years. In patients <30 years old, approximately 20% of the teeth showed defect depths >2 mm before treatment. In 90% of these patients, at least one tooth was affected. The maxillary canines and all mandibular teeth showed a higher risk for vestibular bone loss. Treatment changes in tooth inclination were correlated with horizontal bone loss.Conclusions:Based on these results, it seems reasonable to recommend that peridental bone in orthodontic patients older than 30 be evaluated on a routine basis due to the risk of increased vertical bone loss. Ninety percent of patients younger than 30 showed reduced bone height (dehiscence) of the periodontium of at least one tooth.     

灌服骨碎补水煎液对大鼠正畸牙移动中牙槽骨骨密度的影响

目的通过建立大鼠磨牙移动实验模型,研究骨碎补对正畸牙移动过程中牙槽骨骨密度的影响。方法 选用48只SPF级（无特定病原体动物）8周龄健康雌性W istar大鼠,适应性饲养一周后随机分为两组：实验组和对照组。建立大鼠磨牙移动实验模型,实验组每日灌服骨碎补水煎剂6g/Kg;对照组每日灌服生理盐水3m l,两组动物于正畸加力7、14、21、28天后,分批处死,分离大鼠上下颌骨,测量各期上颌第一磨牙牙齿移动的距离,并选择下颌第一、二、三磨牙根尖下约0.15 cm2的牙槽骨,测量其质量,得到牙槽骨密度值。对两组的实验数据进行统计学分析研究。结果实验7、14、21、28天,实验组上颌第一磨牙移动距离及牙槽骨骨密度均大于对照组,除实验7天时两组的牙齿移动距离平均值及牙槽骨密度平均值不存在显著性差异外,其他各期的差异都有显著性。结论中药骨碎补能减缓牙槽骨骨密度的降低,加速正畸牙移动,缩短正畸治疗的疗程。     

Cone beam computed tomography evaluation of distance from cementoenamel junction to alveolar crest before and after nonextraction orthodontic treatment

Objective:To evaluate the distance between the cementoenamel junction and the alveolar bone crest before and after orthodontic treatment using cone beam computed tomography (CBCT).Materials and Methods:The sample comprised 30 patients with Angle Class I malocclusion and mild to moderate crowding. The study database comprised dental CBCT scans obtained before and after orthodontic treatment. The distance between the cementoenamel junction to the bone crest of the buccal (n  =  720) and lingual (n  =  720) surfaces was measured in 24 teeth for each patient using a specific software tool (Xoran version 3.1.62). The Wilcoxon test was used for statistical analysis, and the level of significance was set at P < .05.Results:The distance between the cementoenamel junction and the bone crest increased in 822 (57%) of the 1440 surfaces after orthodontic treatment. The buccal surface of the lower central incisors had the greatest frequency of increased distance (75%), and the lingual surface of lateral incisors had the lowest (40%). The distance between the cementoenamel junction and the alveolar bone crest was greater than 2 mm (alveolar bone dehiscence) in 162 (11%) of the 1440 surfaces before orthodontic treatment and in 279 (19%) after treatment.Conclusions:The distance from the cementoenamel junction to the bone crest changed after orthodontic treatment; the distance was greater than 2 mm in 11% of the surfaces before treatment and in 19% after treatment.     

增龄因素对鼠正畸牙齿移动中牙周组织骨保护素（OPG）表达的影响

目的 比较在正畸牙齿移动中幼年鼠和成年鼠牙周组织骨保护素(osteoprotegerin,OPG)信使RNA(mRNA)表达的不同,以探讨增龄因素影响正畸骨改建的分子机制。方法以4周(幼年鼠)和24周(成年鼠)雄性大鼠为实验动物,牵引左上第一磨牙近中移动为正畸牙齿移动模型,原位杂交检测牙周膜组织OPG mRNA的表达。结果 1.幼年鼠正畸牙齿移动中加力后3小时张力侧近牙槽骨表面可见OPG表达阳性细胞排列;与幼年鼠相比,成年鼠加力后牵张侧牙周膜细胞的OPG mRNA表达没有明显改变。2.幼年鼠加力后6小时开始压力侧即可观察到破骨细胞的数目明显增多,成年鼠加力后,压力侧加力24小时可见破骨细胞;无论幼年和成年鼠压力侧牙周膜细胞的OPG mRNA表达在加力前后均未见明显改变。结论 增龄因素使牙周组织内OPG表达明显增强;成年牙周组织中较强的OPG表达可能与成人正畸出现的牙槽骨吸收、牙齿移动迟缓相关。     

锥形束CT评估与下颌阻生第三磨牙相关的第二磨牙远中牙槽骨缺损的危险因素

目的 使用锥形束CT(CBCT)评估与下颌阻生第三磨牙(MTM)相关的第二磨牙(MSM)远中牙槽骨缺损的危险因素.方法 在这项横断面研究中,选择2018年1月至2020年1月就诊于合肥市口腔医院的124例因临床治疗需要拍摄CBCT的患者进行了回顾性研究,其中男67例、女57例,年龄18～65岁,平均32.5岁.CBCT...     

上颌前牙牙龈厚度与牙槽骨厚度相关性的数字化测量分析

目的用数字化方法探讨分析上颌前牙唇侧牙龈厚度和牙槽骨厚度的相关性,为上颌前牙区美学修复及种植治疗提供参考。方法根据纳入及排除标准,选取2020年5至10月于第四军医大学口腔医学院口腔修复科行后牙种植修复的患者,共纳入57例,其中男性23例,女性34例,年龄(25.8±4.5)岁。采用口内扫描仪进行口内扫描,并拍摄锥形束CT,利用种植导板软件进行口内扫描数据和锥形束CT数据的拟合配准,测量并记录上颌中切牙、侧切牙和尖牙唇侧龈缘下2 mm处牙龈厚度以及牙槽嵴顶下2、4 mm处牙龈厚度及牙槽骨厚度。结果57例患者上颌中切牙、侧切牙、尖牙龈缘下2 mm处牙龈厚度分别为(1.42±0.21)、(1.19±0.17)和(1.23±0.20)mm(F=12.47,P<0.001);男性上颌前牙龈缘下2 mm和牙槽嵴顶下4 mm处牙龈厚度[分别为(1.31±0.21)和(0.67±0.22)mm]分别显著大于女性相应测量项目[分别为(1.26±0.22)和(0.58±0.19)mm](t=2.01和3.97,P<0.05);上颌前牙唇侧牙槽嵴顶下2、4 mm处牙龈厚度与牙槽骨厚度均呈正相关(r=0.387和0.344,P均<0.05)。结论上颌中切牙牙龈厚度大于侧切牙和尖牙;男性牙龈厚度大于女性;上颌前牙唇侧牙槽嵴顶下2、4 mm处牙龈厚度与牙槽骨厚度呈正相关,即牙龈越厚,牙槽骨也越厚。     

灌服中药骨碎补、丹参对大鼠正畸牙移动过程中骨密度的影响

目的:探讨中药骨碎补、丹参在大鼠正畸牙移动过程中对牙槽骨密度降低的抑制作用。方法:选取72只8周龄、SPF级健康雌性Wistar大鼠,建立正畸牙移动模型,随机分为骨碎补组、丹参组和生理盐水组,每组24只。骨碎补组和丹参组每天分别灌服中药药液6 g/kg,生理盐水组每天灌服0.9%生理盐水3 mL。镍钛螺旋弹簧每周加力1次。3组动物于正畸加力第7、14、21、28天分批处死,每组分别处死6只。分离上、下颌骨,分别测量牙移动距离和牙槽骨密度,采用SPSS18软件包对数据进行统计学分析。结果:骨碎补组、丹参组牙移动距离无显著差异(P>0.05),但两者均大于生理盐水组,差异有显著性(P<0.05);骨碎补组、丹参组牙槽骨密度无显著差异(P>0.05),但两者均大于生理盐水组,差异有显著性(P<0.05)。结论:骨碎补、丹参水煎液在加速正畸牙移动的同时,均能够减缓牙槽骨密度的降低。     

Alveolar bone changes after molar protraction in young adults with missing mandibular second premolars or first molars

ObjectivesTo assess the changes in alveolar bone of the mandibular second molars following molar protraction and investigate the factors associated with the alveolar bone changes.Materials and MethodsCone-beam computed tomography of 29 patients (mean age 22.0 ± 4.2 years) who had missing mandibular premolars or first molars and underwent molar protraction were reviewed. Alveolar bone level was measured as the distance from the cementoenamel junction at six points, buccal, lingual, mesiobuccal (MB), mesiolingual (ML), distobuccal (DB), and distolingual (DL), of the second molars at pretreatment (T0) and after molar protraction (T1). Factors associated with alveolar bone changes at the distal and mesial of the second molars were assessed.ResultsMean alveolar bone changes ranged from −1.2 mm (bone apposition) to 0.8 mm (bone resorption). The presence of a third molar impaction at T0 (P < .001), third molar angulation at T0 (P < .001), and Nolla''s stage of third molar at T0 (P = .005) were significantly associated with alveolar bone level changes distal to the second molars. Treatment duration (P = .028) was significantly associated with alveolar bone level changes mesial to the second molar.ConclusionsPatients with impacted third molars, third molars at an earlier stage of development, and mesially angulated third molars at pretreatment may have less alveolar bone resorption distal to the second molars following protraction. Patients with increased treatment time may have reduced alveolar bone resorption mesial to the second molars.     

正畸牙齿移动牙周膜血管变化的实验研究

目的 :通过定性和定量的方法研究正畸牙齿移动牙周膜 (PDL)血管变化的规律。方法 :2 1只大耳白兔随机分成 7组。光镜下观察兔正畸牙PDL血管的形态和分布特征。应用血管灌注和图像分析方法研究PDL血管密度和面积的变化。结果 :压力侧和张力侧PDL血管变化规律不同。经图像分析压力侧PDL血管密度和面积高峰值在受力后第 7天出现 ,分别为 2 7个 /mm2 和 710 2 1.0 0 μm2 ,张力侧高峰值出现在受力后的第 14天 ,分别为 2 8个 /mm2 和 91339.44 μm2 。结论 :在正畸力作用下 ,牙齿压力侧和张力侧PDL血管发生一系列变化 ,变化规律与牙周组织骨改建周期一致。     

Alveolar bone response to light-force tipping and bodily movement in maxillary incisor advancement: A prospective randomized clinical trial

Objective:To compare alveolar bone thickness and height changes between untreated incisors (control), incisors advanced with light-force tipping, and incisors advanced with bodily movement mechanics.Materials and Methods:Forty-three subjects (aged 9.49 ± 1.56 years) with anterior crossbite were allocated into an untreated group (control), tipping group, or bodily movement group. Lateral cephalograms were taken before advancement (T₀) and after obtaining normal overjet (T₁). Changes in labial and palatal alveolar bone thickness and height surrounding maxillary incisors were evaluated with limited field-of-view cone-beam computed tomography before advancement (CT₀) and 4 months after normal overjet was obtained (CT₁). Wilcoxon matched-pairs signed-rank and Kruskal-Wallis one-way ANOVA tests were used to compare changes within and between groups, as appropriate. The significance level was set at .05.Results:Labial alveolar bone thickness at the midroot and apical levels were significantly decreased in the bodily movement group (P < .05). However, between groups, there was no statistically significant difference in labial bone thickness changes at any level. Palatal and total alveolar bone thickness at the midroot and apical levels were significantly decreased in the tipping group compared with the control and bodily movement groups (P < .05). Neither labial nor palatal bone height changes were significantly different among groups.Conclusions:Maxillary incisor advancement with light-force tipping and bodily movement in growing patients resulted in labial alveolar bone thickness and labial and palatal alveolar bone height changes that were similar to the untreated group.     

A novel success scale for evaluating alveolar cleft repair using cone-beam computed tomography

PurposeRadiographic scales, based on plain radiographs, for the evaluation of alveolar cleft repair, have certain weaknesses and are thought to overestimate to some degree the success of the surgical intervention. The aim of this study was the presentation of a novel success scale for evaluating alveolar cleft repair using cone-beam computed tomography (CBCT).Materials and methodsPatients treated with secondary osteoplasty for unilateral or bilateral alveolar cleft were evaluated using the Bergland and Enemark scales, as well as the novel success scale, which measures the bone height, the bone width and the level of the nasal floor.ResultsA total of 44 patients with a total of 53 alveolar cleft sites were included. According to the new scale, 60% of the cases were defined as successful, with moderate (kappa = 0.511) or substantial (kappa = 0.718) agreement, between the new scale and the Bergland or Enemark scale, respectively. Statistically significant correlation was reported between the new success scale and the closure of space of the lateral incisor, the patient's age at surgery, the graft revision and the presence of residual fistula.ConclusionsThe novel success scale for evaluating alveolar cleft repair using CBCT takes into consideration all dimensions of the bony bridge. Future application is necessary for validation of its potential value.     

Alveolar bone changes after asymmetric rapid maxillary expansion

Objective:To quantitatively evaluate the effects of asymmetric rapid maxillary expansion (ARME) on cortical bone thickness and buccal alveolar bone height (BABH), and to determine the formation of dehiscence and fenestration in the alveolar bone surrounding the posterior teeth, using cone-beam computed tomography (CBCT).Materials and Methods:The CBCT records of 23 patients with true unilateral posterior skeletal crossbite (10 boys, 14.06 ± 1.08 years old, and 13 girls, 13.64 ± 1.32 years old) who had undergone ARME were selected from our clinic archives. The bonded acrylic ARME appliance, including an occlusal stopper, was used on all patients. CBCT records had been taken before ARME (T1) and after the 3-month retention period (T2). Axial slices of the CBCT images at 3 vertical levels were used to evaluate the buccal and palatal aspects of the canines, first and second premolars, and first molars. Paired samples and independent sample t-tests were used for statistical comparison.Results:The results suggest that buccal cortical bone thickness of the affected side was significantly more affected by the expansion than was the unaffected side (P < .05). ARME significantly reduced the BABH of the canines (P < .01) and the first and second premolars (P < .05) on the affected side. ARME also increased the incidence of dehiscence and fenestration on the affected side.Conclusions:ARME may quantitatively decrease buccal cortical bone thickness and height on the affected side.     

大鼠正畸牙移动压力侧牙槽骨中cath K mRNA表达的研究

目的研究组织蛋白酶K（cathepsin K,cath K）mRNA在大鼠正畸牙移动压力侧牙槽骨中的表达变化及时间分布特点,探讨正畸牙移动中牙周改建的分子生物学机制。方法选用80只6周龄SD雄性大鼠建立正畸牙移动模型,分别在加力后2d、5d、7d、10d和14d处死动物各16只,HE染色观察牙周组织改建的变化,TRAP染色计数压力侧破骨细胞数量;实时定量PCR（real-time quantitative PCR）检测cath K mRNA表达变化及时间分布特点。结果cath K mRNA表达随加力时间的增加而增加,在加力后的第7天开始下降。这与牙周组织形态学的变化以及TRAP染色阳性破骨细胞数目的变化规律相一致。结论在生物机械力的诱导下,cathK参与了正畸牙移动骨改建过程中有机基质的降解,cath K mRNA随正畸加力时间的增加出现规律性变化。     

Horizontal alteration of anterior alveolar ridge after immediate implant placement: A retrospective cone beam computed tomography analysis

PURPOSEThe aim of this study was to evaluate the labio-lingual alterations of the alveolar bone where the implant was placed immediately after tooth extraction.MATERIALS AND METHODSImplants were placed immediately after tooth extraction on anterior alveolar ridges in the maxilla and mandible. The pin-guide system was used to help determine the location and path of implants during the surgical process. The horizontal distance from implants to the outer border of alveolar bone was measured at the rim and middle of the implants in the cone beam computed tomography images. The alteration of alveolar bone was evaluated comparing the horizontal distances measured immediately after surgery and 3 months after surgery.RESULTSThe results show that more resorption occurred towards the labial bone than the lingual bone in the maxilla. A similar amount of labial and lingual bone resorption was observed in the mandible.CONCLUSIONConsidering the horizontal alteration of alveolar bone, labio-lingual positioning of the implant towards the lingual bone in the maxilla and at the center of the alveolar ridge in the mandible is recommended when it is placed immediately after tooth extraction.     

非拔牙正畸治疗牙槽嵴高度变化的CBCT研究

［摘要］目的 采用CBCT评估非拔牙正畸治疗前后釉牙骨质界到牙槽嵴顶的高度变化情况。方法 选择安氏Ⅰ类错〖HT5”,7”〗牙〖KG-*3〗合〖HT5”〗畸形的患者30例,存在轻中度拥挤。正畸前后进行CBCT扫描影像。分别对每个患者的24颗牙齿从釉牙骨质界与颊侧(n=720)和舌侧(n=720)牙槽嵴顶之间的距离进行测量和对比分析。 结果 在1 440处测量中,正畸治疗前有130（9.0%）例,治疗后有199例（13.8%）釉牙骨质界到牙槽骨嵴顶的距离超过2 mm（牙槽骨开裂）。 结论 骨开裂在正畸治疗前的牙齿中占9.0%。正畸治疗后,釉牙骨质界与骨嵴顶的距离发生变化。     

Some periodontal tissue reactions to orthodontic tooth movement in monkeys

The purpose of the experiment reported was to study soft tissue changes at teeth which were orthodontically moved into areas with varying thickness and quality of periodontal tissues. The maxillary central incisors and first premolars in 5 adult monkeys were used as experimental teeth. 6 months prior to the start of the orthodontic treatment phase, the maxillary second premolars were extracted. By surgical means, areas with varying width of the keratinized gingiva were established in the incisor and premolar region. Following a clinical baseline examination which involved assessments of gingival width, location of the gingival margin in relation to cemento-enamel junction and probing attachment level, fixed orthodontic appliances were inserted in order to bodily move the two contral incisors in labial direction through the alveolar bone envelope and the first premolars in distal direction into contact with the first molars. Orthodontic forces were applied for a period of 3-4 months. The lateral incisors and first molars were selected as non-moved control teeth. After the experimental teeth had been retained in their new positions for 1 month, the clinical examination was repeated. Tissue blocks containing test and control specimens were subsequently dissected and prepared for microscopic analysis. The analysis included histometric assessments of loss of connective tissue attachment and height of alveolar bone. The results showed that at every second labially moved incisor, the gingival margin had become displaced in apical direction. The degree of displacement, however, was small and only at 2 teeth accompanied by loss of connective tissue attachment. Throughout the study, these particular teeth also showed obvious signs of gingival inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)     

减数正畸治疗中中切牙牙根及牙槽骨形态变化的锥形束CT测量分析

目的： 研究减数正畸治疗对成人患者中切牙牙根吸收及牙槽骨形态的影响。方法： 选取11例行减数正畸治疗的成年患者,于治疗前、后进行全牙列锥形束CT（CBCT）检查,观察治疗前、后上、下中切牙牙根吸收、牙槽骨厚度变化与牙槽骨高度缺损,采用SPSS 23.0软件包对数据进行统计学分析。结果： 部分牙位出现牙长度减小及牙根长度减小,上颌切牙牙根长度变化量大于下颌切牙。中切牙舌腭侧颈部牙槽骨宽度表现为一定程度降低,其中上中切牙腭侧根颈部及下颌中切牙舌侧根中部牙槽骨宽度变化较为明显。下颌中切牙唇侧中部牙槽骨宽度增加,但舌腭侧牙槽骨在正畸治疗后骨开窗、骨开裂位点增多,且较上颌更明显。结论： 减数正畸治疗伴随中切牙牙根一定程度上的吸收和舌腭侧牙槽骨吸收,唇侧牙槽骨骨量增加。下颌舌侧牙槽骨吸收导致骨开窗、骨开裂位点增多。     

锥形束计算机体层摄影术观察下牙槽神经管形态及其临床意义

目的 应用锥形束计算机体层摄影术（CBCT）观测并分析下牙槽神经管在下颌骨内的走行特点,探讨其分布规律,为临床手术提供解剖学依据.方法 采用单纯随机抽样法选取具备下颌后部CBCT 扫描数据的患者60 例,应用CBCT 自带的KaVo eXam Vision 软件测量颏孔区、前磨牙区、磨牙区下牙槽神经管与牙槽嵴顶、下颌骨颊舌侧骨板及下缘的平均距离,对各组测量项目进行成组t 检验比较,并观察其走行特点.结果 下牙槽神经管距下颌下缘小于距牙槽嵴顶的距离,在第二磨牙区距离下颌骨下缘最近;颏孔区至第一磨牙区间,下牙槽神经管距颊侧骨板距离小于距舌侧骨板距离,自第二磨牙后,下牙槽神经管距颊侧骨板距离则大于距舌侧骨板距离;性别及左、右侧下牙槽神经管距离差异无统计学意义（t＝2.437,P ＞ 0.05）.结论 CBCT 扫描有利于更好了解下牙槽神经管的走行及结构特异性,对牙槽外科及种植外科手术方案的制定具有一定临床指导意义.