腭侧埋伏阻生尖牙与鞍桥的相关性研究

目的:比较腭侧埋伏阻尖牙生和尖牙正常萌出患者的蝶鞍大小,检测鞍桥和腭侧埋伏阻生尖牙之间是否存在关联。方法:选择腭侧埋伏阻生尖牙患者的头颅侧位片作为实验组,共103例,尖牙正常萌出者作为对照组,共103例。测量蝶鞍的长度、深度、直径,依据蝶鞍的钙化程度将其分为Ⅰ、Ⅱ、Ⅲ型。结果:除蝶鞍深度外,蝶鞍长度、直径两组间比较差异均有统计学意义。实验组男性的蝶鞍深度大于女性,蝶鞍长度及蝶鞍直径男女无统计学差异。而对照组男性与女性间蝶鞍的大小比较均无统计学差异。实验组鞍桥部分和完全钙化的发生率分别为41.75％和15.53％,但性别间比较差异无统计学意义;对照组鞍桥部分和完全钙化的发生率分别为8.73%和4.85％ 。实验组鞍桥发生率是对照组的8.52倍。结论:腭侧埋伏阻生尖牙患者的蝶鞍长度、直径均较对照组大,其鞍桥的发生率显著增加,但无性别差异。     

上颌腭侧埋伏阻生尖牙的研究进展

上颌尖牙腭侧埋伏阻生在临床上很常见,它会影响上颌牙列的功能和美观。为消除上颌尖牙腭侧埋伏阻生对牙颌生长发育的不利影响,应对其进行早期诊断并选择正确的治疗方法。本文就上颌腭侧埋伏阻生尖牙的发病率、病因、诊断、临床治疗方法以及预后等作一综述。     

替牙期62例上颌尖牙阻生儿童牙弓及腭部形态特征分析

目的:比较上颌尖牙阻生与无阻生儿童牙弓及腭部形态的差异,为上颌尖牙阻生早期识别和干预提供参考.方法:选择8～11岁[平均(9.82±1.04)岁]儿童62例,分为实验组(上颌尖牙阻生)和对照组(无上颌尖牙阻生),每组31例.将2组患者石膏模型通过3D激光扫描后转化为数字模型,测量牙弓宽度、牙弓长度、基骨宽度、腭部宽度、...     

利用锥形束CT研究单侧上颌尖牙埋伏阻生患者牙弓形态特点

目的 利用锥形束CT(Cone beam computed tomography,CBCT)研究单侧上颌尖牙埋伏阻生患者牙弓形态特点,为研究其病因及预防继发病症提供参考.方法 39名单侧上颌尖牙埋伏阻生患者,其中腭侧埋伏19名,唇侧埋伏20名,另设正常对照20名.三组患者年龄无显著性差异.三组患者拍摄CBCT并对牙弓的影像进行测量,比较三组之间以及阻生侧与非阻生侧的牙弓形态特点.结果 尖牙阻生患者的双侧牙弓比较显示,阻生侧前段及整侧牙弓长度均比非阻生侧小(P＜0.001).腭侧组第一磨牙到腭中缝距离(24.06±1.68) mm小于唇侧组(24.86±1.31)mm和对照组(24.88±1.12) mm,腭侧组牙弓周长(72.29±3.50) mm小于唇侧组(75.96±5.26) mm,P＜0.05.结论 上颌尖牙埋伏阻生可能与牙弓长度(尤其是前段)较短有关,且腭侧阻生可能还与牙弓宽度较小有关.     

腭侧埋伏阻生尖牙与颈椎骨骼异常的相关性研究

目的:通过头影测量片、曲面平展片、锥形束CT检测腭侧埋伏阻生尖牙与颈椎骨骼异常之间是否存在关联.方法:选取103例腭侧埋伏阻生尖牙患者作为实验组,103例尖牙正常萌出的安氏I类患者作为对照组,头影测量片记录前4个颈椎融合和环椎后弓缺陷的数据.采用SPSS21.0软件包对腭侧埋伏阻生尖牙与颈椎骨骼异常之间的关系进行r检验.结果:实验组的颈椎融合发生率为71.84％(74例),而对照组为15.53％(16例),实验组显著高于对照组(P＜0.001);实验组的环椎后弓缺陷发生率为10.68％(11例),而对照组为4.85％(5例),实验组和对照组之间无显著差异.结论:腭侧埋伏阻生尖牙患者颈椎骨骼异常的发生率明显增加,颈椎骨骼异常可以配合其他诊断参数,确认尖牙埋伏的情况.     

上颌腭侧埋伏阻生尖牙 CBCT 导引下的牵引治疗

目的:探讨锥形束CT(CBCT)三维(3D)重建在上颌腭侧埋伏阻生尖牙牵引治疗中的指导作用。方法:对22例上颌尖牙(共26颗)腭侧埋伏阻生的青少年患者行CBCT检查。CBCT三维重建观察尖牙形态、腭侧埋伏状况,测量分析与邻近组织的位置关系及相邻切牙牙根吸收情况。结果:CBCT能够真实再现颌骨内埋伏的上颌尖牙。埋伏尖牙均近中倾斜,与平面平均成角61.1°±18.1°,近中异位分别为Ⅰ类埋伏尖牙8颗、Ⅱ类5颗、Ⅲ类3颗、Ⅳ类10颗。3颗相邻侧切牙及2颗中切牙因严重牙根吸收而拔除;26颗上颌腭侧埋伏尖牙均成功牵引至平面排入牙弓并建立正常咬合。结论:CBCT能立体再现上颌尖牙腭侧埋伏阻生特征及与邻近牙的关系等,对治疗方案的制定、开窗牵引具有指导作用,可提高疗效。     

上颌尖牙埋伏阻生患者牙弓形态及拥挤度的研究

目的 上颌尖牙唇侧和腭侧埋伏阻生患者的牙弓宽度、长度、拥挤度与正常(牙合)个体之间是否存在差异.方法 经CT检查上颌尖牙埋伏阻生患者104名,年龄11-28岁.尖牙唇侧阻生患者57名,腭侧阻生患者47名,对其牙弓宽度、长度、拥挤度进行测量,并和正常(牙合)个体进行对照研究.结果 上颌尖牙唇侧埋伏阻生患者82.5%伴有牙弓中重度拥挤,上颌尖牙腭侧埋伏阻生患者57.4%的牙弓基本无拥挤.上颌尖牙埋伏阻生患者中,无论是唇侧埋伏还是腭侧埋伏,其牙弓长度与正常(牙合)无差异.双尖牙区牙弓宽度减小.结论 国人上颌尖牙埋伏阻生患者的牙弓宽度、长度、拥挤度的特点与白种人不同.     

上颌尖牙腭侧埋伏阻生的锥形束CT定位诊断

目的应用锥形束CT（CBCT）探讨上颌腭侧埋伏阻生尖牙的埋伏特征及邻牙牙根吸收情况。方法选取南京医科大学附属口腔医院正畸科就诊的上颌尖牙腭侧埋伏阻生的青少年患者22例,获取CBCT三维数据,应用Dolphin imaging 11.0软件,分析腭侧埋伏尖牙的埋伏状况、与邻牙位置关系并分类,观察邻牙牙根的吸收情况。结果上颌腭侧埋伏尖牙大多近中、腭向倾斜阻生,近中异位以Ⅰ类和Ⅳ类较为多见,分别占30.8%和38.5%;近中倾斜角度多在53.8°~68.5°,腭侧异位距正中矢状面多在5.4~8.4 mm。年龄越大,上颌腭侧埋伏尖牙近中腭向异位越远,近中倾斜角度越大。84.6%的相邻侧切牙及19.2%的中切牙牙根与埋伏尖牙接触;50%的相邻侧切牙及15.4%的邻中切牙牙根吸收,相邻侧切牙吸收多位于根尖1/3,而相邻中切牙吸收多位于根中1/3;相邻切牙牙根吸收概率与腭侧埋伏尖牙与切牙间的最小距离呈反比关系。结论CBCT能在三维方向诊断上颌尖牙埋伏状况及与邻近组织的关系,准确判断邻牙根吸收情况,准确测量埋伏尖牙倾斜度及埋伏深度,为上颌腭侧埋伏尖牙的治疗提供指导。     

上颌尖牙埋伏阻生移植术的临床观察

上颌尖牙埋伏阻生临床较多见 ,笔者自 1992年以来将这种牙拔除后移植到正常位置 ,取得了较好的效果 ,现报告如下 :1　临床资料本组共 18例 ,男 8例 ,女 10例 ,年龄 17～ 2 4岁 ,牙根均已形成。其中 13埋伏阻生 6例 ,2 3埋伏阻生 12例。有乳尖牙滞留者 14例 ,无乳尖牙滞留者 4例。2　治疗方法局麻下在龈唇沟或腭粘膜作切口 ,剥离粘膜瓣 ,去骨 ,拔除埋伏牙。将埋伏牙用盐水纱布包裹待用。测量第一前磨牙与侧切牙的距离 ,如距离较窄 ,片切少许移植牙的近远中面。制备牙槽窝 :如有乳尖牙存在 ,拔除后用圆凿 ,扩大牙槽窝并向上加深 ;如无乳尖牙 ,…     

上颌阻生尖牙与正畸矫治

上凳恒尖牙的埋伏阻生较常见，且影响美观及功能。本文较详细地介绍了近年来国内外文献、资料对上颌阻生尖牙的综合处理。讨论了上颌阻生恒尖牙的发生原因，阻生尖牙的定位方法，阻生尖牙矫治方案的确定，阻生尖牙的外科协助处置以及正畸桥治阻生尖牙的各种方法。     

改良横腭杆作支抗协助导萌腭侧埋伏阻生尖牙10例报告

目的：探讨使用改良的横腭杆正畸临床矫治腭侧埋伏阻生尖牙的疗效。方法：选择2010～2012年在周口市口腔医院正畸科就诊的腭侧埋伏阻生尖牙10例,均经螺旋CT检查确诊为腭侧埋伏,并有较大把握导萌者。所有患者都采用了改良横腭杆的矫治方法。结果：经过平均7.6个月的导萌治疗（最短4.6个月,最长8.4个月）10个病例共12颗埋伏阻生尖牙均导萌成功,埋伏阻生的尖牙均移至理想的位置,咬合关系良好,牙龈附着满意,未见有牙根吸收现象。结论：改良横腭杆协助正畸临床导萌腭侧埋伏阻生尖牙是一种行之有效的治疗方法。     

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阻生牙是临床上常见的牙齿发育障碍之一,尖牙阻生是最常见的类型,其中腭侧阻生尖牙发生率较唇侧阻生更常见。如何准确地诊断、治疗腭侧阻生的尖牙,一直是正畸中非常有挑战的内容。借助锥形束CT的帮助,阻生尖牙的诊断变得越来越容易。激光的应用使开窗手术更易止血,粘接操作更准确可靠。灵活、有序的正畸牵引,使牵引过程更可控,从而提高了治疗效率。对牙周的关注,更加提高了阻生尖牙治疗后的质量。阻生牙牵引后更需注意保持,3～6个月的固定保持更有利于牙周的改建。     

上颌尖牙阻生的诊断和早期干预

上颌尖牙阻生是正畸医生经常碰到的问题之一,其处理方法通常包括外科开窗和较复杂的正畸治疗.上颌尖牙阻生可以通过观测X线片中尖牙近远中向位置的异常进行早期预测,早期的临床干预手段则包括拔除乳尖牙、拔除乳尖牙联合应用口外弓颈牵引、快速上颌扩弓,本文就这2方面内容作一综述.     

上颌腭侧阻生尖牙非手术与手术助萌的比较研究

目的探讨上颌腭侧阻生尖牙通过正畸开辟间隙等非手术助萌的适应证、矫治时间及其临床效果。方法选取9例患者的12颗上颌腭侧阻生尖牙为研究对象,通过曲面全景及头颅侧位片判断阻生尖牙在颌骨内的位置、牙齿的发育阶段及患者骨成熟阶段,通过正畸治疗配合头帽口外弓为阻生尖牙开辟间隙,定期拍摄曲面全景片观察阻生尖牙的萌出潜力。结果 7颗阻生尖牙自动萌出,3颗阻生尖牙采取外科开窗联合正畸牵引治疗,2颗阻生尖牙选择外科拔除。结论正畸开辟间隙后阻生尖牙成功萌出的主要因素可以概括为:萌出路径无干扰、骨成熟早期,根尖孔未闭合,而骨发育阶段比牙发育阶段更有指导意义。     

Forced-eruption time for palatally impacted canines treated with and without ostectomy-decortication technique

Objectives:To compare forced-eruption times for palatally impacted canines treated with and without the ostectomy-decortication technique and to assess the influence of palatally impacted canine pretreatment position and angle on forced-eruption time.Materials and Methods:The sample was composed of 118 patient-subjects with 151 palatally impacted canines treated with the ostectomy-decortication technique (n = 72) and without (n = 79). The orthopantomogram radiographs (OPGs) were analyzed for palatally impacted canine angle and horizontal and vertical position. Recovery time was measured from the start of forced eruption until the canine was within ±1 mm of final dental arch position.Results:The time of forced canine eruption with ostectomy-decortication technique was significantly shorter than without (6.6 vs 21.0 months). Pretreatment canine position significantly increased forced-eruption time in the ostectomy-decortication group but not in the control sample.Conclusions:Forced-eruption time of palatally impacted canines using the ostectomy-decortication technique was 3.2 times more rapid than without. Forced-eruption time increased significantly as a function of pretreatment palatally impacted canine position severity in the ostectomy-decortication group but not in the control.     

Pre-treatment radiographic features for the periodontal prognosis of treated impacted canines

AIM: The aim of this study is to evaluate the prognostic role of the pre-treatment radiographic features on the post-treatment periodontal status of intra-osseous impacted maxillary canines. MATERIAL AND METHODS: A study population of 168 patients (211 canines) was evaluated at the end of the overall surgical-orthodontic treatment consisting of a combined surgical (flap) and orthodontic (direct traction to the centre of the ridge) approach. The pre-treatment variables on the panoramic radiograph were alpha-angle, d-distance and s-sector while the post-treatment periodontal variables were pocket depth (PD) and keratinized tissue width (KT). Multilevel statistical analysis was used to evaluate the role of the pre-treatment radiographic factors on the post-treatment periodontal variables at patient, tooth and site levels. RESULTS: No significant differences in PD or KT were found at the end of surgical-orthodontic treatment with respect to age, gender, site of impaction or pre-treatment radiographic position of the impacted canine. The only statistically, but not clinically, significant difference (about 0.5 mm) was found for the KT that was greater for the palatally impacted canines than for the buccally impacted ones. CONCLUSIONS: alpha-angle, d-distance and s-sector measured on the pre-treatment panoramic radiographs did not represent prognostic indicators of final periodontal status of orthodontically re-positioned canines.     

上颌埋伏尖牙定位及邻牙牙根吸收的多层螺旋CT分析

目的:应用多层螺旋CT(MSCT)对上颌埋伏尖牙进行三维立体定位,同时对邻牙牙根的吸收程度进行评估。方法:应用MSCT扫描38例上颌埋伏尖牙,在多平面重建和容积再现软件中对其三维定位,上颌切牙牙根吸收程度进行分析,并与传统X线平片进行比较。结果:38例上颌埋伏尖牙都能使用MSCT进行准确定位,侧切牙牙根吸收率为36.6%,中切牙的牙根吸收率为16.3%,在牙列中受埋伏尖牙影响最大的是侧切牙的牙根。MSCT评价上颌中切牙及侧切牙牙根吸收的阳性率高于传统X线平片,其差异具有统计学意义。结论:使用MSCT多平面重建和容积再现技术能直观准确地对埋伏尖牙进行定位、诊断邻牙牙根吸收程度,对临床正畸治疗埋伏牙有很高的应用价值。     

Localization of impacted maxillary canines using cone beam computed tomography. Review of the literature

This review analyzed the literature focused on Cone- Beam Computed Tomography (CBCT) diagnostic accuracy and efficacy in detecting impacted maxillary canines, and evaluated the possible advantages in using CBCT technique compared with traditional radiographs. PubMed and Embase searches were performed selecting papers since 1998 up to September 2011, moreover reference lists were hand searched. Two reviewers selected relevant publications on the basis of predetermined inclusion criteria. The literature search yielded 94 titles, of which 5 were included in the review. Three studies used CBCT technique to 3D localize maxillary impacted canines and assess root resorption of adjacent teeth. Other two publications compared traditional radiographs with CBCT images in the diagnosis of maxillary impacted canines. Only three studies presented the results using statistical analysis. The present review highlighted that the use of CBCT has a potential diagnostic effect and may influence the outcome of treatment when compared with traditional panoramic radiography for the assessment of impacted maxillary canines. Furthermore it underlines the need of future studies performed according with high level methodological standards, investigating diagnostic accuracy and effectiveness of CBCT in the diagnosis of maxillary impacted teeth.