拔牙矫治上颌前突患者上前牙内收前后牙根及牙槽骨变化的CBCT测量

目的 探讨通过CBCT观察拔牙矫治上颌前突的患者在内收前后上前牙牙根吸收及牙槽骨改建的情况。方法 选取2016年1月至2019年12月就诊于湖南中医药大学第一附属医院口腔科的正畸患者40例,均采用拔牙矫治。在治疗前后分别拍摄CBCT,观察上前牙牙根吸收及牙槽骨改建情况,并进行统计学测量。结果 内收后,上颌中切牙、侧切牙牙根长度为(11.35±1.02)mm、(11.97±0.90)mm,短于治疗前的(12.16±1.12)mm、(13.02±1.18)mm,差异有统计学意义(P0.05)。上颌中切牙、侧切牙唇侧牙槽骨高度为(3.03±0.40)mm、(2.31±0.85)mm,低于治疗前的(3.60±0.40)mm、(3.38±0.89)mm,差异有统计学意义(P0.05)。上颌中切牙、侧切牙、尖牙腭侧牙槽骨高度为(5.01±1.26)mm、(4.79±1.11)mm、(3.44±0.68)mm,高于治疗前的(2.49±0.70)mm、(3.01±0.52)mm、(2.58±0.70)mm,差异有统计学意义(P0.05)。上颌中切牙、尖牙唇侧根中部牙槽骨厚度为(1.51±0.28)mm、(1.32±0.23)mm,高于治疗前的(0.97±0.23)mm、(1.04±0.18)mm,差异有统计学意义(P0.05)。上颌中切牙、侧切牙、尖牙腭侧根中部牙槽骨厚度为(0.37±0.13)mm、(0.45±0.18)mm、(0.63±0.21)mm,低于治疗前的(1.67±0.40)mm、(1.09±0.30)mm、(1.66±0.36)mm,差异有统计学意义(P0.05)。结论 上颌前突患者内收后,牙根吸收明显,牙槽骨改建以骨吸收为主,骨形成较有限。运用CBCT可以准确观察牙根及牙槽骨的改建情况,具有较高的可靠性,但缺乏统一的三维参考系。

CBCT measurement of root and alveolar bone changes before and after anterior tooth adduction in patients with maxillary protrusion treated by tooth extraction

Objective To investigate the root resorption and alveolar bone remodeling of anterior teeth before and after adduction in patients with maxillary protrusion treated by tooth extraction through CBCT observation.Methods A total of 40 orthodontic patients from January 2016 to December 2019 were selected and treated with tooth extraction.CBCT was taken before and after treatment to observe the root resorption and alveolar bone remodeling of anterior teeth,and statistical measurement was made.Results After adduction,the root lengths of upper central incisors and lateral incisors were (11.35±1.02) mm and (11.97±0.90) mm,respectively,which were shorter than those of (12.16±1.12) mm and(13.02±1.18) mm before treatment,and the difference was statistically significant (P<0.05).The labial alveolar bone heights of upper central incisors and lateral incisors were (3.03±0.40) mm and (2.31±0.85) mm,respectively,which were lower than (3.60±0.40) mm and (3.38±0.89) mm before treatment,and the difference was statistically significant(P<0.05).The palatal alveolar bone heights of upper central incisors,lateral incisors and canines were (5.01±1.26) mm,(4.79±1.11) mm and(3.44±0.68) mm,respectively,which were higher than (2.49±0.70) mm,(3.01±0.52) mm and (2.58±0.70) mm before treatment,and the difference was statistically significant (P<0.05).The thicknesses of alveolar bone in the middle of the labial root of upper central incisors and canines were(1.51±0.28)mm and(1.32±0.23)mm,respectively,which were higher than (0.97±0.23) mm and (1.04±0.18) mm before treatment,and the difference was statistically significant (P<0.05).The thicknesses of alveolar bone in the middle of palatal root of upper central incisors,lateral incisors and canines were(0.37±0.13) mm,(0.45±0.18) mm and (0.63±0.21) mm,respectively,which were lower than (1.67±0.40) mm,(1.09±0.30) mm and (1.66±0.36) mm before treatment,and the difference was statistically significant(P<0.05).Conclusion After adduction in patients with maxillary protrusion,root resorption is obvious,alveolar bone remodeling is mainly bone resorption,and bone formation is limited.CBCT can accurately observe the remodeling of root and alveolar bone,with high reliability,but it lacks a unified three-dimensional reference system.