牙槽骨再生正畸治疗下前牙区牙槽骨发育不良的成人骨性Ⅲ类错畸形

摘要/Abstract

摘要： 目的:定量评估牙槽骨再生正畸治疗下前牙区牙槽骨发育不良的骨性Ⅲ类错成人患者对下前牙区牙周状况及下前牙去代偿的影响。方法:从上海交通大学医学院附属第九人民医院口腔颅颌面科2009年12月—2011年10月就诊的成人连续病例中,选取下前牙区牙槽骨菲薄且有正颌手术适应证的骨性Ⅲ类错畸形患者。在充分告知的前提下,将其中9例接受牙槽骨再生正畸治疗的患者作为研究对象。通过锥形束CT(cone beam computed tomography,CBCT)及头颅定位侧位片分别评价不同治疗阶段下前牙区牙周状况及下前牙去代偿的效果。采用SAS 8.02 软件包对数据进行统计学处理。结果:治疗前、术前正畸结束、治疗结束下前牙牙根长度及舌侧牙槽骨厚度无显著差异(P>0.05)。术前正畸阶段,下前牙区唇侧牙槽骨厚度及下前牙倾斜角度显著增加(P<0.01),术后正畸阶段,两者均未见改变(P>0.05)。下前牙区唇、舌侧牙槽骨高度在术前正畸阶段均显著降低(P<0.05),术后正畸阶段,唇、舌侧牙槽骨高度保持稳定(P>0.05)。结论:牙槽骨再生正畸治疗下前牙区牙槽骨发育不良的骨性Ⅲ类成人患者,下前牙去代偿完全,下前牙区牙周健康。

关键词: 微手术正畸, 骨性Ⅲ类错, 牙槽骨发育不良, 锥形束CT, 头影测量

Abstract: PURPOSE: To investigate the changes of lower incisor proclination and surrounding periodontal condition after periodontal micro-osteotomy assisted orthodontics for skeletal Class Ⅲ malocclusions with alveolar hypoplasia in the lower anterior region. METHODS: The sample consisted of 9 cases diagnosed as severe Class Ⅲ malocclusions with alveolar hypoplasia in the lower anterior region who accepted periodontal micro-osteotomy assisted orthodontic treatment, selected from consecutive patients of Department of Oral & Cranio-maxillofacial Science of Shanghai Ninth People's Hospital from Dec.2009 to Oct. 2011. The changes of lower incisor proclination and surrounding periodontal condition were evaluated with cone-beam CT (CBCT) and lateral cephalometry. Data was processed using SAS8.02 software package. RESULTS: No significant differences were found in the root length and lingual alveolar bone thickness of lower incisors before treatment, after pre-surgical orthodontic treatment, and after treatment (P>0.05). Labial alveolar bone thickness and lower incisor proclination were increased during pre-surgical orthodontic treatment (P<0.01), and both maintained during post-surgical orthodontic treatment (P>0.05). Both vertical labial and lingual alveolar bone loss occurred during pre-surgical orthodontic treatment(P<0.05), but did not deteriorate during post-surgical orthodontics treatment (P>0.05). CONCLUSIONS: With the application of periodontal micro-osteotomy assisted orthodontic technique, adequate lower incisors decompensation could be achieved with minimal surrounding periodontal side effects for skeletal Class Ⅲ malocclusions with alveolar hypoplasia in the lower anterior region.Supported by National Natural Science Foundation of China (10972142), Research Fund of Science and Technology Committee of Shanghai Municipality (08411961600) and Program for Innovative Research Team of Shanghai Municipal Education Commission.

Key words: Periodontal micro-osteotomy assisted orthodontic treatment, Skeletal Class Ⅲ malocclusion, Alveolar hypoplasia, Cone-beam CT, Lateral cephalometry

中图分类号:

R783.5

王博,沈国芳,房兵,孙良龑,吴勇,于洪波,刘加强. 牙槽骨再生正畸治疗下前牙区牙槽骨发育不良的成人骨性Ⅲ类错畸形[J]. 中国口腔颌面外科杂志, 2014, 12(3): 223-227.

WANG Bo, SHEN Guo-fang, FANG Bing, SUN Liang-gong, WU Yong, YU Hong-bo, LIU Jia-qiang. Periodontal micro-osteotomy assisted orthodontic treatment of skeletal Class Ⅲ adults with alveolar hypoplasia in the lower anterior region[J]. China J Oral Maxillofac Surg, 2014, 12(3): 223-227.

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