牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价

doi:10.19438/j.cjoms.2022.03.003

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (3): 225-229.doi: 10.19438/j.cjoms.2022.03.003

牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价

王博^1,*, 于洪波^1,*, 夏韫晖¹, 房兵^2#, 郭秋曼^3#

1.上海交通大学医学院附属第九人民医院口腔颅颌面科,上海 200011;
2.上海交通大学医学院附属第九人民医院口腔正畸科,上海 200011;
3.牙周病科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011

收稿日期:2021-11-29 修回日期:2022-01-16 出版日期:2022-05-20 发布日期:2022-05-20
通讯作者: 房兵,E-mail：braces_dr@hotmail.com;郭秋曼,E-mail：doctorguoqm@163.com。^#共同通信作者
作者简介:王博（1985-）,男,博士,主治医师,E-mail：wb228@126.com;于洪波（1976-）,男,博士,主任医师,E-mail：yuhb@sdu.edu.cn。^*并列第一作者
基金资助:
国家重点研发计划（2017YFB1104100）; 国家自然科学基金（81571022）; 上海交通大学医学院临床研究项目（DLY201808）

Long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect

WANG Bo¹, YU Hong-bo¹, XIA Yun-yui¹, FANG Bing², GUO Qiu-man³

1. Department of Oral and Craniomaxillofacial Surgery, Shanghai 200011, China;
2. Department of Orthodontics, Shanghai 200011, China;
3. Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2021-11-29 Revised:2022-01-16 Online:2022-05-20 Published:2022-05-20

摘要/Abstract

摘要： 目的: 定量评价牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效。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2014年1月起就诊的连续病例中,选择下前牙区存在原发性牙槽骨缺损且治疗结束后随访时间> 2 年的成人错畸形患者,将其中接受牙槽骨再生正畸治疗的30例患者作为研究对象。通过锥形束CT（cone-beam CT,CBCT）评价不同观察时间点术区的牙槽骨形态,采用SAS 9.1软件包对数据进行统计学处理。结果: 牙槽骨再生正畸治疗成人错畸形伴原发性牙槽骨缺损后,术区未见牙根吸收。根尖水平骨厚度增量效果最佳且远期疗效最为稳定,根长3/4水平次之,根长1/2水平未见骨厚度增量效果。术区唇舌侧出现少量牙槽骨高度降低。结论: 牙槽骨再生正畸技术是治疗成人错畸形伴原发性牙槽骨缺损的有效方式,但仍存在术区少量牙槽骨垂直丢失等局限。

关键词: 牙槽骨再生正畸, 成人, 牙槽骨缺损, 锥形束CT, 远期疗效

Abstract: PURPOSE: To quantitively investigate the long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment of adult patients with primary alveolar defect. METHODS: The sample consisted of 30 adult cases with primary alveolar defect in the lower anterior region who accepted periodontal micro-osteotomy assisted orthodontic treatment with over 2 years of follow-up, selected from consecutive patients at the Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital since Jan.2014. Alveolar bone morphology of lower anterior teeth with primary alveolar defect was appraised with the help of cone-beam CT (CBCT) in the surgical sites at different time points. The data were processed using SAS 9.1 software package. RESULTS: Periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect showed stable long-term effect of bone augmentation and minimal root resorption. However, the effect of bone augmentation was less when approaching the alveolar bone crest, and vertical alveolar bone loss was observed on both labial and lingual side in the surgical sites. CONCLUSIONS: Periodontal micro-osteotomy assisted orthodontic treatment is a promising approach for the treatment of adult patients with primary and inflammatory alveolar defect; however, vertical alveolar bone loss could be observed in the surgical sites.

Key words: Periodontal micro-osteotomy assisted orthodontic treatment, Adult, Alveolar defect, Cone-beam CT, Long-term effectiveness

中图分类号:

R783.5

王博, 于洪波, 夏韫晖, 房兵, 郭秋曼. 牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价[J]. 中国口腔颌面外科杂志, 2022, 20(3): 225-229.

WANG Bo, YU Hong-bo, XIA Yun-yui, FANG Bing, GUO Qiu-man. Long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect[J]. China J Oral Maxillofac Surg, 2022, 20(3): 225-229.

参考文献

[1] Aziz T, Flores-Mir C.A systematic review of the association between appliance-induced labial movement of mandibular incisors and gingival recession[J]. Aust Orthod J, 2011, 27(1): 33-39.
[2] 王博, 房兵, 樊林峰, 等. 成人骨性Ⅲ类错下前牙区牙槽骨厚度的测量分析[J]. 上海口腔医学, 2012, 21(4): 422-426.
Wang B, Fang B, Fan LF, et al.Measurement of alveolar bone thickness of adult skeletal ClassⅢ patients in mandibular anterior region[J]. Shanghai Journal of Stomatology, 2012, 21(4): 422-426.
[3] Matsumoto K, Sherrill-Mix S, Boucher N, et al.A cone-beam computed tomographic evaluation of alveolar bone dimensional changes and the periodontal limits of mandibular incisor advancement in skeletal Class Ⅱ patients[J]. Angle Orthod, 2020, 90(3): 330-338.
[4] Alkan Ö, Kaya Y, Tunca M, et al.Changes in the gingival thickness and keratinized gingival width of maxillary and mandibular anterior teeth after orthodontic treatment[J]. Angle Orthod, 2021, 91(4): 459-467.
[5] Cha C, Huang D, Kang Q, et al.The effects of dehiscence and fenestration before orthodontic treatment on external apical root resorption in maxillary incisors[J]. Am J Orthod Dentofacial Orthop, 2021, 160(6): 814-824.
[6] 贺红. 正畸牙移动中牙周界限的探讨[J]. 中华口腔医学杂志, 2021, 56(10):966-970.
He H.Periodontal limits of orthodontic tooth movement[J]. Chinese Journal of Stomatology, 2021, 56(10):966-970.
[7] Eksriwong T, Thongudomporn U.Alveolar bone response to maxillary incisor retraction using stable skeletal structures as a reference[J]. Angle Orthod, 2021, 91(1): 30-35.
[8] Andrews WA, Abdulrazzaq WS, Hunt JE, et al.Incisor position and alveolar bone thickness[J]. Angle Orthod, 2022, 92(1): 3-10.
[9] Chaushu S, Klein Y, Mandelboim O, et al.Immune changes induced by orthodontic forces: a critical review[J]. J Dent Res, 2022, 101(1): 11-20.
[10] Davies RM, Downer MC, Hull PS, et al.Alveolar defects in human skulls[J]. J Clin Periodontol, 1974, 1(2): 107-111.
[11] Jing WD, Xu L, Li XT, et al.Prevalence of and risk factors for alveolar fenestration and dehiscence in the anterior teeth of Chinese patients with skeletal Class Ⅲ malocclusion[J]. Am J Orthod Dentofacial Orthop, 2021, 159(3): 312-320.
[12] Mostafa YA, EI Sharaby FA, EI Beialy AR.Do alveolar bone defects merit orthodontists' respect?[J]. World J Orthod, 2009, 10(1): 16-20.
[13] Evangelista K, Vasconcelos K de F, Bumann A, et al. Dehiscence and fenestration in patients with Class Ⅰ and Class Ⅱ division 1 malocclusion assessed with cone-beam computed tomography [J]. Am J Orthod Dentofacial Orthop, 2010, 138(2): 133.e1-e7.
[14] Yagci A, Veli I, Uysal T, et al.Dehiscence and fenestration in skeletal Class Ⅰ,Ⅱ, and Ⅲ mal-occlusions assessed with cone-beam computed tomography[J]. Angle Orthod, 2012, 82(1): 67-74.
[15] Bock JJ, Czarnota J, Hirsch C, et al.Orthodontic treatment need in a representative adult cohort[J]. J Orofac Orthop, 2011, 72(6): 421-433.
[16] Chow L, Goonewardene MS, Cook R, et al.Adult orthodontic retreatment: a survey of patient profiles and original treatment failings[J]. Am J Orthod Dentofacial Orthop, 2020, 158(3): 371-382.
[17] Meyer-Marcotty P, Klenke D, Knocks L, et al.The adult orthodontic patient over 40 years of age: association between periodontal bone loss, incisor irregularity, and increased orthodontic treatment need[J]. Clin Oral Investig, 2021, 25(11): 6357-6364.
[18] Wilcko WM, Wilcko T, Bouquot JE, et al.Rapid orthodontics with alveolar reshaping: two case reports of decrowding[J]. Int J Periodontics Restorative Den, 2001, 21(1): 9-19.
[19] Wilcko MT, Wilcko WM, Pulver JJ, et al.Accelerated osteogenic orthodontics technique: a 1-stage surgically facilitated rapid orthodontic technique with alveolar augmentation[J]. J Oral Maxillofac Surg, 2009, 67(10): 2149-2159.
[20] Wang B, Shen G, Fang B, et al.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.
[21] 王博, 沈国芳, 房兵, 等. 微手术正畸治疗骨性Ⅲ类错伴下前牙区牙槽骨发育不良的效果评价[J]. 上海口腔医学, 2012, 21(5): 535-540.
Wang B, Shen GF, Fang B, et al.Exploration for micro-osteotomy assisted orthodontic treatment of skeletal Class Ⅲ malocclusions with alveolar hypoplasia in the lower anterior region[J]. Shanghai Journal of Stomatology, 2012, 21(5): 535-540.
[22] Wang B, Shen G, Fang B, et al.Augmented corticotomy assisted surgical orthodontics decompensates lower incisors in ClassⅢmalocclusionpatients[J]. J Oral Maxillofac Surg, 2014, 72(3): 596-602.
[23] Wang B, Shen G, Fang B, et al.Augmented corticotomy-assisted presurgical orthodontics of ClassⅢ malocclusions:a cephalometric and cone-beam computed tomography study[J]. J Craniofac Surg, 2013, 24(6): 1886-1890.
[24] Wang B, Yu H, Shen G, et al.Augmented corticotomy assisted orthodontics of an adult patient with alveolar defect[J]. J Craniofac Surg, 2015, 26(2): 600-601.
[25] Wang B, Shen G, Fang B, et al.Crown-root morphology of lower incisors in patients with Class Ⅲ malocclusion[J]. J Craniofac Surg, 2012, 23(4): e349-e354.
[26] Coskun Ī, Kaya B.Appraisal of the relationship between tooth inclination, dehiscence, fenestration, and sagittal skeletal pattern with cone beam computed tomography[J]. Angle Orthod, 2019, 89(4): 544-551.
[27] Eftekhar M, Kaviani H, Rouzmeh N, et al.Effect of voxel size on detection of fenestration, dehiscence and furcation defects using cone-beam computed tomography[J]. Oral Radiol, 2021, 37(4): 677-686.

牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价

Long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect

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