中国实用口腔科杂志

中国实用口腔科杂志

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基于锥形束CT分析安氏Ⅱ类1分类与安氏Ⅲ类错牙合畸形上颌切牙区牙槽骨形态特征的研究

朱俊贤，毛慧敏，李娇，雷浪   

  1. 南京大学医学院附属口腔医院，南京市口腔医院正畸科，江苏  南京 210008
  • 出版日期:2020-02-15 发布日期:2020-03-06
  • 基金资助:
    南京市卫生青年人才培养工程（QRX17081）

  • Online:2020-02-15 Published:2020-03-06

摘要： 目的　探讨应用锥形束CT（cone-beam CT，CBCT）分析安氏Ⅱ类1分类与安氏Ⅲ类错牙合畸形上颌切牙区牙槽骨的形态特征。方法　选取2015年1月至2018年7月于南京大学医学院附属口腔医院正畸科就诊的安氏Ⅱ类1分类错牙合畸形患者82例（Ⅱ/1组）、安氏Ⅲ类错牙合畸形患者72例（Ⅲ组）、个别正常牙合患者45例（对照组）。所有患者拍摄CBCT影像并行三维重建，选取上颌切牙的正中矢状截面的影像，定点并测量上颌切牙区各牙齿在牙槽嵴顶、根中1/2和根尖处唇腭侧的牙槽骨厚度，以及牙槽骨的倾斜度和高度。结果　上颌切牙区唇腭侧牙槽骨在牙槽嵴顶处均较薄。（1）唇侧牙槽骨厚度：在根中1/2处，Ⅱ/1组中切牙唇侧牙槽骨厚度［（1.31 ± 0.39）mm ］显著高于对照组［（0.87 ± 0.34）mm ］和Ⅲ组［（0.87 ± 0.49）mm ］（P < 0.05）；而Ⅲ组的侧切牙唇侧牙槽骨厚度［（0.62 ± 0.40）mm ］高于Ⅱ/1组［（0.50 ± 0.40）mm ］和对照组［（0.44 ± 0.23）mm ］（P < 0.05）。（2）腭侧牙槽骨厚度：在牙槽嵴顶和根中1/2处，Ⅲ组上颌中切牙腭侧牙槽骨厚度［（0.98 ± 0.32）mm、（3.27 ± 1.92）mm ］显著高于对照组［（0.69 ± 0.22）mm、（2.23 ± 0.90）mm ］和Ⅱ/1组［（0.87 ± 0.24）mm、（2.77 ± 0.87）mm ］（P < 0.05），而Ⅱ/1组和Ⅲ组侧切牙腭侧牙槽骨厚度小于对照组（P < 0.05）。（3）牙槽骨高度和倾斜度：Ⅱ/1组上颌切牙区牙槽骨高度和倾斜度均大于Ⅲ组和对照组。上颌中切牙倾斜度与牙槽骨形态具有相关性，Ⅱ/1组上颌中切牙倾斜度与唇腭侧牙槽骨倾斜度高度相关（P < 0.05）。结论　安氏Ⅱ/1分类和安氏Ⅲ类错牙合畸形具有不同的牙槽骨形态特征，因此在制定正畸治疗方案中要予以考虑不同错牙合畸形对上颌切牙区颌骨的影响。

关键词: 锥形束CT, 牙槽骨厚度, 安氏Ⅱ类1分类错牙合畸形, 安氏Ⅲ类错牙合畸形

Abstract: Objective　To explore the alveolar bone morphology around upper incisors by the cone-beam CT（CBCT）in subjects with Angle Class Ⅱ division 1 and Class Ⅲ malocclusion. Methods　From January 2015 to July 2018，82 patients with Angle Class Ⅱ division 1 malocclusion（Group Ⅱ/1），72 patients with Class Ⅲ malformation（Group Ⅲ）and 45 patients with individual normal occlusion（control group）were treated in the Nanjing Stomatological Hospital，Medical School of Nanjing University. CBCT images were taken and reconstructed. The median sagittal images of the incisors were selected to measure alveolar bone thickness at the alveolar crest，mid-root and apex，inclination of the alveolar process and alveolar height.  Results　Thin alveolar bone can be observed at both the labial and palatal side.（1）Labial alveolar bone thickness（ABT）：at the mid-root level，ABT at the central incisors was higher in the Group Ⅱ/1 ［（1.31 ± 0.39）mm ］ than in control group ［（0.87 ± 0.34）mm ］and Group Ⅲ ［（0.87 ± 0.49）mm ］（P < 0.05），whereas ABT was thicker in Group Ⅲ ［（0.62 ± 0.40）mm ］ than Group Ⅱ/1 ［（0.50 ± 0.40）mm ］ and control group ［（0.44 ± 0.23）mm ］ at the lateral incisors （P < 0.05）.（2）Palatal ABT：At the top of the alveolar and mid-root level，ABT was thicker in the Group Ⅲ ［（0.98 ± 0.32）mm、（3.27 ± 1.92）mm ］than in control group ［（0.69 ± 0.22）mm、（2.23 ± 0.90）mm ］ and Group Ⅱ/1 ［（0.87 ± 0.24）mm、（2.77 ± 0.87）mm ］（P < 0.05），while ABT at the lateral incisors of Group Ⅱ/1 and Ⅲ was smaller than that in control group (P < 0.05). （3）Alveolar bone height and alveolar process inclination：alveolar bone height and alveolar process inclination in the Ⅱ/1 group was larger than control and Ⅲ group. Moreover，inclination of central incisors was correlated with morphologies of alveolar process with a high correlation between incisor inclination and alveolar process inclination（P < 0.05）. Conclusion　Difference can be found in the alveolar morphology between Class Ⅱ Division 1 and Class Ⅲ malocclusion and such difference should be considered in making orthodontic treatment plan.

Key words: cone-beam CT, CBCT；alveolar bone thickness；Angle Class Ⅱ division 1 malocclusion；Angle Class Ⅲ malocclusion