中国实用口腔科杂志

中国实用口腔科杂志 ›› 2021, Vol. 14 ›› Issue (5): 575-579.DOI: 10.19538/j.kq.2021.05.013

• 论著 • 上一篇    下一篇

微种植体支抗整体远中移动下牙列后牙根吸收变化的三维测量研究

熊再道，周培刚，冯海霞，陈秀春    

  1. 苏州市第九人民医院口腔科，江苏  苏州  215200
  • 出版日期:2021-09-30 发布日期:2021-09-30
  • 基金资助:
    苏州市第九人民医院青年科研基金（YK202115）

  • Online:2021-09-30 Published:2021-09-30

摘要： 目的    通过锥形束CT（CBCT）三维重建方法评价微种植体支抗整体远中移动下牙列后的牙根吸收变化情况。方法    选择2017—2020年于苏州市第九人民医院口腔科就诊的21例采用微种植体支抗整体远中移动下颌牙列的骨性安氏Ⅲ类错牙合掩饰治疗患者，于治疗前后分别拍摄CBCT影像，使用Mimics 22.0软件对下颌中切牙、第一前磨牙及第一磨牙进行三维重建并测量治疗前后牙根体积及长度。采用SPSS 22.0软件对数据进行统计学分析。结果    3个牙位的治疗后牙根体积均较治疗前显著减小，其中下颌第一磨牙体积减小（14.27 ± 8.98）mm3，第一前磨牙体积减小（10.74 ± 5.70）mm3，中切牙体积减小（9.11 ± 4.08）mm3，并且下颌第一磨牙牙根体积减小量明显大于中切牙（P < 0.05）。治疗后下颌第一磨牙的牙根长度未发生明显减小（P > 0.05）；而第一前磨牙牙根长度减小（0.52 ± 0.84）mm，中切牙长度减小（0.78 ± 1.39）mm，较治疗前均发生了较明显的减小（P < 0.05）。治疗结束后下颌中切牙、第一前磨牙、第一磨牙分别远中移动了（3.81 ± 2.15）、（3.16 ± 1.52）、（2.93 ± 1.72）mm，3个牙位的牙根体积减小量与其远移量均具有线性相关关系（r值依次为0.675、0.519、0.481，P值依次为< 0.001、0.002、0.006）。结论    下牙列整体远中移动后，牙根体积较长度发生了更显著的减小，采用牙根体积结合长度为指标诊断评估牙根吸收具有更高的敏感性。

关键词: 骨性安氏Ⅲ类错牙合, 微种植体, 牙根吸收, 锥形束CT

Abstract: Objective    To evaluate of the change in root resorption by cone-beam computed tomography（CBCT）three dimensional reconstruction method after distalization total lower dentition combined with micro-implant anchorage. Methods    CBCT images were taken before and after treatment in 21 Angle class Ⅲ skeletal malocclusion patients，who received distalization of total lower dentition with micro-implant anchorage. Three dimensional reconstruction of mandibular central incisor，first premolar and first molar was performed by Mimics 22.0 software，and root volume and length were measured before and after treatment. SPSS 22.0 software was used to analyze the data. Results    Root volume of three teeth decreased significantly after treatment. Compared with that before treatment，the volume of the mandibular first molar decreased by（14.27 ± 8.98）mm3，the volume of the first premolar decreased by（10.74 ± 5.70）mm3，and the volume of the central incisor decreased by（9.11 ± 4.08）mm3；the volume absorption of the mandibular first molar root was significantly higher than that of the central incisor（P < 0.05）. After treatment，the root length of the mandibular first molar did not decrease significantly（P > 0.05），while the root length of the first premolar decreased by （0.52 ± 0.84）mm and the central incisor decreased by （0.78 ±1.39）mm，there being a significant decrease in both groups（P < 0.05）. After treatment，the mandibular central incisor，first premolar and first molar moved distally by （3.81 ± 2.15）mm，（3.16 ± 1.52）mm and（2.93 ± 1.72）mm，and there was the correlation between the reduction of root volume and distalization. Conclusion    After the distal movement of the total lower dentition，the root volume decreases more significantly than the length，so the volume combined with length is more sensitive in the diagnosis of root resorption.

Key words: Angle class Ⅲ skeletal malocclusion, micro-implant, root resorption, cone-beam computed tomography