中国实用口腔科杂志

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不同安氏错牙合畸形中切牙Collum角差异性锥形束CT分析

王小明王晶张博苏涛邹敏   

  1. 西安交通大学附属口腔医院正畸科,陕西  西安  710004
  • 出版日期:2018-02-15 发布日期:2018-03-13

  • Online:2018-02-15 Published:2018-03-13

摘要:

目的 通过锥形束CT(CBCT)影像测量比较成人不同安氏错牙合分类之间上下中切牙Collum角的差异性规律,为预防前牙骨开裂及骨开窗提供指导。方法 根据临床咬合检查分类,筛选2014—2016年就诊于西安交通大学附属口腔医院正畸科患者116例,其中安氏错牙合Ⅰ类30例、Ⅱ类1分类(Ⅱ1类)29例、Ⅱ类2分类(Ⅱ2类)27例、Ⅲ类30例。使用Invivo 5软件对CBCT图像进行三维定位,获得右侧上下中切牙正中矢状截面图,Auto CAD 2007软件测量牙冠长轴根方延长线与牙根长轴的夹角(Collum角,冠根角的补角),再进行各组之间大小差异性单因素方差分析及Scheffe法多重比较。结果 不同安氏错牙合类型患者之间中切牙Collum角大小差异有统计学意义(P<0.05);安氏Ⅱ2类组上中切牙Collum角为(7.02 ± 1.83)°,显著大于其他错牙合类型;安氏Ⅱ1类下中切牙Collum角为(-2.25 ± 4.76)°,牙冠相对于牙根可偏唇侧,与其他错牙合类型组存在显著性差异;安氏Ⅲ类组下中切牙Collum角(8.15 ± 2.50)°,显著大于其他错牙合类型。结论 不同安氏错牙合类型上下中切牙Collum角差异显著,安氏Ⅱ2类上中切牙、安氏Ⅲ类下中切牙牙冠相对牙根偏舌侧,安氏Ⅱ1类下中切牙牙冠相对牙根偏唇侧,前牙内收或唇倾时应考虑该情况,以防牙根穿出骨皮质。

关键词: 安氏错牙合类型, Collum角, 中切牙, 锥形束CT

Abstract:

Objective To measure and compare the discrepancy of Collum angle of incisors among different types of Angle malocclusion using CBCT,and to provide guidance for the prevention of alveolar bone fenestration and dehiscence in anterior region. Methods The cases of malocclusion were chosen in the Xi'an Jiao Tong University Hospital of Stomatology from 2014 to 2016,and four types of malocclusion were obtained class Ⅰ(30 cases),class Ⅱ1 (29 cases),class Ⅱ2(27 cases),class Ⅲ(30 cases),according to the clinical occlusion. Sagittal sections of right upper and lower incisors were obtained by three-dimensional CBCT images using Invivo 5 software, and Auto CAD 2007 software was used to measure the angle formed by the long axis of crown and root(Collum angle),and then analyzing the differences among groups were analyzed by single factor variance and compared by Scheffe method. Results There were significant differences in the size of Collum angle among different types of malocclusion(P<0.05). The Collum angle of upper incisor in class Ⅱ2 was (7.02 ± 1.83)°,which was significantly larger than that of other groups. The Collum angle of lower incisor in Class Ⅱ1 was(-2.25 ± 4.76)°,which meaned that the crown could be lip side compared to the root,and there was significant difference compared with the other groups. The Collum angle of the lower incisor in class Ⅲ was(8.15 ± 2.50)°,which was also significantly larger than other groups. Conclusion There are significant differences in the Collum angle of the upper and lower incisors among different types of malocclusion. The crown of upper incisor in Class Ⅱ 2 and lower incisor in Class Ⅲ can be lingual side to the root,and the crown of lower incisor in Class II1 can be lip side compared to the root,which should be taken into consideration when the incisor is pulled backward or inclined to lip to avoid the root cutting through bone cortex.

Key words: Angle malocclusion;Collum angle;central incisor;cone-beam CT, CBCT