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目的:应用锥束计算机体层摄影术(cone-beam computed tomography,CBCT)研究成年骨性II类及III类高角错合患者下切牙区牙槽骨形态的差异。方法:从2015年10月至2017年8月在北京大学口腔医院就诊并且拍摄了CBCT的患者中筛选出骨性II类及III类高角错合患者各31名,对患者下切牙区牙槽骨的高度、牙槽骨面积及牙槽骨厚度进行测量,并应用SPSS 17.0软件进行独立样本 t 检验分析。结果:两组相比,骨性Ⅲ类组患者的下切牙牙槽骨唇侧根尖区的牙槽骨面积及唇侧总牙槽骨面积均低于骨性Ⅱ类组患者,下切牙唇侧根尖处的牙槽骨厚度也低于骨性Ⅱ类组患者,差异有统计学意义(P<0.05)。在下切牙牙槽骨舌侧釉牙骨质界(cemento-enamel junction,CEJ)下6 mm,骨性Ⅲ类组患者的舌侧根尖区及舌侧总牙槽骨面积均低于骨性Ⅱ类组患者。在下切牙牙槽骨舌侧CEJ下4 mm、6 mm以及舌侧根尖处的牙槽骨厚度,骨性Ⅲ类组患者也低于骨性Ⅱ类组患者,差异有统计学意义(P<0.05)。结论:骨性III类高角错合患者下切牙区牙槽骨的面积及厚度在唇舌侧根尖区明显小于骨性II类高角错合患者,在对其进行前牙的唇舌向移动时尤其要注意转矩的控制,以防止根吸收及骨开窗、骨开裂的发生。
OBJECTIVE: To study the difference of alveolar bone morphology in inferior incisors of adult skeletal Class II and Class III malocclusion patients using cone-beam computed tomography (CBCT). Methods: From October 2015 to August 2017 at the Peking University Stomatological Hospital and the patients with CBCT were screened out, there were 31 patients with high grade II and III high angle malocclusion respectively. The alveolar bone Height, alveolar area and alveolar bone thickness were measured, and SPSS 17.0 software was used for independent sample t-test analysis. Results: Compared with the two groups, the alveolar bone area and labial alveolar bone area in the labial alveolar area of the lower incisor alveolar bone group were lower than those in the bony group Ⅱ group, The thickness of alveolar bone was also lower than that of patients with osteosarcoma Ⅱ, the difference was statistically significant (P <0.05). Under the cemento-enamel junction (CEJ) of 6 mm in the inferior incisor, the total area of the lingual apical and lingual alveolar bone in the osteosarcoma group Ⅲ was lower than that in the skeletal class Ⅱ Group patients. The thickness of alveolar bone at 4 mm and 6 mm under the CEJ of the inferior incisor alveolar bone and at the apical lingual apex were also lower in patients with osteosarcoma type Ⅲ than in patients with osteosarcoma Ⅱ group (P & lt; 0.05 ). CONCLUSIONS: The area and thickness of the alveolar bone in the lower incisor area of patients with osteal Class III malocclusion are significantly less than those with high malocclusion in the lingual area, with particular attention paid to the labial and lingual movement of the anterior teeth Torque control to prevent root absorption and bone fenestration, bone cracking occurs.