上颌窦底对上颌第一磨牙近中移动的影响

doi:10.19439/j.sjos.2022.06.018

摘要/Abstract

摘要： 目的: 探讨上颌窦底对上颌第一磨牙近中移动的影响。方法: 通过锥形束CT（cone-bean CT,CBCT）筛选减数上颌第一前磨牙的正畸患者,根据上颌第一磨牙是否有牙根与上颌窦底接触或进入上颌窦内分为病例组与对照组,根据牙根进入上颌窦深度对病例组进行再分组。纳入正畸患者32例,64颗上颌第一磨牙,其中病例组34颗（Ⅱ亚类5颗、Ⅲ亚类14颗、Ⅳ亚类15颗）,对照组30颗。测量正畸治疗后上颌第一磨牙各牙根及近中颊尖点的近中移动距离,通过各牙根的虚拟牙根长轴的近中倾斜角度,评估治疗后的牙根吸收情况。采用SPSS 22.0软件包对数据进行统计学分析。结果: 正畸治疗后,病例组及对照组各牙根均发生大于2 mm的近中移动,对照组与病例组近中颊尖的近中移动距离无统计学差异（P>0.05）。病例组牙根移动距离显著小于对照组（P<0.05）,对照组与病例组正畸治疗后第一磨牙均发生近中倾斜,对照组倾斜程度显著小于病例组（P<0.05）。病例组Ⅳ亚类第一磨牙近中倾斜程度显著大于Ⅲ亚类组及对照组（P<0.05）。病例组与对照组牙根吸收情况均以无或轻度吸收为主。结论: 使用恰当的正畸力,牙根进入上颌窦底的上颌第一磨牙可以产生有效的近中移动,且牙根较少出现中重度吸收;但牙倾斜程度较牙根未进入上颌窦的上颌第一磨牙大。牙根进入上颌窦深度越深,其倾斜程度越大。

关键词: 上颌窦底, 上颌第一磨牙, 牙根移动距离, 牙根吸收, 锥形束CT

Abstract: PURPOSE: To investigate the impact of maxillary sinus floor on the mesial movement of maxillary first molar. METHODS: Orthodontic patients with maxillary first premolars extracted were selected. Their maxillary first molars were divided into case group and control group according to whether their roots were in contact with the maxillary sinus floor. The case group was further divided into three subtypes according to the depth of the root extruded into the maxillary sinus. A total of 64 maxillary first molars from 32 patients were enrolled in this study, including 34 in the case group (five in subtype Ⅱ, fourteen in subtype Ⅲ, and 15 in subtype Ⅳ) and 30 in the control group. The mesial movement distance of each root and crown and the inclination of each root long axis were measured, and resorption of each root was evaluated. SPSS 22.0 software package was used for data analysis. RESULTS: After orthodontic treatment, the mesial movement distance of roots from both groups were all lager than 2mm. The mesial movement distance of the crown was not statistically different between the two groups (P>0.05), while the mesial movement distance of the roots in the control group was significantly larger than in the case group（P<0.05）. Inclined movement towards the mesial direction was found in both groups, and the inclination angle was significantly larger in the case group（P<0.05）. The inclination angle of the first molars in the subtype Ⅳ was significantly larger than that in the subtype Ⅲ and the control group. Most of the maxillary first molars from both groups had no obvious root resorption（P>0.05）. CONCLUSIONS: With the proper force system, maxillary first molars with roots extruded into the maxillary sinus floor can be moved mesialy with mild or no root resorption, while a larger inclination can be found compared with maxillary first molars without root extruding into the maxillary sinus floor. The deeper the root extruding into the maxillary sinus, the larger the inclination angle will be.

Key words: Maxillary sinus floor, Maxillary first molar, Root movement distance, Root resorption, Cone-bean CT

中图分类号:

R783.5

周子芊, 陈振琦. 上颌窦底对上颌第一磨牙近中移动的影响[J]. 上海口腔医学, 2022, 31(6): 661-667.

ZHOU Zi-qian, CHEN Zhen-qi. Impact of maxillary sinus floor on the mesial movement of maxillary first molar[J]. Shanghai Journal of Stomatology, 2022, 31(6): 661-667.

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