上海口腔医学

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (6): 589-594.doi: 10.19439/j.sjos.2025.06.005

• 论著 • 上一篇    下一篇

微创颌骨手术联合正畸治疗上颌前突对牙根及牙槽骨的影响

周琴1, 陈琦雯1, 鄢洁雅1, 刘加强2   

  1. 1.上海市静安区牙病防治所, 上海 200070;
    2.上海交通大学医学院附属第九人民医院 口腔颅颌面科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海市口腔医学研究所, 上海 200011
  • 收稿日期:2025-05-16 修回日期:2025-07-24 发布日期:2025-12-30
  • 通讯作者: 刘加强,E-mail：liujqmj@163.com
  • 作者简介:周琴（1983-）,女,硕士,E-mail：chenkl1@163.com
  • 基金资助:
    国家自然科学基金面上项目（82071081）; 上海市卫生健康委员会卫生行业临床研究专项（卓越项目）（20224Z0010）; 上海市静安区加强公共卫生体系建设三年行动计划（2023-2025年）项目（JAGW2023204)

The influence of minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion on tooth roots and alveolar bone

Zhou Qin1, Chen Qiwen1, Yan Jieya1, Liu Jiaqiang2   

  1. 1. Shanghai Jing'an District Dental Disease Prevention and Control Institute. Shanghai 200070;
    2. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2025-05-16 Revised:2025-07-24 Published:2025-12-30

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摘要： 目的:探讨微创颌骨手术联合正畸治疗上颌前突后,对上前牙牙根长度及牙槽骨厚度的影响,为临床治疗方案选择提供参考。方法:选择2018年1月—2024年2月就诊于上海交通大学医学院附属第九人民医院的上颌前突女性患者40例,按治疗方案分为两组—试验组（20例）采用微创颌骨手术联合正畸治疗,对照组（20例）采用单纯拔牙正畸治疗。比较两组正畸疗程及治疗前后上前牙牙根长度和牙槽骨厚度的变化。结果:试验组关闭间隙时间为（7.2±1.15）个月,正畸总时间为（19.6±3.35）个月,均显著短于对照组的（12.93±1.27） 个月及（27.0±3.22）个月（P<0.001）;两组排齐整平时间无显著差异（P=0.63）。两组治疗后上前牙牙根均出现吸收,但两组间无显著差异（P>0.05）。唇侧根颈部、根中部牙槽骨厚度试验组治疗后表现为增加,对照组治疗后表现为减少,两组间比较有显著差异（P<0.01）。结论:微创颌骨手术联合正畸治疗上颌前突可显著缩短正畸疗程,增加上前牙唇侧牙槽骨厚度,降低骨开窗、骨开裂风险,但无法减少正畸相关的牙根吸收。

关键词: 上颌前突, 微创颌骨手术, 正畸治疗, 牙根吸收, 牙槽骨厚度

Abstract: PURPOSE: To explore the effects of minimally invasive jaw surgery combined with orthodontic treatment on the root length of maxillary anterior teeth and alveolar bone thickness after correcting maxillary protrusion, and to provide a reference for the selection of clinical treatment plans. METHODS: A total of 40 female patients with maxillary protrusion who visited Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to February 2024 were selected and divided into two groups according to the treatment plan: the experimental group(n=20) received minimally invasive jaw surgery combined with orthodontic treatment, and the control group(n=20) received orthodontic treatment with simple tooth extraction. The orthodontic treatment course and changes in the root length of maxillary anterior teeth and alveolar bone thickness before and after treatment were compared between the two groups. RESULTS: The space closure time in the experimental group was (7.2±1.15) months, and the total orthodontic treatment time was (19.6±3.35) months, both significantly shorter than those in the control group [(12.93±1.27) months and (27.0±3.22) months, respectively] (P<0.001); there was no significant difference in the alignment and leveling time between the two groups(P=0.63). Root resorption of maxillary anterior teeth occurred in both groups after treatment, but there was no significant difference between the two groups(P>0.05). The thickness of the labial alveolar bone at the root neck and mid-root regions increased in the experimental group after treatment, while it decreased in the control group, and the difference between the two groups was significant (P<0.01). CONCLUSIONS: Minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion can significantly shorten the orthodontic treatment course and increase the thickness of the labial alveolar bone of maxillary anterior teeth to reduce the risk of bone dehiscence and fenestration. However, it cannot reduce orthodontically related root resorption.

Key words: Maxillary protrusion, Minimally invasive jaw surgery, Orthodontic treatment, Root resorption, Alveolar bone thickness

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