上前牙内收过程中转矩控制的影像学研究

摘要/Abstract

摘要： 目的研究上前牙内收过程中转矩控制与移动方式、内收与牙槽骨改建之间的关系。方法选取111例拔牙患者治疗前、后的头颅侧位片,7例拔牙患者关闭间隙前、后的锥形束CT（CBCT）,测量上前牙唇倾度,切缘、根尖水平和垂直向位移及牙槽骨厚度变化,采用SAS 8.02 软件包分别对各测量项目进行t检验和χ²检验。结果上前牙控根内收者,唇倾度改变量小,切缘舌侧位移量小,根尖舌侧位移量大,内收后根尖牙槽骨总厚度减少,牙长度减少（P<0.05）;牙槽骨改建量少于牙移动量,成人与青少年无显著差异。结论上前牙内收过程中,更多的转矩控制会引起较多的整体移动和部分控根的倾斜移动,以及较高的牙根吸收率。舌侧牙槽骨适应性改建量较小,过度舌侧移动会超过其改建能力,引起牙槽骨、牙体损伤。

关键词: 头颅侧位片, 锥形束CT, 上前牙内收, 转矩控制

Abstract: PURPOSE: To investigate the relationship between torque control and movement type of the teeth and to investigate the correlation between reconstruction of the alveolar bone and retraction of the upper anterior teeth. METHODS: Cephalograms of pre-treatment and post-treatment of 111 cases and cone-beam computed tomography of pre-retraction and post-retraction of 7 cases were collected. The inclination degree of the upper anterior teeth, the horizontal and vertical displacement of edge and apex,and the thickness of the alveolar bone at the apex level were measured. Student's t test and Pearson χ² test were performed for statistical analysis with SAS 8.02 software package. RESULTS: Cases who received torque control during the period of retraction displayed less change of inclination degree of the upper anterior teeth, less lingual displacement of the edge, more lingual displacement of the apex. The total thickness of the alveolar bone at the apex level and the length of the teeth significantly decreased after retraction(P<0.05). The amount of the alveolar bone rebuilt after retraction was less than that of the tooth movement, and there was no significant difference between teenagers and adults. CONCLUSIONS: During retraction of the upper anterior teeth, cases who received torque control showed less inclination degree change of the upper anterior teeth, less lingual displacement of the edge, more lingual displacement of the apex. More bodily movement and partially controlled tipping movement as well as higher incident rate of severe root resorption would also arise. There was correlation between reconstruction of the alveolar bone and the tooth movement. Since the amount of adaptive reconstruction of the lingual alveolar bone was limited, and there was no difference between teenagers and adults, excessive lingual displacement would surpass its adaption ability, and gave rise to alveolar bone and tooth damage.

Key words: Lateral cephalometric radiographs, Cone-beam CT, Retraction of upper anterior teeth, Torque control

中图分类号:

R783.5

杨雪, 钱玉芬. 上前牙内收过程中转矩控制的影像学研究[J]. 上海口腔医学, 2016, 25(4): 469-474.

YANG Xue, QIAN Yu-fen. Torque control evaluated by lateral cephalometric radiography and cone-beam CT after retraction of the upper anterior teeth[J]. Shanghai Journal of Stomatology, 2016, 25(4): 469-474.

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