上海口腔医学

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (2): 129-134.doi: 10.19439/j.sjos.2021.02.004

• 论著 • 上一篇    下一篇

腭侧错位的上颌侧切牙牙根位置锥形束CT测量分析

毛艳敏, 许衍, 罗薇, 卢芸, 刘月华   

  1. 上海市口腔病防治院 正畸科,复旦大学附属口腔医院口腔生物医学工程实验室,上海 200001
  • 收稿日期:2020-05-26 修回日期:2020-08-27 出版日期:2021-04-25 发布日期:2021-05-11
  • 通讯作者: 刘月华,E-mail: liuyuehua@fudan.edu.cn
  • 作者简介:毛艳敏（1987-）,女,硕士,主治医师,E-mail:mym1987911@163.com
  • 基金资助:
    上海申康医院发展中心第二轮三年行动计划（SHDC2020CR2043B）; 上海市卫生和计划生育委员会青年项目（20164Y0031）; 上海市卫生健康委员会青年项目（20194Y0380）; 上海市口腔病防治院面上项目（SSDC-2018-10）

Study of the root position of palatally malposed maxillary lateral incisor based on cone-beam CT images

MAO Yan-min, XU Yan, LUO Wei, LU Yun, LIU Yue-hua   

  1. Department of Orthodontics, Shanghai Stomatological Hospital; Oral Biomedical Engineering Laboratory, Fudan University. Shanghai 200001, China
  • Received:2020-05-26 Revised:2020-08-27 Online:2021-04-25 Published:2021-05-11

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摘要： 目的:通过锥形束CT(CBCT)测量分析上颌腭侧错位的侧切牙牙根位置分布规律,为正畸治疗中此类牙的移动设计提供参考依据。方法:选取符合入选标准伴上颌侧切牙腭侧错位的病例共200例,调取其CBCT,将腭侧错位的上颌侧切牙根长平分8等份,自根尖向牙槽嵴顶方向依次做标记点T1-T8,分别测量各位点的唇侧、腭侧牙槽骨厚度;测量其牙体长轴与牙槽骨长轴的相对倾斜角度。采用SPSS 19.0软件包对测量数据进行统计学分析。结果:除T1、T7、T8外,其余各位点唇侧骨壁平均厚度均<1 mm。T3、T4、T5处唇侧骨壁平均厚度最薄,均不足0.5 mm（P<0.05）。T4至T8的唇侧骨壁平均厚度呈递增趋势（P<0.05）。腭侧骨壁平均厚度均>1 mm,T8至T1腭侧骨壁平均厚度呈递增趋势（P<0.05）。牙体长轴与牙槽骨长轴交角均为负值（冠腭侧根唇侧）,平均为-31.06°。结论:上颌腭侧错位的侧切牙牙根向唇侧倾斜。其唇侧骨壁普遍较薄, 特别在距根尖1/4~1/2段,常存在唇侧骨板缺如情况。正畸过程中,若需将腭侧错位的上颌侧切牙唇向移位,首选倾斜移动,不宜做唇向控根移动,以防出现严重的骨开窗、开裂或牙根吸收。

关键词: 腭侧错位, 上颌侧切牙, 牙根位置, 骨厚度

Abstract: PURPOSE: The goal of this investigation was to measure and analyze the root position of palatally malposed maxillary lateral incisor based on cone-beam CT(CBCT)images, in order to provide references for orthodontists to move this kind of teeth scientifically. METHODS: CBCT data from 200 patients meeting the selection criteria with palatally malposed maxillary lateral incisor were investigated in this study. The root was divided into eight equal parts by length, then T1 to T8 were orderly pointed from root apex to alveolar ridge crest. The labial and palatal bone thickness at each point was measured; meanwhile, the angle between the long axis of the tooth and that of the alveolar bone was measured.The data was analyzed using SPSS 19.0 software package. RESULTS: The mean labial bone thicknesses at all researched points were less than 1.00 mm, except for point T1,T7 and T8. The mean labial bone thicknesses at point T3, T4 and T5 were the thinnest, which were all less than 0.5 mm(P<0.05). The mean thicknesses of labial bone gradually increased from T4 to T8(P<0.05). The mean palatal bone thicknesses were all more than 1.00 mm at the eight points,the mean thicknesses of palatal bone gradually increased from T8 to T1(P<0.05). All the angulations between the long axes of teeth and those of the alveolar bone were negative, indicating the root was close to the labial alveolar wall. The average angulation was minus 31.06 degrees. CONCLUSIONS: Results suggest that the root of palatally malposed maxillary lateral incisor is close to the labial wall of the alveolar bone, its labial alveolar bone is frequently quite thin or even deficient, especially in the zone between 1/4 root length to the root apex and the mid-root. If we move the palatally malposed maxillary lateral incisor labially, it is better to choose tipping movement, instead of bodily movement, in order to avoid serious bone fenestration and dehiscence or root absorption.

Key words: Palatally malposed, Maxillary lateral incisor, Root position, Bone thickness

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