上海口腔医学

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (4): 410-413.doi: 10.19439/j.sjos.2021.04.014

• 论著 • 上一篇    下一篇

骨性Ⅱ类上颌磨牙后间隙解剖特征分析

刘莉萍1,2, 杨彤彤1,3, 程佳秀1   

  1. 1.山西医科大学 口腔医学院,山西 太原 030001;
    2.山西省儿童医院妇幼保健院 口腔科,山西 太原 030000;
    3.山西医科大学第一医院 口腔科,山西 太原 030001
  • 收稿日期:2019-12-19 修回日期:2020-03-29 出版日期:2021-08-25 发布日期:2021-09-23
  • 通讯作者: 杨彤彤,E-mail:yangtongtong@163.com
  • 作者简介:刘莉萍（1992-）,女,硕士研究生,住院医师,E-mail:305575325@qq.com
  • 基金资助:
    山西省重点研发计划项目（201903D122）

Anatomical limits of distal displacement of bony maxillary molars in patients with skeletal Class Ⅱ malocclusion

LIU Li-ping1,2, YANG Tong-tong1,3, CHENG Jia-xiu1   

  1. 1. Shanxi Medical University School and Hospital of Stomatology. Taiyuan 030001;
    2. Department of Stomatology, Children's Hospital and Women Health Center of Shanxi. Taiyuan 030000;
    3. Department of Stomatology, The First Hospital of Shanxi Medical University School. Taiyuan 030001, Shanxi Province, China
  • Received:2019-12-19 Revised:2020-03-29 Online:2021-08-25 Published:2021-09-23

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摘要： 目的: 比较骨性Ⅰ类与骨性Ⅱ类错患者的上颌磨牙后间隙,探讨骨性Ⅱ类上颌骨前突患者磨牙后移的解剖因素。方法: 对32例骨性Ⅰ类和36例骨性Ⅱ类错患者共136侧上颌骨后段锥形束CT（cone-beam CT,CBCT）资料进行分析。以上颌第一、二磨牙功能尖连线为测量参考线,在上颌第二磨牙远颊根所在平面上,选择上颌第二磨牙的釉-牙骨质界（cemento-enamel junction,CEJ）水平、根分叉水平、距离根分叉2、4、6 mm水平及远颊根根尖水平,测量从上颌第二磨牙到上颌结节远中骨皮质边缘距离。采用SPSS 23.0软件包对数据进行分析,比较骨性Ⅰ类与骨性Ⅱ类错患者上颌磨牙后间隙在不同测量水平处的测量值。结果: 不同性别在各水平测量的磨牙后间隙结果无显著差异;骨性Ⅱ类组测量值均大于骨性Ⅰ类组,2组测量值均在釉-牙骨质界水平最小,分别为（4.18±1.40）和（5.12±2.16） mm;随着测量水平上移,所测得间隙值增长,在根尖处最大,分别为（8.64±2.41）和（10.02±2.27） mm。结论: 骨性Ⅱ类错患者有更大的间隙提供远移。在推上颌磨牙向后时,应更多关注第二磨牙远中沿咬合线的釉-牙骨质界水平的解剖极限。

关键词: 磨牙后间隙, 磨牙远移, 上颌结节, 上颌骨前突

Abstract: PURPOSE: To compare the posterior space of the maxillary molar with osseous dislocation and investigate the retromolar space available for molar distalization in patients with maxillary prognathism. METHODS: Cone-beam CT (CBCT) data of 136 posterior maxillary segments in 32 patients with skeletal Class I malocclusion and 36 patients with skeletal Class Ⅱ malocclusion were analyzed. The functional tip of the maxillary first and second molars was connected as the measuring reference line, the reference plane for measurement parallel to the reference line, which passed the furcation of the mandibular second molar root, was set as the “0 mm” plane. Four additional planes, which were parallel to the 0 mm-plane and located at 2, 4, 6 mm apical to the 0 mm-plane, cemento-enamel junction (CEJ) and root tip, were named the"2 mm, 4 mm, 6 mm, CEJ and TIP", in order to measure the distance from the maxillary second molar to maxillary tubercle bone cortex in the edge. SPSS 23.0 software package was used to analyze the data. RESULTS: At all levels of measurement, the retromolar space of the values in male and female patients was not significantly different, ClassⅡ malocclusion were significantly greater than those in ClassⅠmalocclusion, with the minimum values at the CEJ level, (4.18±1.40) and (5.12±2.16) mm, respectively. As the measured level moved up, the measured clearance value increased and reached the maximum at the root tip, which was (8.64±2.41) and (10.02±2.27) mm, respectively. CONCLUSIONS: Compared with ClassⅠmalocclusion, patients with ClassⅡmalocclusion have greater retromolar space for maxillary molar distalization along the posterior line of occlusion. More attention should be paid to the anatomical limit of maxillary second molar at the CEJ level along the bite line in the distal direction when maxillary molar is pushed backward.

Key words: Retromolar space, Molar distalization, Maxillary tubercle, Maxillary prognathism

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