闭合式牵引矫治上前牙埋伏阻生的安全性及对牙髓血流、咀嚼功能的影响

doi:10.19439/j.sjos.2024.05.013

摘要/Abstract

摘要： 目的： 分析闭合式牵引矫治上前牙埋伏阻生的安全性及对牙髓血流、咀嚼功能的影响。方法： 选择2017年1月—2022年12月收治的80例上前牙埋伏阻生患者,随机分为试验组与对照组,每组各40例。2组均接受导萌术联合正畸牵引治疗,试验组采用闭合式牵引矫治,对照组采用开放式牵引矫治。比较2组临床疗效、治疗时长、咀嚼能力、牙根长度、牙根周围骨密度、牙美学评分、不同时间点[治疗前（T0）、牵引治疗第1周（T1）、牵引治疗保持期（T2）及修复后3个月（T3）]牙髓血流量及不良事件发生情况。采用SPSS 22.0软件包对数据进行统计学分析。结果： 试验组（95.00%）、对照组（90.00%）总有效率相比无显著差异（P>0.05）,2组牵引萌出时间与正畸时间相比差异显著（P<0.05）,2组治疗前、后咀嚼效率、咬合力及咀嚼疼痛评分差值相比差异显著（P<0.05）,2组治疗前、后牙根长度、牙根周围骨密度差值无显著差异（P>0.05）。2组治疗前、后白色美学评分差值无显著差异（P>0.05）,红色美学评分差值差异显著（P<0.05）。2组各时间点牙髓血流量无显著差异（P>0.05）,T1时2组牙髓血流量到达峰值,高于T0;T2时迅速下降,低于T1但高于T0;T3时逐渐下降,低于T1、T2但高于T0（P<0.05）。试验组不良事件发生率（10.00%）与对照组（27.50%）相比,差异显著（P<0.05）。结论： 闭合式与开放式牵引矫治均可有效治疗上前牙埋伏阻生,2种方式对牙根长度、周围骨密度及牙髓血流量无显著影响。虽然闭合牵引矫治的治疗时间略长,但更利于提高患者咀嚼能力,且美观度与安全性更高,值得临床推广。

关键词: 闭合式牵引, 上前牙, 埋伏阻生, 安全性, 牙髓血流量, 咀嚼功能

Abstract: PURPOSE: To analyze the safety of closed traction appliance in the treatment of impacted anterior teeth and its effect on pulp blood flow and masticatory function. METHODS: A total of 80 patients with impacted anterior teeth who received treatment from January 2017 to December 2022 were selected, and randomly divided into experimental group and control group with 40 cases in each group. The two groups of patients were treated with occlusion adjustment and orthodontic traction. Closed traction was used in the experimental group, while open traction was used in the control group. The clinical efficacy, treatment duration, chewing ability, root length, periroot bone density, dental aesthetic score, pulp blood flow at different time points and the occurrence of adverse events were compared between the two groups. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: The total effective rate was 95.00% in the experimental group and 90.00% in the control group, with no significant difference(P>0.05). There was significant difference in traction eruption time and orthodontic time between the two groups(P<0.05). There were significant differences in masticatory efficiency, bite force and masticatory pain score between the two groups before and after treatment(P<0.05). There was no significant difference in root length and periroot bone density between the two groups before and after treatment(P> 0.05). There was no significant difference in white aesthetic score between the two groups before and after treatment(P> 0.05), but there was significant difference in red aesthetic score between the two groups before and after treatment(P< 0.05). There was no significant difference in pulp blood flow between the two groups at each time point(P>0.05). At T1, the pulp blood flow reached its peak higher than T0; at T2, it rapidly decreased below T1 but higher than T0; at T3, it gradually decreased below T1 and T2 but higher than T0(P<0.05). The incidence of adverse events in the experimental group was 10.00% compared with 27.50% in the control group, and the difference was statistically significant(P<0.05). CONCLUSIONS: Both closed traction and open traction correction can effectively treat the impacted anterior teeth, and the two methods have no significant effects on root length, surrounding bone density and pulp blood flow. Although the treatment time of closed traction is slightly longer, it is more beneficial to improve patients' masticatory ability, and has high aesthetics and safety, which is worthy of clinical promotion.

Key words: Closed traction, Anterior teeth, Ambush impacted, Security, Pulp blood flow, Masticatory function

中图分类号:

R783.5

朱麒, 赵蔚, 吴华英. 闭合式牵引矫治上前牙埋伏阻生的安全性及对牙髓血流、咀嚼功能的影响[J]. 上海口腔医学, 2024, 33(5): 517-522.

ZHU Qi, ZHAO Wei, WU Hua-ying. Safety of closed traction appliance in the treatment of impacted anterior teeth and its effect on pulp blood flow and masticatory function[J]. Shanghai Journal of Stomatology, 2024, 33(5): 517-522.

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