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正畸患者上颌前牙整体内收和压低时应用微螺钉支抗后牙牙槽骨吸收

Apical root resorption in orthodontic patients with en-masse maxillary anterior retraction and intrusion with miniscrews.

机构信息

Department of Orthodontics and Craniofacial Dentistry Chang Gung Memorial Hospital, Taipei, Taiwan.

出版信息

Am J Orthod Dentofacial Orthop. 2010 Feb;137(2):207-12. doi: 10.1016/j.ajodo.2008.02.027.

Abstract

INTRODUCTION

The purposes of this retrospective study were to investigate the apical root resorption of maxillary incisors in orthodontic patients with en-masse maxillary anterior retraction and intrusion with miniscrews and the factors disposing a patient to apical root resorption.

METHODS

Fifty adult patients with maxillary protrusion were included; 30 were treated with miniscrews and extraction of the maxillary first premolars (group I), and 20 were treated with extraction of the maxillary first premolars (group II). For each patient, periapical films of the maxillary incisors and lateral cephalometric radiographs were taken before and after treatment to evaluate apical root resorption and cephalometric measurements. The intergroup differences were analyzed with the Student t test and the correlations between apical root resorption and cephalometric measurements were analyzed by the Pearson correlation.

RESULTS

The apical root resorption values were 16.0% to 20.0% (2.5-2.8 mm) in group I and 13.4% to 14.4% (2.1-2.3 mm) of the original root length in group II. Group I had significantly more severe Class II jaw discrepancy (ANB, 7.1 degrees +/- 1.9 degrees ) than did group II (ANB, 3.2 degrees +/- 2.9 degrees ). The amount of maxillary en-masse anterior retraction (8.2 +/- 2.4 mm), the duration of treatment (28.3 +/- 7.3 months), and apical root resorption of maxillary lateral incisors were significantly greater in group I than in group II. Apical root resorption of the maxillary central incisors was significantly correlated to the duration of treatment but not to the amount of en-masse retraction, intrusion, or palatal tipping of maxillary incisors.

CONCLUSIONS

Miniscrew anchorage allows for more maxillary en-masse anterior retraction in patients with severe Class II cases. But the time needed for the greater amount of maxillary en-masse anterior retraction with miniscrew anchorage is longer and might dispose the patient to more apical root resorption.

摘要

介绍

本回顾性研究的目的是探讨使用微螺钉整体上颌前牙内收和压低治疗上颌前突患者中上颌切牙根尖吸收的情况,以及导致患者根尖吸收的因素。

方法

共纳入 50 例上颌前突成年患者,其中 30 例患者采用微螺钉和上颌第一前磨牙拔牙(I 组),20 例患者采用上颌第一前磨牙拔牙(II 组)。每位患者在治疗前后均拍摄上颌切牙根尖片和侧位头颅侧位片,以评估根尖吸收和头影测量值。采用 Student t 检验比较两组间的差异,采用 Pearson 相关分析根尖吸收与头影测量值的相关性。

结果

I 组的根尖吸收值为 16.0%至 20.0%(2.5-2.8mm),占原始根长的 13.4%至 14.4%(2.1-2.3mm)。I 组的 II 类颌间关系(ANB,7.1 度 +/- 1.9 度)明显比 II 组(ANB,3.2 度 +/- 2.9 度)严重。I 组上颌整体前牙内收量(8.2 +/- 2.4mm)、治疗时间(28.3 +/- 7.3 个月)和上颌侧切牙根尖吸收量明显大于 II 组。上颌中切牙根尖吸收与治疗时间显著相关,但与上颌切牙整体内收量、内收量、压入量或腭倾斜量无关。

结论

微螺钉支抗允许在严重 II 类错颌病例中进行更多的上颌整体前牙内收。但是,使用微螺钉支抗进行更大的上颌整体前牙内收所需的时间更长,可能导致患者出现更多的根尖吸收。

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