Department of Orthodontics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Angle Orthod. 2012 Jul;82(4):645-52. doi: 10.2319/070111-424.1. Epub 2011 Nov 30.
To test the hypothesis that there is no difference in vertical alveolar bone loss and alveolar bone thickness around maxillary and mandibular central incisors in normal occlusion samples and skeletal Class III malocclusion patients.
The study sample comprised 20 Korean normal occlusion subjects (mean age, 22.1 years; group 1) and patients with skeletal Class III malocclusion with anterior open bite (mean age, 22.4 years; group 2). Three-dimensional (3D) cone beam computed tomography (CBCT) images were taken before orthodontic treatment, and sagittal slices chosen at the labio-lingually widest point of the maxillary and mandibular right central incisor were evaluated, respectively. The amount of vertical alveolar bone loss and/or alveolar bone thickness of the labial and lingual plate at the root apex were measured.
Group 2 had statistically significant more vertical bone loss than group 1 (P < .05). Alveolar bone at the apex was significantly thinner in group 2 (P < .05), except for the maxillary incisors. Mandibular incisors showed greater alveolar bone loss than was seen in maxillary incisors in both groups, especially at the lingual side in group 2 (P < .05). Overall, alveolar bone thickness at the apex was wider than cementoenamel junction (CEJ) width, except for the mandibular incisors in group 2, for which the percentage was 81.33%.
The hypothesis is rejected. Special care should be taken to avoid aggravating preexisting alveolar bone loss in the anterior teeth, especially in the mandible, in skeletal Class III patients, who may be more vulnerable to alveolar bone loss during orthodontic treatment.
验证无牙颌患者和安氏Ⅲ类错颌患者牙槽骨垂直吸收量和牙槽骨厚度无差异的假设。
本研究纳入 20 名韩国正常牙合患者(平均年龄 22.1 岁;第 1 组)和 20 名安氏Ⅲ类错颌伴前牙开颌患者(平均年龄 22.4 岁;第 2 组)。所有患者在正畸治疗前均接受了锥形束 CT 检查,分别对上下颌右侧中切牙唇舌向最宽处的矢状位切片进行分析。测量牙槽骨垂直吸收量和/或根尖处唇舌侧牙槽骨厚度。
第 2 组牙槽骨垂直吸收量明显多于第 1 组(P <.05)。第 2 组牙槽骨颊舌向根尖处明显变薄(P <.05),但上颌中切牙除外。与上颌中切牙相比,下颌中切牙在两组中均有更多的牙槽骨吸收,尤其是第 2 组的舌侧(P <.05)。除第 2 组下颌中切牙外,牙槽骨颊舌向根尖处厚度均大于牙骨质界宽度,百分比为 81.33%。
该假设不成立。在正畸治疗中,应特别注意避免加重安氏Ⅲ类错颌患者的前牙牙槽骨吸收,尤其是下颌前牙。