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正畸微螺钉的失败率与牙根临近、植入角度、骨接触长度和骨密度的关系。

Orthodontic miniscrew failure rate and root proximity, insertion angle, bone contact length, and bone density.

机构信息

Division of Orthodontics and Dentofacial Orthopedics, Tohoku University Graduate School of Dentistry, Sendai, Japan.

出版信息

Orthod Craniofac Res. 2013 Feb;16(1):44-55. doi: 10.1111/ocr.12003. Epub 2012 Sep 3.

DOI:10.1111/ocr.12003
PMID:23311659
Abstract

OBJECTIVES

To test the hypothesis that there is no significant correlation between miniscrew failure rate and root proximity, insertion angle, bone contact length, and bone density.

SETTING AND SAMPLE POPULATION

This study included 107 patients in whom 190 miniscrews had been placed from April 2008 to October 2009 in Tohoku University Hospital (Sendai, Japan).

MATERIALS AND METHODS

Cone beam computed tomography scans (CBCT) and periapical radiographs were taken before and after miniscrew placement. Differences in root proximity, screw insertion angle, bone contact length, and bone density were statistically compared; comparisons were also made between the CBCT images and periapical radiographs.

RESULTS

A significantly higher success rate was observed in the maxilla than in the mandible. The distance between the miniscrew and the root surface was significantly smaller in the failure group. There were no significant differences in the insertion angle, bone contact length, or bone density between the success group and the failure group. The concordance rate between the periapical dental radiographs and CBCT images was 46.5%.

CONCLUSION

While bone contact length, miniscrew angle, and bone density did not exert major effects on miniscrew failure, root proximity was the factor that most affected miniscrew failure, especially for miniscrews placed in the mandible. CBCT was superior to periapical dental X-rays for evaluating the proximity of miniscrews to the root. Correction of the X-ray attenuation coefficient value was necessary for measuring bone density using CBCT.

摘要

目的

验证微螺钉失败率与牙根邻近度、植入角度、骨接触长度和骨密度之间无显著相关性的假设。

设置和样本人群

本研究纳入了 2008 年 4 月至 2009 年 10 月在日本东北大学医院(仙台)接受治疗的 107 名患者,共植入 190 颗微螺钉。

材料和方法

在微螺钉植入前后进行锥形束 CT 扫描(CBCT)和根尖片检查。对牙根邻近度、螺钉植入角度、骨接触长度和骨密度的差异进行统计学比较;还比较了 CBCT 图像和根尖片。

结果

上颌的成功率明显高于下颌。失败组的微螺钉与牙根表面的距离明显较小。成功组和失败组之间的植入角度、骨接触长度或骨密度无显著差异。根尖牙科 X 射线与 CBCT 图像的符合率为 46.5%。

结论

虽然骨接触长度、微螺钉角度和骨密度对微螺钉失败没有产生重大影响,但牙根邻近度是影响微螺钉失败的最重要因素,尤其是在下颌植入的微螺钉。CBCT 优于根尖牙科 X 射线,可用于评估微螺钉与牙根的邻近度。使用 CBCT 测量骨密度时,需要校正 X 射线衰减系数值。

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