Associate professor and program director, Division of Orthodontics, Department of Craniofacial Sciences, Charles Burstone Professor, School of Dental Medicine, University of Connecticut, Farmington, Conn.
Am J Orthod Dentofacial Orthop. 2013 Dec;144(6):848-59. doi: 10.1016/j.ajodo.2013.08.017.
The purpose of this study was to evaluate the alveolar bone dimensional changes with cone-beam computed tomography after space-opening procedures for an endosseous implant in patients with unilateral or bilateral maxillary lateral incisor agenesis.
A pilot retrospective cohort study was conducted of 11 patients (13 sites) in whom the canines had erupted less than 2 mm distally to the central incisors. Pretreatment and posttreatment scans obtained from 3 private practice offices were evaluated for changes in alveolar bone width, height, and labial concavity. A fiducial line representing the ideal location of the longitudinal axis of an endosseous dental implant was used as a reference for the spatial location of the alveolar bone at the lateral incisor site in reference to the adjacent tooth roots at posttreatment. The posttreatment width and height measurements scans were compared with normative data from the contralateral incisor in patients with unilateral agenesis (n = 6).
Alveolar bone width was significantly decreased on average from 17% to 25% along the height of the ridge (2-10 mm) (P <0.05). The labial concavity was significantly increased compared with the initial dimensions (P <0.05). No significant changes were found in alveolar bone ridge height.
Significant alveolar bone width decreases and increases in labial concavity were found after implant ridge development in patients with maxillary lateral incisor agenesis. The alveolar bone ridge was located more lingually than the adjacent teeth, suggesting a need for bone grafting to achieve proper fixture placement.
本研究的目的是评估单侧或双侧上颌侧切牙缺失患者在进行骨内种植体开窗术后，使用锥形束 CT 评估牙槽骨的尺寸变化。
这是一项在 3 家私人诊所进行的试点回顾性队列研究，纳入了 11 名患者（13 个位点），这些患者的尖牙远中向切牙萌出少于 2mm。对治疗前和治疗后的扫描图像进行评估，以评估牙槽骨宽度、高度和唇侧凹陷的变化。使用代表骨内牙种植体长轴理想位置的基准线作为参考，以评估治疗后侧切牙位点牙槽骨相对于相邻牙根的空间位置。将治疗后扫描的宽度和高度测量值与单侧缺失患者对侧同名牙的正常数据（n=6）进行比较。
牙槽骨宽度在牙槽嵴的高度上（2-10mm）平均减少了 17%至 25%（P<0.05）。与初始尺寸相比，唇侧凹陷显著增加（P<0.05）。牙槽骨嵴高度没有显著变化。
在上颌侧切牙缺失患者进行种植体牙槽嵴发育后，发现牙槽骨宽度显著减少，唇侧凹陷增加。牙槽骨嵴的位置比相邻牙齿更偏向舌侧，这表明需要进行植骨以实现适当的种植体放置。
