Morris Jason W, Campbell Phillip M, Tadlock Larry P, Boley Jimmy, Buschang Peter H
Private Practice, San Diego, Calif.
Department of Orthodontics, Baylor College of Dentistry, Texas A&M Health Health Science Center, Dallas, Tex.
Am J Orthod Dentofacial Orthop. 2017 May;151(5):851-859. doi: 10.1016/j.ajodo.2016.09.027.
This study was designed to evaluate the long-term prevalence of gingival recession after orthodontic tooth movements, focusing on the effects of mandibular incisor proclination and expansion of maxillary posterior teeth.
Records of 205 patients (162 female, 43 male) were obtained from 2 private practice orthodontists. Using pretreatment (age, 14.0 ± 5.9 years) and posttreatment (age, 16.5 ± 6.0 years) lateral cephalograms and dental models, mandibular incisor proclination and maxillary arch widths were measured. Gingival recession was measured based on posttreatment and postretention (age, 32.3 ± 8.5 years) intraoral photographs and models. Associations between tooth movements and gingival recession were evaluated statistically.
Only 5.8% of teeth exhibited recession at the end of orthodontic treatment (only 0.6% had recession >1 mm). After retention, 41.7% of the teeth showed recession, but the severity was limited (only 7.0% >1 mm). There was no relationship between mandibular incisor proclination during treatment and posttreatment gingival recession. Incisors that finished treatment angulated (IMPA) at 95° or greater did not show significantly more recession than did those that finished less than 95°. There were weak positive correlations (r = 0.17-0.41) between maxillary arch width increases during treatment and posttreatment recession.
Orthodontic treatment is not a major risk factor for the development of gingival recession. Although greater amounts of maxillary expansion during treatment increase the risks of posttreatment recession, the effects are minimal.
本研究旨在评估正畸牙齿移动后牙龈退缩的长期患病率,重点关注下颌切牙前倾和上颌后牙扩弓的影响。
从2名私人执业正畸医生处获取了205例患者(162例女性,43例男性)的记录。使用治疗前(年龄14.0±5.9岁)和治疗后(年龄16.5±6.0岁)的头颅侧位片和牙模,测量下颌切牙前倾度和上颌牙弓宽度。根据治疗后和保持后(年龄32.3±8.5岁)的口腔内照片和模型测量牙龈退缩情况。对牙齿移动与牙龈退缩之间的关联进行统计学评估。
在正畸治疗结束时,仅有5.8%的牙齿出现退缩(退缩>1mm的仅占0.6%)。保持后,41.7%的牙齿出现退缩,但严重程度有限(>1mm的仅占7.0%)。治疗期间下颌切牙前倾与治疗后牙龈退缩之间无关联。治疗结束时倾斜度(IMPA)为95°或更大的切牙,其退缩情况并不比倾斜度小于95°的切牙明显更严重。治疗期间上颌牙弓宽度增加与治疗后退缩之间存在弱正相关(r=0.17 - 0.41)。
正畸治疗不是牙龈退缩发生的主要危险因素。尽管治疗期间上颌扩弓量增加会增加治疗后退缩的风险,但影响很小。