Angle Orthod. 2017 Sep;87(5):672-680. doi: 10.2319/102716-774.1. Epub 2017 May 29.
To quantify treatment-related changes in peridental bone height and thickness in orthodontic patients.
Cone-beam computed tomographs (CBCTs) of 43 patients (24 female, 19 male; mean age: 25 years, 5 months) who underwent orthodontic treatment with multibracket appliances for at least 1 year were chosen for retrospective evaluation. Dehiscence depth and changes in bone width and tooth inclination were determined for 954 teeth.
There was a significant decrease in peridental bone height (dehiscence; -0.82 ± 1.47 mm) and bone thickness (-0.56 ± 0.7 and -0.69 ± 0.9 mm at 5 mm and 10 mm apical to the CEJ, respectively) during treatment (P < .001). A significantly greater dehiscence depth with increased vertical bone loss occurred in patients older than 30 years. In patients <30 years old, approximately 20% of the teeth showed defect depths >2 mm before treatment. In 90% of these patients, at least one tooth was affected. The maxillary canines and all mandibular teeth showed a higher risk for vestibular bone loss. Treatment changes in tooth inclination were correlated with horizontal bone loss.
Based on these results, it seems reasonable to recommend that peridental bone in orthodontic patients older than 30 be evaluated on a routine basis due to the risk of increased vertical bone loss. Ninety percent of patients younger than 30 showed reduced bone height (dehiscence) of the periodontium of at least one tooth.
定量研究正畸患者牙周骨高度和厚度的治疗相关性变化。
选择 43 名(24 名女性,19 名男性;平均年龄:25 岁 5 个月)接受多托槽矫治器正畸治疗至少 1 年的患者的锥形束 CT(CBCT)进行回顾性评估。确定 954 颗牙齿的骨裂深度以及骨宽度和牙齿倾斜度的变化。
治疗过程中,牙周骨高度(骨裂)显著降低(-0.82 ± 1.47mm),骨厚度(颊侧 CEJ 根方 5mm 和 10mm 处分别为-0.56 ± 0.7mm 和-0.69 ± 0.9mm)也显著降低(P <.001)。年龄大于 30 岁的患者,骨裂深度随垂直骨丢失增加而显著增加。年龄小于 30 岁的患者中,约 20%的牙齿在治疗前存在深度>2mm 的缺损。在这些患者中,有 90%的患者至少有一颗牙齿受到影响。上颌尖牙和所有下颌牙齿都有较高的颊侧骨丢失风险。牙齿倾斜度的治疗变化与水平骨丢失相关。
基于这些结果,建议 30 岁以上的正畸患者常规评估牙周骨,因为他们存在垂直骨丢失增加的风险。90%的 30 岁以下患者中,至少有一颗牙齿的牙周骨高度(骨裂)降低。