Chen Xiang, Zhang Xiang-Feng, Huang Qian-Qian, Zhang Yi, Wang Hua-Qiao
Department of Orthodontics,The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education. Chongqing 401147. E-mail:
Shanghai Kou Qiang Yi Xue. 2018 Apr;27(2):150-155.
The aim of this clinical study was to evaluate the changes of alveolar bone morphology before and after upper incisors retraction with mini implant anchorage using cone-beam CT (CBCT).
Twenty-two young patients with dentoalveolar maxillary protrusion and extraction of 2 maxillary first premolars were evaluated with CBCT. CBCT scans were obtained before treatment and 3 months after retraction of the incisors. The movement patterns of the upper incisors were assessed with Mimics15.0. The labial and palatal alveolar plates at crest level, midroot level, and apical level for bone-thickness changes and labial and palatal vertical bone level during retraction of the maxillary anterior segments were assessed with Invivo5.0. Paired t tests were used to evaluate the changes.
The edge of the maxillary incisor and the root apex appeared lingual movement horizontally, but the moving distance was larger than the root apex. The edge of the incisors was moved downward, and the root apex was moved upward obviously. The palatal thickness and total thickness of the alveolar bone showed significant decrease at the crest level and midroot level after retraction while the apical level showed significant increase(P<0.05). The palatal vertical bone level also showed great loss (P<0.05).
After extensive retraction of the maxillary incisors, tilt movements are controlled with high traction hooks and microscrew implants. The decreases in palatal bone thickness are much more significant compared with the increases in labial bone thickness. Alveolar bone remodeling doesn't follow the movement of tooth, suggesting that the limitation of anterior teeth retraction should be taken into consideration.
本临床研究旨在使用锥形束CT(CBCT)评估微型种植体支抗内收上颌前牙前后牙槽骨形态的变化。
对22例患有牙性上颌前突且拔除2颗上颌第一前磨牙的年轻患者进行CBCT评估。在治疗前和内收前牙3个月后进行CBCT扫描。使用Mimics15.0评估上颌前牙的移动模式。使用Invivo5.0评估上颌前段内收过程中牙槽嵴顶、牙根中部和根尖水平处唇侧和腭侧牙槽骨板的厚度变化以及唇侧和腭侧垂直骨水平。采用配对t检验评估变化情况。
上颌切牙边缘和根尖在水平方向出现舌向移动,但切牙边缘移动距离大于根尖。切牙边缘向下移动,根尖明显向上移动。内收后牙槽嵴顶和牙根中部水平处腭侧骨厚度和总骨厚度显著降低,而根尖水平处显著增加(P<0.05)。腭侧垂直骨水平也有明显降低(P<0.05)。
上颌前牙大量内收后,使用高位牵引钩和微螺钉种植体控制倾斜移动。与唇侧骨厚度增加相比,腭侧骨厚度降低更为显著。牙槽骨重塑不随牙齿移动,提示应考虑前牙内收的限度。