Wang X C, Wang L, Gu Y, Wang Y H, Zhao C Y
Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University & Institute of Stomatology, Nanjing Medical University, Nanjing 210029, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2019 Nov 9;54(11):739-744. doi: 10.3760/cma.j.issn.1002-0098.2019.11.004.
To analyze the treatment efficacy in the vertically impacted maxillary central incisors using cone-beam CT (CBCT) and explore the treatment timing and the influence of orthodontic traction on the root development and alveolar bone height in the mixed dentition. Twenty-two patients with vertically impacted maxillary central incisor who were admitted to the Department of Orthodontics, Stomatological Hospital affiliated to Nanjing Medical University from December 2012 to December 2017 were selected [12 males and 10 females, (9.2±0.9) years]. Based on the dental age, patients were classified as early treatment group (teeth ranging from a third to two thirds of root formation, 12) and late treatment group (teeth with nearly or fully complete root formation, 10). The contralateral maxillary central incisor was used as the control. Three-dimensional reconstruction of CBCT before treatment, after treatment and one year after treatment was carried out to measure root length, tooth surface area, tooth volume, labial and lingual apical alveolar bone thickness, the loss of labial alveolar bone height and intraosseous root ratio. The clinical crown length was measured in the mouth. The difference values of the measurement variables between the impacted teeth and the control teeth were calculated and analyzed(measurement values of impacted teeth were subtracted from control values). The values of root length difference beween the impacted teeth and the control teeth in the early and late treatment group were (1.58±1.56) mm and (2.57±1.00) mm, respectively after the treatment and the values were significantly less than those corresponding values before treatment [(3.47±1.40) and (3.36±0.79) mm] (0.05). After the treatment, the values of the surface area and volume difference between the impacted teeth and the control teeth in the early treatment group [(0±34) mm(2) and (-10±44) mm(3)] were significantly less than those corresponding values before treatment [(38±31) mm(2) and (55±70) mm(3)] (0.05). The value differences of any measurement variables between the early and late treatment group were not significantly different after the treatment (0.05). The root length and intraosseous root ratio of the impacted teeth after the treatment in the early and late treatment group were significantly less than those of the control teeth after the treatment (0.05). The clinical crown length, the loss of labial alveolar bone height of the impacted teeth after the treatment were significantly larger than those of the control teeth after the treatment (0.05). Orthodontic traction promoted the root growth and development of the vertically impacted maxillary central incisors. However, the root length and alveolar bone height still cannot reach the normal level after treatment. Treatment timing had no effect on root development and alveolar bone height of vertically impacted maxillary central incisors in mixed dentition.
分析锥形束CT(CBCT)在上颌中切牙垂直阻生治疗中的疗效,探讨混合牙列期的治疗时机以及正畸牵引对牙根发育和牙槽骨高度的影响。选取2012年12月至2017年12月在南京医科大学附属口腔医院正畸科就诊的22例上颌中切牙垂直阻生患者[男12例,女10例,(9.2±0.9)岁]。根据牙龄,将患者分为早期治疗组(牙根形成1/3至2/3,12例)和晚期治疗组(牙根近完全形成或完全形成,10例)。以对侧上颌中切牙作为对照。在治疗前、治疗后及治疗后1年进行CBCT三维重建,测量牙根长度、牙表面积、牙体积、唇侧和舌侧根尖牙槽骨厚度、唇侧牙槽骨高度丧失及骨内牙根比。在口腔内测量临床冠长度。计算并分析患牙与对照牙测量变量的差值(对照值减去患牙测量值)。治疗后早期和晚期治疗组患牙与对照牙的牙根长度差值分别为(1.58±1.56)mm和(2.57±1.00)mm,均显著小于治疗前相应值[(3.47±1.40)和(3.36±0.79)mm](P<0.05)。治疗后,早期治疗组患牙与对照牙的表面积和体积差值[(0±34)mm²和(-10±44)mm³]显著小于治疗前相应值[(38±31)mm²和(55±70)mm³](P<0.05)。治疗后早期和晚期治疗组各测量变量的差值差异无统计学意义(P>0.05)。早期和晚期治疗组治疗后患牙的牙根长度和骨内牙根比均显著小于治疗后对照牙(P<0.05)。治疗后患牙的临床冠长度、唇侧牙槽骨高度丧失均显著大于治疗后对照牙(P<0.05)。正畸牵引促进了上颌中切牙垂直阻生牙根的生长发育。然而,治疗后牙根长度和牙槽骨高度仍未达到正常水平。治疗时机对混合牙列期上颌中切牙垂直阻生的牙根发育和牙槽骨高度无影响。