Mao M X, Xu L, Jing W D, Xu X, Hou J X, Li X T, Wang X X
Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Department of Periodontology, Peking Union Medical College Hospital, Beijing 100032, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Feb 18;52(1):77-82. doi: 10.19723/j.issn.1671-167X.2020.01.012.
To measure the distance from cemento-enamel junction (CEJ) to alveolar crest (AC) of labial side of anterior teeth on skeletal Angle class III patients under direct vision during periodontal bone augmentation surgery and to make relevant analysis to find the relevant factors.
In the study, 46 skeletal Angle class III patients (10 males and 36 females) received periodontal bone augmentation surgery of anterior teeth were included, with 67 jaws (27 maxillae and 40 mandibles) and 400 anterior teeth (161 maxillary anterior teeth and 239 mandibular anterior teeth). The mean age was 23.65 years. Maxillary anterior teeth consisted of 54 central incisors, 53 lateral incisors and 54 canines. Mandibular anterior teeth consisted of 79 central incisors, 80 lateral incisors and 80 canines. CEJ-AC was measured in three sites (mesial sites, central sites and distal sites) by Williams periodontal probes during periodontal bone augmentation surgery under direct vision by the same researcher.
The average CEJ-AC of 400 anterior teeth was (2.21±1.48) mm. The average CEJ-AC of maxillary anterior teeth was (1.72±1.13) mm, more than (2.54±1.60) mm of mandibular anterior teeth (P<0.05). The average CEJ-AC of canines was (2.42±1.78) mm, more than (2.06±1.27) mm of central incisors or (2.16±1.32) mm of lateral incisors (P<0.05). The average CEJ-AC of central sites was (3.04±2.01) mm, more than (1.79±0.86) mm of mesial sites or (1.81±0.89) mm of distal sites (P<0.05). CEJ-AC of 233 anterior teeth was more than 2 mm, accounting for 58.25%, and 117 anterior teeth with dehiscence were found, accounting for 29.25%. Multilevel and multivariate Logistic regression showed age, jaw, tooth and site were the relevant factors to the position of alveolar crest.
The position of alveolar crest of skeletal Angle class III patients who received periodontal bone augmentation surgery was lower than that of the general population, causing periodontal risks during decompensation orthodontics therapy before orthognathic surgery. The position of alveolar crest was lower in older patients than in younger patients, in mandibular teeth than in maxillary teeth, in canines than in central incisors or lateral incisors, and in central sites than in mesial sites or distal sites of labial side, which showed much higher risk.
在直视下测量骨性安氏III类错颌患者前牙唇侧牙骨质-釉质界(CEJ)至牙槽嵴顶(AC)的距离,并进行相关分析以找出相关因素。
本研究纳入46例接受前牙牙周骨增量手术的骨性安氏III类错颌患者(男10例,女36例),共67个颌骨(上颌27个,下颌40个)及400颗前牙(上颌前牙161颗,下颌前牙239颗)。平均年龄23.65岁。上颌前牙包括54颗中切牙、53颗侧切牙和54颗尖牙。下颌前牙包括79颗中切牙、80颗侧切牙和80颗尖牙。在牙周骨增量手术过程中,由同一名研究人员在直视下用Williams牙周探针在三个部位(近中部位、中央部位和远中部位)测量CEJ-AC。
400颗前牙的平均CEJ-AC为(2.21±1.48)mm。上颌前牙的平均CEJ-AC为(1.72±1.13)mm,低于下颌前牙的(2.54±1.60)mm(P<0.05)。尖牙的平均CEJ-AC为(2.42±1.78)mm,高于中切牙的(2.06±1.27)mm或侧切牙的(2.16±1.32)mm(P<0.05)。中央部位的平均CEJ-AC为(3.04±2.01)mm,高于近中部位的(1.79±0.86)mm或远中部位的(1.81±0.89)mm(P<0.05)。233颗前牙的CEJ-AC大于2mm,占58.25%,发现117颗前牙有骨裂,占29.25%。多水平多因素Logistic回归显示年龄、颌骨、牙齿和部位是牙槽嵴位置的相关因素。
接受牙周骨增量手术的骨性安氏III类错颌患者牙槽嵴位置低于一般人群,在正颌手术前的正畸代偿治疗过程中存在牙周风险。牙槽嵴位置在老年患者中低于年轻患者,在下颌牙中低于上颌牙,在尖牙中高于中切牙或侧切牙,在唇侧中央部位高于近中部位或远中部位,显示出更高的风险。