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基于锥形束 CT 分析的 III 类错(牙合)患者下颌不对称类型和牙代偿差异。

Mandibular asymmetry types and differences in dental compensations of Class III patients analyzed with cone-beam computed tomography.

出版信息

Angle Orthod. 2023 Nov 1;93(6):695-705. doi: 10.2319/013023-73.1.

Abstract

OBJECTIVES

To assess differences in dental compensation of the incisors and first molars in skeletal Class III patients with roll-, yaw-, and translation-dominant mandibular asymmetries.

MATERIALS AND METHODS

A total of 90 skeletal Class III adult patients (mean age, 22.00 ± 3.31 years; range, 18-37.9 years) with facial asymmetry were enrolled and divided into the roll-, yaw-, and translation-dominant type groups (n = 30 per group). The vertical, transverse, and anteroposterior distances and axial angles of the teeth were measured using cone-beam computed tomography images. The measurements were compared between the deviated and nondeviated sides using a paired t-test and among the three groups using one-way analysis of variance with a Tukey post hoc test.

RESULTS

The roll-dominant groups showed the greatest values for the bilateral difference in the vertical position of the maxillary (2.42 ± 1.24 mm) and mandibular molars (2.23 ± 1.28 mm; P < .001). The transverse deviations of the maxillary (2.19 ± 1.51 mm) and mandibular incisors (-2.11 ± 1.39 mm) were greater in the yaw-dominant groups than those of other groups. Regarding tooth axial angle, the yaw-dominant group showed the greatest tipping of the mandibular incisor (-4.13 ± 3.30°; P < .001).

CONCLUSIONS

Dental compensation differed depending on the type of facial asymmetry. The roll-dominant type showed more vertical compensation of the posterior teeth, whereas the yaw-dominant type exhibited more tipping of the molars and incisors. By precisely assessing dental compensation in each asymmetry type, sufficient dental decompensation could be achieved.

摘要

目的

评估下颌骨不对称中以滚转、偏航和平移为主导的骨性 III 类患者切牙和第一磨牙的牙齿补偿差异。

材料和方法

共纳入 90 名面部不对称的骨性 III 类成年患者(平均年龄 22.00 ± 3.31 岁;年龄范围 18-37.9 岁),并将其分为以滚转、偏航和平移为主导的类型组(每组 30 名)。使用锥形束 CT 图像测量牙齿的垂直、横向和前后距离和轴角。使用配对 t 检验比较偏侧和非偏侧侧之间的测量值,并使用单因素方差分析和 Tukey 事后检验比较三组之间的测量值。

结果

以滚转为主导的组显示上颌(2.42 ± 1.24 mm)和下颌磨牙(2.23 ± 1.28 mm)垂直位置双侧差异的最大差值(P <.001)。偏航为主导的组中,上颌(2.19 ± 1.51 mm)和下颌切牙的横向偏差(-2.11 ± 1.39 mm)大于其他组。关于牙齿轴向角度,偏航为主导的组显示下颌切牙最大的倾斜(-4.13 ± 3.30°;P <.001)。

结论

牙齿补偿因面部不对称类型而异。滚转主导型表现出后牙更多的垂直补偿,而偏航主导型则表现出更多的磨牙和切牙倾斜。通过准确评估每种不对称类型的牙齿补偿,可以实现足够的牙齿补偿不足。

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