前牙美学区微型螺钉植入的最佳部位：针对不同垂直骨面型的锥形束CT研究
Optimal sites for miniscrew insertion in anterior aesthetic region: a CBCT study for different vertical skeletal patterns.
作者信息
Feng Xiaoyan, Weng Luxi, Li Xin, Shen Yiyang, Lin Jun
机构信息
Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China.
出版信息
BMC Oral Health. 2025 Jul 11;25(1):1148. doi: 10.1186/s12903-025-06538-6.
INTRODUCTION
The objective of this retrospective cohort study was to measure the root distance, bone thickness and bone density in maxillary anterior region with different vertical skeletal patterns based on CBCT data, and provide reference for the optimal site for miniscrew insertion in anterior aesthetic region.
METHODS
60 adult patients(18-29years) with skeletal Class I angle (ANB angle = 2° ± 2°) were selected and divided into three groups (n = 20) according to vertical skeletal patterns.The population was divided into 3 groups according to the measured SN-GoGn angle: hypodivergent (SN-GoGn < 27°), average (27°≤ SN-GoGn ≤ 37°) and hyperdivergent (SN-GoGn > 37°) groups. The CBCT data was processed and measured by Dolphin Imaging and Mimics Medical. Measurement indicators included interradicular distances (IRD), overall bone thickness (OBT), cortical bone thickness (CBT), cortical and cancellous bone density (CoBD & CaBD). One-way ANOVA test of variance was used for statistical comparisons.
RESULTS
IRD increased with apical height, reaching an maximum average measurement of 4.750 ± 1.226 mm at 10 mm axial section. Within the same axial section, the IRD of the region between the two central incisors was significantly larger than that of the other regions. There was no statistical difference in IRD among different vertical skeletal patterns. OBT increased with vertical height in the 2-6 mm axial sections, and no significant difference among three groups. There was a statistical difference of the CBT at 4-8 mm axial sections among the three groups (P < 0.05), but not at 10 mm axial section. There was no statistical difference (P < 0.05) of CaBD among different vertical skeletal patterns. However, there are statistically difference of CoBD in many regions between hypodivergent and hyperdivergent groups.
CONCLUSIONS
The anatomical structure in anterior aesthetic region of individuals varies greatly, and interradicular distances is not affected by vertical skeletal pattern. However, in general, hypodivergent patients have higher bone density and greater bone thickness than that of hyperdivergent patients, which means more safe regions to choose for miniscrew insertion.
引言
本回顾性队列研究的目的是基于锥形束计算机断层扫描（CBCT）数据，测量不同垂直骨骼型上颌前部区域的牙根间距、骨厚度和骨密度，为前牙美学区域微螺钉植入的最佳部位提供参考。
方法
选取60例成年患者（18 - 29岁），均为安氏I类骨面型（ANB角 = 2° ± 2°），根据垂直骨骼型分为三组（每组n = 20）。根据测量的SN - GoGn角将人群分为三组：低角型（SN - GoGn < 27°）、平均角型（27°≤ SN - GoGn ≤ 37°）和高角型（SN - GoGn > 37°）。CBCT数据由Dolphin Imaging和Mimics Medical软件处理并测量。测量指标包括牙根间距（IRD）、整体骨厚度（OBT）、皮质骨厚度（CBT）、皮质骨和松质骨密度（CoBD和CaBD）。采用单因素方差分析进行统计学比较。
结果
牙根间距随根尖高度增加，在轴向10mm处达到最大平均测量值4.750 ± 1.226mm。在同一轴向平面内，两颗中切牙之间区域的牙根间距显著大于其他区域。不同垂直骨骼型之间的牙根间距无统计学差异。在轴向2 - 6mm平面内，整体骨厚度随垂直高度增加，三组之间无显著差异。三组在轴向4 - 8mm平面内的皮质骨厚度有统计学差异（P < 0.05），但在轴向10mm平面内无差异。不同垂直骨骼型之间的松质骨密度无统计学差异（P < 0.05）。然而，低角型和高角型组在许多区域的皮质骨密度有统计学差异。
结论
个体前牙美学区域的解剖结构差异很大，牙根间距不受垂直骨骼型影响。然而，一般来说，低角型患者比高角型患者具有更高的骨密度和更大的骨厚度，这意味着微螺钉植入有更多安全区域可供选择。
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