Lupi J E, Handelman C S, Sadowsky C
Department of Orthodontics, University of Illinois, Chicago, College of Dentistry, USA.
Am J Orthod Dentofacial Orthop. 1996 Jan;109(1):28-37. doi: 10.1016/s0889-5406(96)70160-9.
This study assessed the frequency of root resorption and alveolar bone loss in 88 adults who had undergone orthodontic treatment. Pretreatment and posttreatment periapical radiographs were used to determine the amount of external apical root resorption and alveolar bone loss of the maxillary and mandibular incisors. Alveolar bone loss in the posterior quadrants was determined from bite-wing radiographs. The number of incisors showing root resorption, including blunting, increased from 15% before treatment to 73% after treatment. The number of incisors having moderate to severe apical root resorption was 2% before treatment and 24.5% after treatment. The number of anterior sites in which loss of alveolar bone height exceeded 2 mm from the cementoenamel junction to the alveolar crest increased from 19% before treatment to 37% after treatment; the number of posterior sites was 7% before treatment and 14% after treatment. Bone LOSS > or = 1.5 mm from the pretreatment to posttreatment stages occurred in 11% of the incisors and 3% of the posterior sites. A marked increase in the prevalence of root resorption and alveolar bone loss occurred over the course of treatment. The prevalence of iatrogenic effects for adults may be higher for incisors than in previously reported adolescent studies. A small subgroup with multiple sites of either root resorption or bone loss account for a disproportionate number of iatrogenic sequelae. However, in general, the iatrogenic experience did not preclude the orthodontic treatment of adults.
本研究评估了88名接受过正畸治疗的成年人牙根吸收和牙槽骨丧失的发生率。治疗前和治疗后的根尖片用于确定上颌和下颌切牙的根尖外吸收量和牙槽骨丧失情况。后牙象限的牙槽骨丧失通过咬合翼片确定。出现牙根吸收（包括根尖钝圆）的切牙数量从治疗前的15%增加到治疗后的73%。治疗前有中度至重度根尖吸收的切牙数量为2%，治疗后为24.5%。从牙骨质釉质界到牙槽嵴牙槽骨高度丧失超过2mm的前牙部位数量从治疗前的19%增加到治疗后37%；后牙部位治疗前为7%，治疗后为14%。从治疗前到治疗后阶段牙槽骨丧失≥1.5mm的情况在11%的切牙和3%的后牙部位出现。在治疗过程中，牙根吸收和牙槽骨丧失的发生率显著增加。成人医源性影响的发生率对于切牙可能高于先前报道的青少年研究。有多个牙根吸收或骨丧失部位的一小部分亚组占医源性后遗症的比例过高。然而，总体而言，医源性情况并不妨碍对成人进行正畸治疗。
