切牙管与上颌中切牙位置关系的定量研究

摘要/Abstract

摘要： 目的本研究旨在通过研究切牙管与上颌中切牙之间的位置关系，以期为临床治疗及后续研究提供借鉴和参考。方法选取76例正在进行正畸治疗的成人患者，以PP平面为参考平面，在正中矢状面上定义以下三个测量水平，此三个水平均与PP平面平行。N水平：鼻腭孔高度水平；R水平：上颌中切牙牙根根尖高度水平；I水平：切牙孔高度水平。定义以下测量项目：N水平切牙管唇侧牙槽骨板厚度（NT）；R水平切牙管唇侧牙槽骨板厚度（RT）；I水平切牙管唇侧牙槽骨板厚度（IT）。N水平切牙管宽度（NW）；R水平切牙管宽度（RW）；I水平切牙管宽度（IW）；上颌中切牙根尖距离（RR）；R水平UR1到切牙管距离（RRD）；R水平UL1到切牙管距离（RLD）；I水平UR1到切牙管距离（IRD）；I水平UL1到切牙管距离（ILD）。在CBCT图像上对以上指标进行测量，并对结果进行统计学分析。结果 RRD大于IRD；RLD大于ILD，有统计学差异（P<0.05）。RRD与RLD；IRD与ILD，无统计学差异（P＞0.05）。NW小于RW；RW小于IW，有统计学差异（P<0.05）。NT大于RT，有统计学差异（P<0.05）；NT与IT之间无显著性差异（P＞0.05）；RT与IT之间无显著性差异（P＞0.05）。结论 U1根尖至切牙管平均距离仅为3.5 mm；U1在I水平牙根至切牙管平均距离仅为2.4 mm，应注意在上颌前牙内收时有可能导致牙根根尖及牙根舌侧面的吸收。并且当上颌前牙内收尤其配合压低移动时，应注意有可能造成牙根近中邻面的吸收。

关键词: 切牙管, 上颌中切牙, 上前牙内收, CBCT

Abstract: Objective To study the positional relationship between the incisive canal and the maxillary central incisors, in order to provide reference for clinical treatment and subsequent research. Methods Seventysix adults undergoing orthodontic treatment were selected. Three measurement levels were defined on the CBCT image, and the measurement level paralleling to PP plane included:nasopalatine foramen level (N), root tip level (R), incisive foramen level (I). The following measuring projects were defined, the N level incisive canal lip side alveolar bone plate thickness (NT), R level incisive canal lip side alveolar bone plate thickness (RT), I level incisive canal lip side alveolar bone plate thickness (IT), N level incisive canal width (NW), R level incisive canal width (RW), I level incisive canal width (IW), the maxillary central incisor apex distance (RR), R level UR1 to incisive canal distance (RRD), R level UL1 to incisive canal distance RLD, I level UR1 to incisive canal distance (IRD), I level UL1 to incisive canal distance (ILD). The above projects were measured on CBCT images and the results were statistically analyzed. Results RRD was g reater than IRD, RLD was greater than ILD, and the difference was statistically significant (P<0.05). There was no significant difference between RRD and RLD, IRD and ILD (P>0.05). NW was less than RW; RW was less than IW, and there was a statistical difference (P<0.05). NT was greater than RT, with a statistical difference (P<0.05). There was no significant difference between NT and IT (P>0.05). There was no significant difference between RT and IT (P>0.05). Conclusion The average distance from the root tip of U1 to the incisive canal is only 3.5 mm, while the Ilevel average distance from the root of the U1 to the incisive canal is only 2.4 mm. It should be noted that the retraction of the maxillary anterior teeth may lead to the absorption of the root apex and the lateral side of the root. When the retraction of the maxillary anterior teeth is especially matched with the intrusion movement, attention should be paid to the possibility of the absorption of the mesial surface of the roots.

Key words: incisive canal, maxillary central incisors, maxillary anterior teeth retraction, cone beam computed tomography

中图分类号:

R783.5

颜冬施雨佳葛悦包涵谢宁朱宪春. 切牙管与上颌中切牙位置关系的定量研究[J]. 口腔医学, 2021, 41(7): 627-630.

参考文献 20

[1]	SARVER D M.The importance of incisor positioning in the esthetic smile: the smile arc[J].American Journal of Orthodontics and Dentofacial Orthopedics, 2001, 120(2):98-111
[2]	SARVER D M.Interactions of hard tissues,soft tissues,and growth over time,and their impact on orthodontic diagnosis and treatment planning[J].American Journal of Orthodontics and Dentofacial Orthopedics, 2015, 148(3):380-386
[3]	TURLEY P K.Evolution of esthetic considerations in orthodontics[J].American Journal of Orthodontics and Dentofacial Orthopedics, 2015, 148(3):374-379
[4]	YANG S, GUO Y, YANG X, et al.Effect of mesiodistal angulation of the maxillary central incisors on esthetic perceptions of the smile in the frontal view[J].American Journal of Orthodontics and Dentofacial Orthopedics, 2015, 148(3):396-404
[5]	陈扬熙.口腔正畸学——基础、技术与临床[M]. 北京: 人民卫生出版社, 2012: 568-569.
[6]	许天民.传统最大支抗控制方式对磨牙控制的研究[C]. 中国广东深圳:2006.
[7]	CHUNG C J, CHOI Y J, KIM K H.Approximation and contact of the maxillary central incisor roots with the incisive canal after maximum retraction with temporary anchorage devices: Report of 2 patients[J].American Journal of Orthodontics and Dentofacial Orthopedics, 2015, 148(3):493-502
[8]	HANDELMAN C S.The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae[J].The Angle Orthodontist, 1996, 66(2):95-110
[9]	KAPILA S D, NERVINA J M.CBCT in orthodontics: assessment of treatment outcomes and indications for its use[J].Dento Maxillo Facial Radiology, 2015, 44(1):20140280-20140280
[10]	VENKATESH E, ELLURU S V.Cone beam computed tomography: basics and applications in dentistry[J].Journal of Istanbul University Faculty of Dentistry, 2017, 51(3 Suppl 1):S102-S121
[11]	MATSUMURA T, ISHIDA Y, KAWABE A, et al.Quantitative analysis of the relationship between maxillary incisors and the incisive canal by cone-beam computed tomography in an adult Japanese population[J].Progress in Orthodontics, 2017, 18(1):24-24
[12]	CHO E A, KIM S J, CHOI Y J, et al.Morphologic evaluation of the incisive canal and its proximity to the maxillary central incisors using computed tomography images[J].The Angle Orthodontist, 2016, 86(4):571-576
[13]	戴静桃，李平，李安，等.切牙管与上颌中切牙牙根位置关系的研究[J].中国美容医学, 2014, 23(22):1904-1908
[14]	PAN Y, CHEN S.Contact of the incisive canal and upper central incisors causing root resorption after retraction with orthodontic mini-implants: A CBCT study[J].The Angle Orthodontist, 2019, 89(2):200-205
[15]	JIA X, HU W, MENG H.Relationship of central incisor implant placement to the ridge configuration anterior to the nasopalatine canal in dentate and partially edentulous individuals: a comparative study[J]. PeerJ. 2015, 3: e1315.[J].PeerJ, 2015, 3(3):e1315-e1315
[16]	GONUL Y, BUCAK A, ATALAY Y, et al.MDCT evaluation of nasopalatine canal morphometry and variations: An analysis of 100 patients[J].Diagnostic and Interventional Imaging, 2016, 97(11):1165-1172
[17]	ZHOU Z, CHEN W, SHEN M, et al.Cone beam computed tomographic analyses of alveolar bone anatomy at the maxillary anterior region in Chinese adults[J].Journal of Biomedical Research, 2014, 28(6):498-505
[18]	吴亚芸，牛忠英，闫澍，等.汉族人上颌中切牙牙根直径及根管管径与年龄关系的研究[J]. 实用口腔医学杂志. 2015, 31(06): 784-788.[J].实用口腔医学杂志, 2015, 31(06):784-788
[19]	KHOJASTEPOUR L, HAGHNEGAHDAR A, KESHTKAR M.Morphology and Dimensions of Nasopalatine Canal: a Radiographic Analysis Using Cone Beam Computed Tomography[J].Journal of Dentistry (Shiraz, Iran), 2017, 18(4):244-250
[20]	BORNSTEIN M M, BALSIGER R, SENDI P, et al.Morphology of the nasopalatine canal and dental implant surgery: a radiographic analysis of 100 consecutive patients using limited cone-beam computed tomography[J].Clinical Oral Implants Research, 2011, 22(3):295-301