腭正中旁区支持组织厚度和腭穹窿形态相关性的三维评估

doi:10.13591/j.cnki.kqyx.2024.01.008

摘要/Abstract

摘要：

目的本研究拟通过应用锥形束计算机体层摄影术(cone beam computed tomography, CBCT),测量不同腭穹窿形态的正畸患者在腭正中旁区域腭部支持组织厚度,分析腭正中旁区种植支抗钉植入的安全区域,为临床正畸治疗提供参考。方法随机招募青少年正畸患者72例(男36例,女36例),根据腭穹窿高宽比分为高穹窿组和低穹窿组,使用CBCT图像分析法测量受试者上颌腭正中旁区各位点的支持组织厚度。结果第三腭皱襞处的黏膜厚度均高于其他位点,腭部黏膜由内向外呈逐渐增厚的趋势,高穹窿组腭部黏膜普遍厚于低穹窿组;腭部骨和总支持组织厚度从前后方向上均呈现中间高、两侧低的特点,在第三腭皱襞后2 mm处腭部骨组织厚度最大,在第三腭皱襞前4 mm及其前方部位,从内向外骨组织厚度逐渐增高,其后的部位反之,低穹窿组骨支持组织厚度普遍高于高穹窿组;腭部总支持组织在第三腭皱襞处及其后方2 mm内腭部总组织厚度最大,从内向外总支持组织厚度逐渐增加,低穹窿组骨支持组织厚度稍高于高穹窿组。结论在低穹窿组患者腭部植入微种植支抗具有更高的稳定性;在距腭中缝旁5~9 mm、第三腭皱襞及其后方2 mm的范围内更适合高穹窿组患者植入微种植支抗。

关键词: 腭正中旁区, 微种植支抗, 腭穹窿形态, CBCT

Abstract:

Objective To measure the thickness of palatal supporting tissue in the paramedian section of the palate in orthodontic patients with different palatal vault morphology by cone beam computed tomography(CBCT), and analyze the safe area of placement of orthodontic mini-implants in the paramedian section of the palate, so as to provide reference for clinical orthodontic treatment. Methods A total of 72 adolescent orthodontic patients(36 males and 36 females)were randomly recruited. According to the height width ratio of the palatal vault, they were divided into the high palatal vault group and the low palatal vault group. CBCT image analysis method was used to measure the thickness of supporting tissue at various points in the maxillary paramedian region. Results The thickness of mucosa at the third palatal ruga was higher than that at other sites, and the palatal mucosa gradually thickened from inside to outside. It was generally thicker in the high palatal vault group than that in the low palatal vault group. The thickness of palatal bone and total supporting tissue was high in the middle and low on both sides from the anterior and posterior directions. The thickness of palatal bone tissue was the largest at 2 mm behind the third palatal ruga and it gradually increased from inside to outside at 4 mm before the third palatal ruga, and the position behind it was the opposite. It was generally higher in the low palatal vault group than that in the high palatal vault group. The thickness of the total supporting tissue of the palate was the largest at the third palatal ruga and 2 mm behind it. It gradually increased from inside to outside and in the low palatal vault group, it was slightly higher than that in the high palatal vault group. Conclusion In the low palatal vault group, the palatal micro-implant anchorage has higher stability. It is more suitable for patients in the high palatal vault group to implant micro-implant anchorage within the range of 5-9 mm away from the mid palatal suture and 2 mm behind the third palatal ruga.

Key words: paramedian section of the palate, micro-implant anchorage, palatal vault morphology, CBCT

中图分类号:

R783.5

周举, 马俊青. 腭正中旁区支持组织厚度和腭穹窿形态相关性的三维评估[J]. 口腔医学, 2024, 44(1): 36-40.

ZHOU Ju, MA Junqing. Three-dimensional evaluation of the correlation between thickness of supporting tissue in the palatal paramedian section and palatal vault morphology[J]. Stomatology, 2024, 44(1): 36-40.

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参考文献 19

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位点	MT			BST			TST
位点	TR	R2	R4	TR	R2	R4	TR	R2	R4
A8	^d2.93±0.71^b	^gh3.18±0.80^ab	^m3.47±0.78^a	ⁱ2.33±1.30^b	^o2.65±0.92^ab*	^t3.11±1.11^a*	ⁱ5.26±1.34^b	^o5.83±1.01^a*	^u6.58±1.27^a*
A6	^de2.73±0.75^c	^gh3.26±0.89^b	^lm3.75±0.98^a	^h2.69±1.54^b	ⁿ2.89±1.30^ab*	^s3.17±1.23^a*	^h5.42±1.30^b*	ⁿ6.14±1.66^a	^t6.92±1.73^a
A4	^ef2.34±0.84^c*	^h3.09±0.94^b	^kl4.28±1.27^a	^g4.90±2.13^a	^m5.16±1.79^a*	^r5.37±1.59^a*	^g7.24±2.02^b	^m8.29±1.93^a*	^s9.65±2.39^a
A2	^f2.10±0.74^c	^h3.13±1.13^b	^jk4.57±1.39^a	^f6.67±2.54^a	^l6.18±1.98^a*	^q5.81±2.00^a	^f8.77±2.45^a	^l9.31±2.59^a*	^r10.38±2.54^a
TR	^de2.78±0.93^c*	^g3.80±1.39^b	ⁱ5.31±1.43^a	^d8.33±2.34^a*	^j8.15±2.28^a	^p8.01±2.84^a	^d11.11±2.37^a*	^j11.95±2.73^a	^p13.32±3.14^a
P2	^de2.56±0.97^c*	^gh3.48±1.50^b	^ijk4.88±1.52^a	^d8.58±2.13^a	^j8.52±2.06^a	^p8.42±1.87^a	^d11.14±1.98^b	^j12.00±2.31^a	^p13.30±2.49^a
P4	^def2.50±1.12^c*	^gh3.66±1.39^b	^ij4.96±1.36^a	^e8.12±2.14^a	^k7.54±1.90^a	^q6.98±1.85^a	^e10.62±2.34^b*	^k11.20±2.00^a	^q11.94±1.85^a
P6	^def2.51±0.95^c	^g3.81±1.43^b*	^ijk4.74±1.29^a	^g5.49±1.16^a*	^m5.34±1.86^a	^f5.23±1.91^a	^f8.00±1.30^b*	^m9.15±2.33^b	^r9.97±1.83^a
P8	^de2.62±0.90^c*	^gh3.69±1.17^b*	^ijk4.68±1.23^a	^h3.91±0.99^a*	ⁿ3.78±1.29^a	^s3.54±1.43^a	^h6.53±1.21^b*	^no7.47±1.97^b*	^s8.22±1.39^a*

位点	MT			BST			TST
位点	TR	R2	R4	TR	R2	R4	TR	R2	R4
A8	^d2.44±0.61^b	^h2.80±0.70^a	^k3.06±0.78^a	ⁱ2.98±1.41^a	^o3.20±1.56^a*	^v3.63±1.73^a*	ⁱ5.42±1.40^b	^o6.00±1.67^ab*	^v6.69±1.93^a*
A6	^ef2.08±0.64^c	^h2.77±0.87^b	^jk3.34±0.97^a	^h4.10±1.85^a	ⁿ4.33±1.83^a*	^u4.53±1.90^a*	^h6.18±1.91^b*	ⁿ7.10±1.69^b	^u7.87±2.14^a
A4	^fg1.82±0.45^c*	^h2.74±0.88^b	^ijk3.81±1.16^a	^g5.54±2.25^a	^m5.65±2.36^a*	^t6.05±2.82^a*	^g7.36±2.20^b	^m8.39±2.40^ab*	^t9.86±3.03^a
A2	^g1.74±0.44^c	^h2.55±1.20^b	^jk4.05±1.21^a	^f7.55±2.83^a	^l7.11±2.89^a*	^r6.55±1.81^a	^f9.29±2.76^a	^l9.66±3.36^a*	^r10.60±2.63^a
TR	^e2.46±0.47^c*	^h3.31±1.17^b	ⁱ4.69±1.50^a	^d9.05±1.78^a*	^j8.78±2.28^a	^p8.70±2.40^a	^d11.51±1.81^b*	^j12.09±2.62^b	^p13.39±3.25^a
P2	^g1.85±0.42^c*	^h2.90±1.67^b	^ij4.44±1.67^a	^d9.35±2.19^a	^j9.23±1.64^a	^p9.12±1.92^a	^d11.20±1.82^b	^j12.13±2.41^b	^p13.56±2.73^a
P4	^efg1.88±0.49^c*	^h2.80±1.25^b	^ij3.83±1.46^a	^e8.81±1.89^a	^k8.51±1.98^ab	^q8.24±2.41^b	^e10.69±1.89^b*	^k11.31±1.87^ab	^q12.07±2.29^a
P6	^efg1.91±0.59^c	^h2.87±0.98^b*	^ij3.80±1.09^a	^f6.95±1.75^a*	^m6.48±1.98^ab	^s6.31±2.30^b	^f8.86±1.83^b*	^m9.35±1.99^ab	^s10.11±2.26^a
P8	^efg1.93±0.50^c*	^h2.98±0.79^b*	^ij3.81±1.05^a	^h4.68±1.76^a*	ⁿ4.62±1.24^a	^u4.56±1.82^a	^h6.61±1.77^b*	ⁿ7.60±1.56^ab*	^u8.37±1.90^a*