第三磨牙先天缺失与颅颌面结构相关性的研究

doi:10.13591/j.cnki.kqyx.2023.01.010

摘要/Abstract

摘要： 目的通过对第三磨牙先天缺失患者的缺失位置、数目与颅颌面部的头影测量指标进行研究,分析第三磨牙先天缺失与颅颌面结构的相关性。方法共纳入123例患者,其中无第三磨牙先天缺失的患者纳入对照组,共64例;有至少一颗第三磨牙缺失纳入缺失组,共59例。对纳入患者的头颅侧位片进行头影测量和统计学分析,测量指标包括FMA、IMPA、Ar-Go、GoGn-SN、Co-A、Co-Gn、ANS-Me、SN-MP、Ar-Go-Me、SNA、SNB、ANB、Y轴角、Y轴长度、Ar-Go、Go-Me、MP-OP、FH-PP、FH-OP共18项骨组织指标,U1-SN、U1-L1、U1-NA、L1-NB、U1-APo、L1-APo共6项牙性指标,UL-EP、LL-EP、鼻唇角共3项软组织指标,分析第三磨牙先天缺失与颅颌面结构的相关性。结果第三磨牙最常见缺失位置发生于上颌且最常见的缺失数目为一颗。对照组患者Ar-Go-Me和SN-MP更大(P<0.05),U1-SN、U1-NA、L1-NB、UL-EP、LL-EP更大(P<0.05),U1-L1更小(P<0.01),对照组患者Ar-Go和Go-Me与缺失组之间的差异没有统计学意义(P>0.05)。结论四颗第三磨牙均存在的患者相比有第三磨牙缺失的患者,下颌骨更易向后下旋转且更容易发育成凸面型,与高角面型、凸面型具有较高的相关性。

关键词: 第三磨牙, 颅颌面结构, 头影测量

Abstract: Objective To analyze the correlation between third molar agenesis and craniofacial morphology by studying the location and number of congenital missing third molars and results of craniofacial cephalometric measurement. Methods A total of 123 patients were included, including 64 patients in the control group without congenital third molar absence and 59 patients in the absence group with at least one third molar absent. Cephalometric measurements included FMA, IMPA, AR-Go, GoGn-Sn, Co-A, Co-Gn, ANS-Me, Go-Me, SN-MP, Ar-Go-Me, SNA, SNB, ANB, Y-axis angle, Y-axis length, Ar-Go, Go-Me, MP-OP, FH-PP, FH-OP, a total of 18 bone tissue indicators, U1-SN, U1-L1, U1-NA, L1-NB, U1-APo and L1-APo, a total of 6 dental indicators, and UL-EP, LL-EP and nasolabial angle, a total of 3 soft tissue indicators. The correlation between congenital agenesis of third molars and craniofacial morphology was analyzed. Results The most common missing location of the third molar occured in the upper jaw and the most common number of missing teeth was one. In control group, Ar-Go-Me and SN-MP were larger (P<0.05), U1-SN, U1-NA, L1-NB, UL-EP and LL-EP were larger (P<0.05), and U1-L1 was smaller (P<0.01). There were no significant differences in Ar-Go and Go-Me between the two groups(P>0.05). Conclusion Patients with four third molars are more likely to have backward and downward rotation of the mandible and are more likely to develop into a convex facial type than patients with missing third molars, which has a higher correlation with hyperdivergent growth pattern and convex facial type.

Key words: third molar, craniomaxillofacial structure, cephalometric measurement

中图分类号:

R783.5

吴利娜, 熊鑫, 吴雁格, 张秦兰蕙, 王军. 第三磨牙先天缺失与颅颌面结构相关性的研究[J]. 口腔医学, 2023, 43(1): 57-61.

WU Lina, XIONG Xin, WU Yange, ZHANG Qinlanhui, WANG Jun. Relationship between congenital absence of third molars and craniomaxillofacial structure[J]. Stomatology, 2023, 43(1): 57-61.

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骨组织指标	指标	定义
骨组织指标
	FMA/(°)	下颌平面角,下颌平面与眶耳平面所成的夹角
	IMPA/(°)	下中切牙长轴延长线和下颌平面的交角
	GoGn-SN/(°)	下颌平面和前颅底平面的交角
	Co-A/mm	上颌长度,连接髁顶点(髁突最后上点)与上牙槽座点的距离
	Co-Gn/mm	下颌长度,髁顶点和颏前点的距离
	ANS-Me/mm	前鼻棘点到颏部下点的距离
	SN-MP/(°)	下颌平面角,前颅底平面与下颌平面所成的夹角
	Ar-Go-Me/(°)	下颌角,由升支平面与下颌平面构成
	SNA/(°)	由蝶鞍中心、鼻根点及上牙槽座点所构成的角
	SNB/(°)	由蝶鞍中心、鼻根点及下牙槽座点所构成的角
	ANB/(°)	上牙槽座点、鼻根点、下牙槽座点构成的角
	Y轴角/(°)	蝶鞍点至颏顶点连线与眶耳平面所形成的夹角
	Y轴长度/mm	蝶鞍点至颏顶点的距离
	Ar-Go/mm	下颌升支高度,关节点至下颌角点的距离
	Go-Me/mm	下颌支长度,下颌角点至颏下点的距离
	MP-OP/(°)	牙合平面-下颌平面角,Downs平面与下颌平面所成的夹角
	FH-OP/(°)	牙合平面角,Downs平面与眶耳平面所成的夹角
	FH-PP/(°)	腭平面角,腭平面与眶耳平面所成的夹角
牙性指标
	U1-SN/(°)	上中切牙长轴与SN平面相交的下内角
	U1-L1/(°)	上下中切牙长轴交角,牙长轴由切缘点和根尖点构成
	U1-NA/(°)	上中切牙长轴与NA连线的交角
	L1-NB/(°)	下中切牙长轴与NB连线的交角
	U1-APo/(°)	上中切牙长轴到A-Pog连线的下交角的角度
	L1-APo/(°)	下中切牙长轴到A-Pog连线的下交角的角度
软组织指标
	UL-EP/mm	上唇突点至审美平面EP的距离
	LL-EP/mm	下唇突点至审美平面EP的距离
	鼻唇角/(°)	鼻小柱点和鼻下点与鼻下点和上唇突点连线的交角

测量项目	缺失组	对照组	P
性别
男性,n(%)	10(20.41)	8(14.29)	0.490
女性,n(%)	49(79.59)	56(85.71)
年龄/岁	30.41±4.69	29.61±4.67	0.350

牙齿缺失数量/颗	缺失位置	n
1	18	9
	28	9
	38	3
	48	5
2	18,28	17
	18,38	2
	18,48	1
	28,38	2
	28,48	0
	38,48	3
3	18,28,38	0
	18,28,48	3
	18,38,48	1
	28,38,48	0
4	18,28,38,48	4

骨性分类	缺失组	对照组
Ⅰ	28(49.12)	29(50.88)
Ⅱ	19(42.22)	26(57.88)
Ⅲ	12(57.14)	9(42.86)

骨面型	缺失组	对照组
高角	2(20.00)	8(50.88)
均角	41(46.07)	48(57.78)
低角	16(66.67)	8(42.86)