青少年正畸患者下颌第三磨牙萌出的影响因素研究

doi:10.13591/j.cnki.kqyx.2023.08.005

摘要/Abstract

摘要：

目的分析青少年正畸患者下颌第三磨牙萌出的影响因素。方法选取初次就诊时下颌第三磨牙阻生的青少年正畸患者。记录患者性别、安氏分类、下颌第三磨牙发育程度、减数拔牙,通过软件生成的侧位片测量下颌第三磨牙轴倾角度(8-SN)、下颌第二、第三磨牙之间的夹角(7-8axis)、下颌第三磨牙萌出间隙(7D-ABR)以及下颌第三磨牙的萌出高度(8-OP)。根据第二次拍摄CBCT时第三磨牙阻生程度将病例分为萌出组和未萌出组。采用Logistic回归分析下颌第三磨牙萌出的影响因素。结果由Logistic回归分析得出,安氏Ⅰ类错𬌗、减数拔牙、下颌第三磨牙牙根形成、正畸治疗前下颌第三磨牙长轴与前颅底平面的夹角越大,下颌第二磨牙长轴与第三磨牙的夹角越小,更有利于下颌第三磨牙的萌出。结论青少年患者正畸治疗后下颌第三磨牙的萌出受减数拔牙、下颌第三磨牙发育程度、安氏分类、8-OP、7-8axis、8axis-SN等多方面因素的影响。

关键词: 下颌第三磨牙, 萌出, 正畸治疗

Abstract:

Objective To delineate and analyze the factors affecting the eruption of mandibular third molars in adolescent orthodontic patients. Methods Adolescent orthodontic patients with impacted mandibular third molars at their first visit were retrospectively screened.The record of gender, Angle Classification, development of mandibular third molar, tooth extraction, the angle of mandibular third molar inclination(8-SN), the angle between mandibular second and third molars(7-8axis), the eruption space of mandibular third molars(7D-ABR) and the eruption height of mandibular third molars(8-OP) were measured by software-generated lateral cephalometric radiographs. The cohort were classified into eruption group and un-eruption group according to the degree of impaction of the third molar during the second CBCT image. Logistic regression analysis was utilized to analyze the factors affecting the eruption status of mandibular third molars. Results Among the factors, Angle Class Ⅰ malocclusion, tooth extraction, the root formation of mandibularthirdmolars, a larger angle between the long axis of the third molar and the anterior skull base plane, and a smaller angle between the long axis of the second molar and the third molar were conducive to the eruption of mandibular third molars. Conclusion The eruption status of mandibular third molars after orthodontic treatment is influenced by several factors,including orthodontic extraction, development of mandibular third molars, Angle's classification, 8-OP, 7-8 axis, and 8axis-SN.

Key words: mandibular third molar, eruption status, orthodontic treatment

中图分类号:

R782.1

黄虹, 李媛, 景秋平, 石逸瑾, 阳胜军, 王东苗. 青少年正畸患者下颌第三磨牙萌出的影响因素研究[J]. 口腔医学, 2023, 43(8): 697-701.

HUANG Hong, LI Yuan, JING Qiuping, SHI Yijin, YANG Shengjun, WANG Dongmiao. Factors affecting the eruption status of mandibular third molars in adolescent orthodontic patients[J]. Stomatology, 2023, 43(8): 697-701.

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测量指标	定义
7D-ABR/mm	下颌第二磨牙冠远中冠接触点沿??平面到下颌升支前缘相交的距离
8-OP/mm	第三磨牙冠的最高点到??平面的距离
7-8axis/(°)	第二磨牙和第三磨牙长轴之间的角度
8axis-MP/(°)	第三磨牙的长轴与下颌平面之间的角度
RP-MP/(°)	下颌支平面和下颌平面之间的角度
8axis-SN/(°)	第三磨牙的长轴与前颅底平面之间的角度
8axis-FH/(°)	第三磨牙的长轴与眶耳平面之间的夹角
MP-SN/(°)	下颌平面和眶耳平面之间的角度
MP-FH/(°)	下颌平面和眶耳平面之间的夹角

相关因素	下颌第三磨牙状态		P
相关因素	萌出	未萌出	P
性别^a
女	206(69.1%)	66(55%)
男	92(30.9%)	54(45%)	0.01^*
减数拔牙^a
否	153(51.3%)	83(69.2%)
是	145(48.7%)	37(30.8%)	<0.01^*
下颌第三磨牙发育程度^a
仅牙冠形成	139(46.6%)	83(69.2%)
牙根形成	159(53.4%)	37(30.8%)	<0.01^*
安氏分类^a
Ⅰ类	116(38.9%)	34(28.3%)
Ⅱ类	70(23.5%)	54(45%)
Ⅲ类	112(37.6%)	32(26.7%)	<0.01^*
7D-ABR^b/mm	0.84±1.49	1.13±1.83	0.12
8-OP^b/mm	-0.57±1.06	-1.77±1.36	<0.01^*
8axis-SN^b/(°)	35.80±11.95	25.97±12.49	<0.01^*
7-8axis^b/(°)	26.15±9.68	35.20±11.77	<0.01^*
下颌平面角^b/(°)	37.81±6.03	36.72±6.06	0.09
下颌角^b/(°)	124.39±9.99	123.52±12.19	0.45

相关因素	下颌第三磨牙状态		P	95%CI
相关因素	萌出	未萌出	P	95%CI
性别
女	206(69.1%)	66(55%)
男	92(30.9%)	54(45%)	0.93	(0.54,1.95)
减数拔牙
否	153(51.3%)	83(69.2%)
是	145(48.7%)	37(30.8%)	0.02^*	(0.26,0.87)
下颌第三磨牙发育程度
仅牙冠形成	139(46.6%)	83(69.2%)
牙根形成	159(53.4%)	37(30.8%)	0.01^*	(0.22,0.78)
安氏分类
Ⅰ类	116(38.9%)	34(28.3%)
Ⅱ类	70(23.5%)	54(45%)	0.02^*	(1.11,4.58)
Ⅲ类	112(37.6%)	32(26.7%)	0.89	(0.51,2.17)
7D-ABR/mm	0.84±1.49	1.13±1.83	0.61	(0.97,1.26)
8-OP/mm	-0.57±1.06	-1.77±1.36	<0.01^*	(0.29,0.51)
8axis-SN/(°)	35.80±11.95	25.97±12.49	<0.01^*	(0.89,0.97)
7-8axis/(°)	26.15±9.68	35.20±11.77	0.02^*	(1.01,1.10)
下颌平面角/(°)	37.81±6.03	36.72±6.06	0.39	(0.92,1.03)
下颌角/(°)	124.39±9.99	123.52±12.19	0.29	(0.95,1.01)