青少年下切牙先天性缺失对牙颌面形态的影响

doi:10.13591/j.cnki.kqyx.2026.07.007

摘要/Abstract

摘要：

目的分析先天性下切牙缺失的青少年牙颌面特征,探讨下切牙缺失对牙颌面形态的影响。方法本研究共纳入对照样本60例和缺牙样本114例(缺牙组(1颗)69例,缺牙组(2颗)45例),通过对头颅侧位片进行头影测量分析,比较正常牙列与缺失下切牙的青少年人群牙颌面特征差异,并对结果进行统计学分析。结果与对照组相比,骨组织测量中,SNB角、ANB角、下颌平面角、Po-NB距、SGn-FH角、下面高和后前面高比存在显著差异(P<0.05);牙体测量中,L1-NB角、L1-NB距及L1-MP角均显著减小(P<0.05);软组织测量中,LL-EP、FH-N'Pog'和N'-Sn-Pog'存在显著差异(P<0.05)。结论青少年下前牙先天性缺失多表现为Ⅱ类低角骨面型,且较多出现下颌骨垂直向及矢状向发育不足,但颏部出现代偿性生长,发育良好。切牙牙轴舌向倾斜明显,缺2颗切牙的患者切牙舌倾更为显著。此外,软组织颏部发育良好,但下唇相对后缩。

关键词: 先天性下切牙缺失, 牙颌面形态, 头颅侧位片, 头影测量

Abstract:

Objective To analyze the dento-maxillofacial features of adolescents with congenital absence of lower incisor teeth, and explore the influence of lower incisor absence on dento-maxillofacial morphology. Methods A total of 60 control samples and 114 samples with missing teeth(missing 1 tooth: 69; missing 2 teeth: 45)were included in the study. By means of cephalometric imaging analysis on the lateral cephalic radiography, the differences in the dento-maxillofacial features between the normal population and teenagers with lower incisor missing teeth were compared, and the results were statistically analyzed. Results Compared with control group, SNB, ANB, FMA, Po-NB and SGn-FH were significantly different in bone tissue measurement(P<0.05). In tooth measurement, L1-NB angle, L1-NB distance and L1-MP angle were significantly reduced(P<0.05). LL-EP, FH-N'Pog' and N'-Sn-Pog' were significantly different in soft tissue measurements(P<0.05). Conclusion The congenital absence of lower incisor teeth in adolescents is mostly manifested as Class Ⅱ skeletal pattern, and most of thempresented with mandibular underdevelopment including the vertical and sagittal directions. However, the chin has compensatory growth. The lingual inclination of the incisor axis is obvious in the missing teeth group, and the lingual inclination of the incisor is more obvious in the patients with 2 missing incisor teeth. In addition, the chin soft tissue is well developed, but the lower lip is relatively retracted.

Key words: congenital absence of lower incisor teeth, dento-maxillofacial morphology, lateral cephalic radiography, cephalometric measurement

中图分类号:

R783.5

于鑫, 陆胜男, 章婷, 谢慧敏, 石慧. 青少年下切牙先天性缺失对牙颌面形态的影响[J]. 口腔医学, 2026, 46(7): 531-535.

YU Xin, LU Shengnan, ZHANG Ting, XIE Huimin, SHI Hui. The influence of congenital absence of lower incisors in adolescents on the morphology of dento-maxillofacial features[J]. Stomatology, 2026, 46(7): 531-535.

图/表 3

图1

表1

表2

参考文献 20

[1]	Rakhshan V. Congenitally missing teeth(Hypodontia): A review of the literature concerning the etiology, prevalence, risk factors, patterns and treatment[J]. Dent Res J, 2015, 12(1): 1-13.
[2]	Fan LW, Ma L, Zhu GR, et al. A Genome-wide association study of premolar agenesis in a Chinese population[J]. Oral Dis, 2023, 29(3): 1102-1114. doi: 10.1111/odi.v29.3
[3]	Gracco ALT, Zanatta S, Forin Valvecchi F, et al. Prevalence of dental agenesis in a sample of Italian orthodontic patients: An epidemiological study[J]. Prog Orthod, 2017, 18(1): 33. doi: 10.1186/s40510-017-0186-9 pmid: 29034420
[4]	Naoum S, Allan Z, Yeap CK, et al. Trends in orthodontic management strategies for patients with congenitally missing lateral incisors and premolars[J]. Angle Orthod, 2021, 91(4): 477-483. doi: 10.2319/092320-809.1 pmid: 33657211
[5]	杨军星, 李莹, 唐中元, 等. 先天缺失2颗下切牙患者侧貌特征和拔牙矫治前后侧貌变化[J]. 吉林大学学报(医学版), 2019, 45(3): 627-633.
[6]	吴华, 冯海兰. 6 453名17-21岁青年人恒牙发育异常的调查[J]. 中华口腔医学杂志, 2005, 40(6): 489-490.
[7]	李婧, 张卫兵. 骨性Ⅰ类女性下切牙先天缺失者颏部形态的三维研究[J]. 口腔医学, 2021, 41(10): 915-918.
[8]	Zhang J, Liu HC, Lyu X, et al. Prevalence of tooth agenesis in adolescent Chinese populations with or without orthodontics[J]. Chin J Dent Res, 2015, 18(1): 59-65. pmid: 25815384
[9]	董雪, 高丽荣, 窦一峰, 等. 下切牙缺失患者不同垂直骨面型颏部形态特征的对比分析[J]. 新医学, 2023, 54(1): 70-74. doi: 10.3969/j.issn.0253-9802.2023.01.015
[10]	Costa AMG, Trevizan M, Matsumoto MAN, et al. Association between tooth agenesis and skeletal malocclusions[J]. J Oral Maxillofac Res, 2017, 8(2): e3.
[11]	Chung LK, Hobson RS, Nunn JH, et al. An analysis of the skeletal relationships in a group of young people with hypodontia[J]. J Orthod, 2000, 27(4): 315-318. pmid: 11099569
[12]	Yüksel S, Uçem T. The effect of tooth agenesis on dentofacial structures[J]. Eur J Orthod, 1997, 19(1): 71-78. doi: 10.1093/ejo/19.1.71
[13]	Tavajohi-Kermani H, Kapur R, Sciote JJ. Tooth agenesis and craniofacial morphology in an orthodontic population[J]. Am J Orthod Dentofacial Orthop, 2002, 122(1): 39-47. doi: 10.1067/mod.2002.123948
[14]	Endo T, Ozoe R, Kojima K, et al. Congenitally missing mandibular incisors and mandibular symphysis morphology[J]. Angle Orthod, 2007, 77(6): 1079-1084. doi: 10.2319/020106-37.1 pmid: 18004906
[15]	徐宏, 赵文科, 秦玉福, 等. 正畸患者先天性牙缺失与错牙合畸形矢状骨型的关系[J]. 实用口腔医学杂志, 2007, 23(1): 60-62.
[16]	潘永初, 马俊青, 王林, 等. 下颌切牙先天缺失女性患儿的牙颌面形态分析[J]. 口腔医学, 2008, 28(3): 130-132.
[17]	曲幸辉, 张月兰. 下颌先天性缺失一颗恒切牙的正畸学研究[J]. 医学综述, 2014, 20(22): 4099-4101.
[18]	夏雪妍, 吴梦婕. 唇部形态影响因素及其与正畸治疗相关性的研究进展[J]. 口腔医学, 2024, 44(8): 635-640.
[19]	Newman GV. Congenitally missing mandibular incisors: Treatment procedures[J]. Am J Orthod, 1967, 53(7): 482-491. pmid: 5229712
[20]	Chen DD, Cheng JH, Hsu CS. Relationship between craniofacial morphology and congenitally missing mandibular incisors[J]. J Dent Sci, 2022, 17(2): 928-934. doi: 10.1016/j.jds.2021.12.009 pmid: 35756788

测量指标		对照组 n=60		缺牙组(1颗) n=69		缺牙组(2颗) n=45		单因素方差分析
测量指标		对照组 n=60		缺牙组(1颗) n=69		缺牙组(2颗) n=45		F		P
骨组织测量指标
SNA/(°)	81.97±1.55		81.89±2.68		80.95±2.34		1.059		0.354
SNB/(°)	80.46±1.33		78.03±3.07		78.01±2.61		6.344		0.003^**
ANB/(°)	1.67±1.26		3.87±1.65		2.95±2.04		9.597		0.000^***
FH-NPo/(°)	85.23±2.07		85.36±2.49		86.44±2.94		1.199		0.309
NA-APo/(°)	5.80±3.00		7.57±4.01		5.05±5.57		1.874		0.163
FMA/(°)	30.92±2.10		27.40±5.04		26.43±4.53		6.135		0.004^**
SGn-FH/(°)	66.30±3.06		63.31±2.96		61.49±2.51		12.608		0.000^***
Po-NB/mm	0.93±0.86		1.55±1.02		1.83±1.53		5.440		0.007^**
N-ANS/mm	51.99±3.53		51.62±3.43		51.71±3.02		1.460		0.241
ANS-Me/mm	64.00±5.04		60.80±4.41		57.98±4.33		7.009		0.002^**
S-Go/mm	73.00±3.28		73.18±6.32		73.04±4.90		0.007		0.993
S-Go/N-Me/%	63.11±4.23		65.11±4.01		66.65±4.29		4.833		0.012^*
牙体测量指标
U1-NA距/mm	6.00±1.41		6.93±2.41		6.69±4.03		0.676		0.513
U1-NA角/(°)	25.06±4.45		28.54±7.55		28.58±12.97		1.107		0.338
L1-NB距/mm	7.57±1.02		5.00±1.58		3.19±1.54		43.806		0.000^***
L1-NB角/(°)	33.65±1.81		25.70±3.78		20.58±5.33		54.630		0.000^***
U1-L1/(°)	126.17±3.71		121.97±9.84		127.32±13.51		1.758		0.182
U1-SN(°)	107.21±5.29		110.45±7.23		109.55±11.53		0.902		0.412
IMPA/(°)	94.75±3.53		93.37±4.97		88.53±5.77		7.818		0.001^**
软组织测量指标
UL-EP/mm	2.09±1.15		1.63±2.40		1.02±1.99		1.292		0.283
LL-EP/mm	3.46±0.95		1.59±2.74		0.77±1.97		8.024		0.001^**
Z角/(°)	71.24±2.74		66.17±8.29		69.45±8.16		3.019		0.057
FH-N'Pog'/(°)	88.88±1.76		90.55±2.57		91.52±1.71		7.173		0.002^**
N'-Sn-Pog'/(°)	167.54±1.98		162.55±4.25		164.23±4.26		10.270		0.000^***

测量指标	对照组vs.缺牙组(1颗)		对照组vs.缺牙组(2颗)		缺牙组(1颗) vs.缺牙组(2颗)
测量指标	差值	P	差值	P	差值	P
骨组织测量指标
SNB/(°)	4.43	0.004^**	4.45	0.005^**	0.02	0.996
ANB/(°)	-2.20	0.000^***	-1.28	0.013^*	0.92	0.231
FMA/(°)	3.52	0.007^**	4.49	0.004^***	0.97	0.571
SGn-FH/(°)	2.99	0.002^**	4.81	0.000^***	1.82	0.062
Po-NB/mm	-0.62	0.004^**	-0.90	0.005^**	-0.28	0.597
ANS-Me/mm	3.20	0.011^*	6.02	0.001^**	2.82	0.086
S-Go/N-Me/%	-2.00	0.121	-3.54	0.010^*	-1.54	0.276
牙体测量指标
L1-NB距/mm	2.57	0.000^***	4.38	0.000^***	1.81	0.001^**
L1-NB角/(°)	7.95	0.000^***	13.07	0.000^***	5.12	0.003^**
IMPA/(°)	1.38	0.394	6.22	0.000^***	4.84	0.013^**
软组织测量指标
LL-EP/mm	1.87	0.002^**	2.69	0.000^***	0.82	0.268
FH-N'Pog'/(°)	-1.67	0.017^*	-2.64	0.000^***	-0.97	0.273
N'-Sn-Pog'/(°)	4.99	0.000^***	3.31	0.004^**	-1.684	0.213