骨皮质切开术辅助上切牙内收后对牙根及牙槽骨影响的锥形束CT研究

›› 2021, Vol. 41 ›› Issue (6): 503-508.

骨皮质切开术辅助上切牙内收后对牙根及牙槽骨影响的锥形束CT研究

王亮¹,程磊¹,王林¹,谷妍²,吴可¹,赵春洋²

1. 南京医科大学附属口腔医院
2. 南京医科大学口腔疾病研究江苏省重点实验室，南京医科大学附属口腔医院正畸科，

收稿日期:2021-01-27 修回日期:2021-03-08 出版日期:2021-06-28 发布日期:2021-06-25
通讯作者: 赵春洋 E-mail:zhaochunyang_orth@163.com
基金资助:
国家自然科学基金;江苏省高校优势学科建设工程项目

Cone-beam CT analysis on the effects of corticotomy-assisted en masse retraction on root and alveolar bone

Received:2021-01-27 Revised:2021-03-08 Online:2021-06-28 Published:2021-06-25

摘要/Abstract

摘要： 目的　探讨骨皮质切开术辅助上切牙内收后对上颌切牙牙根吸收、牙槽骨厚度和牙槽骨高度的影响。方法　招募0例拔除两个上颌第一前磨牙的骨性Ⅱ类1分类错??畸形患者，分为骨皮质切开术组（n=10）和对照组（n=10）。矫治前后拍摄锥形束CT，测量两组矫治前后上颌切牙牙根长度、牙槽骨厚度和牙槽骨丧失高度。结果　骨皮质切开术组矫治疗程明显小于对照组（P<0.05）；骨皮质切开术组和对照组上颌切牙牙根吸收未见明显差异（P>0.05）；骨皮质切开术组治疗前后在上颌中切牙和侧切牙根中和根尖水平唇侧牙槽骨厚度的变化量大于对照组（P<0.05）；骨皮质切开术组中切牙腭侧牙槽骨丧失高度量大于对照组（ P<0.05）。结论　骨皮质切开术辅助上切牙内收结合植骨术可以增加切牙区的牙槽骨厚度，但是在内收过程中不能减少牙根吸收,且对腭侧牙槽骨高度有一定损害。

关键词: 关键词：骨皮质切开术, 上前牙内收, 牙根吸收, 牙槽骨

Abstract: Objective To investigate the effect of corticotomy-assisted en masse retraction on root length ,alveolar bone thickness and alveolar bone height in the anterior area . Methods Twenty patients who needed two maxillary first premolars extracted due to skeletal class II malocclusion were recruited and assigned to the corticotomy group（n=10） or the control group(n=10). All CBCT scans were performed before and after treatment and three-dimensional reconstruction was carried out .The root length , alveolar bone thickness and alveolar bone loss height of the upper incisor region were measured . Results The treatment time in corticotomy group were shorter than that in the control group and the differences were significant(P<0.．05)．There is no significant difference on the maxillary incisor root resorption between the corticotomy group and the control group (P ＞0.05).The increase in labial alveolar bone thickness at midroot level and apical level for the upper central and lateral incisors of corticotomy group were significantly greater than those of control group (P < 0.05). The amount of palatal alveolar bone loss for the upper central incisors in the corticotomy group was greater than that in the control group(P < 0.05).Conclusion Corticotomy-assisted en masse incisor retraction with bone material can increase alveolar bone thickness at the incisor site,but cannot reduce the amount of root resorption and damage the palatal alveolar bone height.

Key words: [Key words] corticotomy, upper anterior retraction , root resorption, alveolar bone

中图分类号:

R783.5

王亮程磊王林谷妍吴可赵春洋. 骨皮质切开术辅助上切牙内收后对牙根及牙槽骨影响的锥形束CT研究[J]. 口腔医学, 2021, 41(6): 503-508.

参考文献 19

[1]	陈香, 张向凤, 黄倩倩, 等. 微种植体支抗辅助内收上切牙后牙槽骨改建的锥形束CT研究[J]. 上海口腔医学, 2018,27(2):150-155.
[2]	Guo Y, He S, Gu T, et al. Genetic and clinical risk factors of root resorption associated with orthodontic treatment[J]. Am J Orthod Dentofacial Orthop, 2016,150(2):283-289.
[3]	Ahn H W, Moon S C, Baek S H. Morphometric evaluation of changes in the alveolar bone and roots of the maxillary anterior teeth before and after en masse retraction using cone-beam computed tomography[J]. Angle Orthod, 2013,83(2):212-221.
[4]	程磊, 赵春洋, 李明, 等. 骨皮质切开术辅助矫治骨性Ⅱ类错(牙合)畸形的疗效研究[J]. 中华口腔医学杂志, 2017,52(7):404-409.
[5]	潘成琼, 李明, 秦燕军, 等. 上颌前牙牙槽骨骨皮质切开辅助治疗轻度骨性Ⅱ类错牙合畸形的临床观察[J]. 实用口腔医学杂志, 2016,32(4):495-500.
[6]	秦燕军, 严斌, 潘成琼, 等. 骨皮质切开术辅助正畸治疗的临床研究[J]. 口腔医学, 2016,36(12):1092-1097.
[7]	Bhattacharya P, Bhattacharya H, Anjum A, et al. Assessment of Corticotomy Facilitated Tooth Movement and Changes in Alveolar Bone Thickness - A CT Scan Study[J]. J Clin Diagn Res, 2014,8(10):C26-C30.
[8]	Wang B, Shen G, Fang B, et al. Augmented corticotomy-assisted presurgical orthodontics of class III malocclusions: a cephalometric and cone-beam computed tomography study[J]. J Craniofac Surg, 2013,24(6):1886-1890.
[9]	Killiany D M. Root resorption caused by orthodontic treatment: an evidence-based review of literature[J]. Semin Orthod, 1999,5(2):128-133.
[10]	Ma Z G, Yang C, Xie Q Y, et al. A Novel Surgical Technique for Augmented Corticotomy-Assisted Orthodontics: Bone Grafting With Periosteum[J]. J Oral Maxillofac Surg, 2016,74(1):170-180.
[11]	Patterson B M, Dalci O, Papadopoulou A K, et al. Effect of piezocision on root resorption associated with orthodontic force: A microcomputed tomography study[J]. Am J Orthod Dentofacial Orthop, 2017,151(1):53-62.
[12]	Al-Naoum F, Hajeer M Y, Al-Jundi A. Does alveolar corticotomy accelerate orthodontic tooth movement when retracting upper canines? A split-mouth design randomized controlled trial[J]. J Oral Maxillofac Surg, 2014,72(10):1880-1889.
[13]	Ahn H W, Seo D H, Kim S H, et al. Morphologic evaluation of dentoalveolar structures of mandibular anterior teeth during augmented corticotomy-assisted decompensation[J]. Am J Orthod Dentofacial Orthop, 2016,150(4):659-669.
[14]	Tuncer N I, Koseoglu-Secgin C, Arman-Ozcirpici A. An unusual case of invasive cervical resorption after piezosurgery-assisted en masse retraction[J]. Am J Orthod Dentofacial Orthop, 2019,156(1):137-147.
[15]	Consolaro A. Force distribution is more important than its intensity![J]. Dental Press J Orthod, 2014,19(1):5-7.
[16]	Kurohama T, Hotokezaka H, Hashimoto M, et al. Increasing the amount of corticotomy does not affect orthodontic tooth movement or root resorption, but accelerates alveolar bone resorption in rats[J]. Eur J Orthod, 2017,39(3):277-286.
[17]	Machibya F M, Zhuang Y, Guo W, et al. Effects of bone regeneration materials and tooth movement timing on canine experimental orthodontic treatment[J]. Angle Orthod, 2018,88(2):171-178.
[18]	Wang B, Shen G, Fang B, et al. Augmented corticotomy-assisted surgical orthodontics decompensates lower incisors in Class III malocclusion patients[J]. J Oral Maxillofac Surg, 2014,72(3):596-602.
[19]	温馥嘉, 陈贵, 刘怡. 基于锥形束 CT 的强支抗内收上前牙病例牙根及牙槽骨的形态学分析[J]. 北京大学学报（医学版）, 2016,48(4):702-708.