骨性Ⅱ类错牙合下颌基骨与牙弓形态的研究

doi:10.13591/j.cnki.kqyx.2025.06.007

摘要/Abstract

摘要：

目的通过三维数字化模型,对骨性Ⅱ类患者的下颌基骨弓与牙弓之间的关系进行研究,并与骨性Ⅰ类患者相对比,以期为临床准确诊断和后续治疗提供一定参考。方法选取骨性Ⅱ类错牙合畸形患者的模型25副,骨性Ⅰ类个别正常牙合患者的模型25副,扫描选取的下颌模型并通过软件构建数字化三维模型。确定膜龈联合处最凸点并连线(WALA嵴),确定临床冠中心点(FA点),建立研究所需参考平面和平面直角坐标系。用WALA嵴点和FA点坐标进行四次多项式曲线拟合,代表相应的基骨弓曲线和牙弓曲线。在距离坐标水平轴3、10、18 mm处依次测量并计算基骨弓曲线与牙弓曲线的宽度差。比较骨性Ⅱ类与骨性Ⅰ类错牙合基骨弓和牙弓宽度差的差异。结果骨性Ⅱ类患者下颌前段、中段及后段基骨弓与牙弓的宽度差分别为-1.58 mm、1.80 mm、3.80 mm,骨性Ⅰ类患者下颌前段、中段及后段基骨弓与牙弓的宽度差分别为2.08 mm、2.92 mm、4.24 mm,前段与中段骨性Ⅱ类与骨性Ⅰ相比较具差异有统计学意义(P<0.05),后段无统计学差异(P>0.05)。结论骨性Ⅱ类患者前段牙弓位于基骨弓外侧,基骨弓宽度小于牙弓宽度;中段和后段牙弓位于基骨弓内侧,基骨弓宽度大于牙弓宽度。骨性Ⅰ类患者各段基骨弓宽度大于牙弓宽度,牙弓位于基骨内侧。骨性Ⅱ类患者中段基骨弓与牙弓的宽度差小于骨性Ⅰ类。

关键词: 骨性Ⅱ类错牙合畸形, 牙弓与基骨形态, WALA 嵴, 曲线拟合

Abstract:

Objective To study the relationship between the mandibular bone arch and the dental arch in patients with skeletal Class Ⅱmalocclusion and compare it with the Class Imalocclusion by establishing a 3D digital model. Methods A total of 25 cases with skeletal Class Ⅱ malocclusion and 25 cases with skeletal Class Ⅰ normal occlusion were selected. The mandibular model was scanned and a three-dimensional digital model was set up. After the determination of the WALA ridge and the FA point, the reference plane and coordinate system was established. Four degree polynomial curve fitting was performed with WALA ridge and FA point coordinates to represent the corresponding basal and dental arch curves. The width difference between the basal arch curve and the dental arch curve was measured and calculated at 3 mm, 10 mm, and 18 mm away from the horizontal axis of the coordinate. The differences of basal bone and dental arch width between skeletal Class Ⅱ and skeletal Class Ⅰ malocclusion was compared. Results The width differences between the arch and the dental arch in the anterior, middle and posterior mandibular segments of skeletal Class Ⅱ patients were -1.58 mm, 1.80 mm and 3.80 mm, respectively. The width differences between the arch and the dental arch in the anterior, middle and posterior mandibular segments of skeletal Class Ⅰ patients were 2.08 mm, 2.92 mm and 4.24 mm, respectively. There was a significant difference between skeletal Class Ⅱ and skeletal Class Ⅰ in the anterior and middle segments(P<0.05), but no significant difference in the posterior segment(P>0.05). Conclusion In skeletal Class Ⅰ patients, the width of the basal bone is larger than that of the dental arch, and the dental arch was located medial to the basal bone. In skeletal Class Ⅱ patients, the width of the anterior arch is larger than the width of the basal bone, that is, the dental arch is located outside the basal bone. The width difference of the basal arch in skeletal Class Ⅱ is smaller than that in skeletal Class Ⅰ.

Key words: skeletal ClassⅡ malocclusions, dental and basal bone arch form, WALA ridge, curve fitting

中图分类号:

R783.5

白煜, 高盟, 刘冬梅, 王涛, 冯雪. 骨性Ⅱ类错牙合下颌基骨与牙弓形态的研究[J]. 口腔医学, 2025, 45(6): 436-439.

BAI Yu, GAO Meng, LIU Dongmei, WANG Tao, FENG Xue. Study on the morphology of the mandibular basal bone and dental arch of skeletal Class Ⅱ malocclusion[J]. Stomatology, 2025, 45(6): 436-439.

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分段	测量部位	Ⅱ类	Ⅰ类	P
前段	牙弓	27.12±2.53	23.54±2.49	0.000^**
	基骨	25.54±1.73	25.61±1.34	0.887
中段	牙弓	39.06±2.09	38.57±1.96	0.461
	基骨	40.86±1.96	41.49±1.85	0.315
后段	牙弓	46.86±2.73	47.70±2.63	0.343
	基骨	50.67±2.22	51.94±2.43	0.095

分段		宽度差	t	P
前段	Ⅱ类	-1.58±2.44	4.527	0.000^*
	Ⅰ类	2.08±2.59
中段	Ⅱ类	1.80±1.49	2.298	0.027^*
	Ⅰ类	2.92±1.54
后段	Ⅱ类	3.80±1.42	1.011	0.318
	Ⅰ类	4.24±1.20