正畸牵引对牙根发育完全和未完全的埋伏前牙牙根及牙周组织的影响

Effect of orthodontic traction on root and periodontal tissues of impacted anterior teeth with developed or underdeveloped roots

目的探讨正畸牵引对牙根发育完全和牙根未发育完全的埋伏前牙牙根及牙周组织的影响。方法回顾性选择2017年6月至2020年1月在泰州市中医院行正畸牵引治疗上颌埋伏前牙患者102例(共108颗埋伏前牙)的临床资料。根据牙根发育情况,将患者分为牙根发育完全组(54颗埋伏前牙)和牙根未发育完全组(54颗埋伏前牙),牙根发育完全组男28例、女23例,年龄(16.22±6.54)岁;牙根发育不完全组男29例、女22例,年龄(16.54±6.60)岁。两组均采用正畸牵引治疗并作为治疗牙,以同颌同名未治疗牙(54颗埋伏前牙)作为对照牙。记录并对比各组正畸牵引前后牙根指标(牙根长度、牙根壁厚度、牙根弯曲率、牙髓活力)及牙周组织指标(附着龈宽度、唇侧骨板厚度)情况。结果牙根发育不完全组牵引后牙根长度(13.27±2.24)mm、牙根壁厚度(2.53±0.25)mm大于牵引前(12.28±2.18、2.10±0.16)mm,差异均有统计学意义(P<0.05);牙根发育完全组牵引后牙根长度(11.03±2.02)mm低于牵引前(12.01±2.11)mm和对照牙(13.22±1.23)mm,牙根壁厚度(2.20±0.19)mm低于对照牙(2.52±0.24)mm,差异均有统计学意义(P<0.05);牵引后牙根发育完全组牙根长度(11.03±2.02)mm、牙根壁厚度(2.20±0.19)mm低于牙根发育不完全组(13.27±2.24、2.53±0.25)mm,差异均有统计学意义(P<0.05);牙根发育完全组对照牙牙根长度(13.22±1.23)mm低于牙根发育不完全组(13.80±1.55)mm,差异均有统计学意义(均P<0.05)。牙根发育不完全组、牙根发育完全组牵引后附着龈宽度、唇侧骨板厚度均小于牵引前对照牙,差异均有统计学意义(均P<0.05);牙根发育不完全组牵引后附着龈宽度、唇侧骨板厚度大于牙根发育完全组,差异均有统计学意义(均P<0.05);牙根发育完全组对照牙唇侧骨板厚度小于牙根发育不完全组,差异有统计学意义(P<0.05)。结论正畸牵引可使牙根未发育完全的埋伏前牙牙周组织迅速改建,且时间短、对牙根吸收影响轻。

ObjectiveTo investigate the effect of orthodontic traction on root and periodontal tissues of impacted anterior teeth with developed or underdeveloped roots.MethodsThis was a retrospective study.The clinical data of 102 patients(108 anterior teeth in total)who underwent orthodontic traction at Taizhou Hospital of Traditional Chinese Medicine from June 2017 to January 2020 were selected.According to the root development status,the patients were divided into a complete root development group(54 anterior teeth)and an incomplete root development group(54 anterior teeth).There were 28 males and 23 females in the complete root development group,with an average age of(16.22±6.54)years.There were 29 males and 22 females in the incomplete root development group,with an average age of(16.54±6.60)years.Both groups were treated by orthodontic traction.The teeth treated by orthodontic traction were regarded as treatment teeth,and the untreated teeth of the same jaw and the same name(54 anterior teeth)were regarded as control teeth.Root indexes(root length,root wall thickness,root curvature rate,and pulp vitality)and periodontal tissue indexes(attached gingival width and labial bone plate thickness)before and after orthodontic traction were recorded and compared among the groups.ResultsIn the incomplete root development group,the root length and root wall thickness after traction were significantly higher than those before traction[(13.27±2.24)mmvs(12.28±2.18)mm,(2.53±0.25)mmvs(2.10±0.16)mm,P<0.05 for both].In the fully developed group,the root length was(11.03±2.02)mm,which was significantly lower than that before traction[(12.01±2.11)mm]and that of control teeth[(13.22±1.23)mm],and the root wall thickness was(2.20±0.19)mm,which was significantly lower than that of control teeth[(2.52±0.24)mm](P<0.05 for all).After traction,the root length and root wall thickness of the complete root development group were(11.03±2.02)mm and(2.20±0.19)mm,respectively,both of which were significantly lower than those of the incomplete root development group[(13.27±2.24)mm,(2.53±0.25)mm](P<0.05 for both).The root length of the control group with complete root development was significantly lower than that of the control group with incomplete root development[(13.22±1.23)mmvs(13.80±1.55)mm,P<0.05].After traction,the width of attached gingiva and the thickness of the labial bone plate were significantly lower than those before traction in all the three groups(P<0.05 for all).The width of the attached gingiva and the thickness of the labial bone plate in the incomplete root development group were significantly larger than those of the complete root development group(P<0.05 for both).The thickness of the labial bone plate in the control group with complete root development was significantly lower than that of the control group with incomplete root(P<0.05).ConclusionOrthodontic traction for impacted anterior teeth with underdeveloped roots is associated with rapid periodontal tissue reconstruction,short orthodontic traction time,and mild root absorption.