露龈笑患者上颌前牙区牙槽骨形态的研究

The study of upper anterior alveolar morphology in gummy smile patients

目的通过锥形束CT(cone-beam computed tomography,CBCT)扫描测量露龈笑患者上颌前牙区牙槽骨,探讨露龈笑患者的牙槽骨解剖特征,为微种植钉的植入提供参考。方法选取63例临床表现露龈笑的成年患者,CBCT扫描并三维重建。在距离牙槽嵴顶4 mm、6 mm、8 mm高度的3个层面上分别测量上颌前牙区相邻两牙根间的近远中向、唇腭向骨质厚度及唇侧皮质骨厚度。结果在相邻两牙之间,近远中向牙根间的距离随测量高度的增加逐渐增加(P<0.05)。中切牙与侧切牙间的牙根间距离最小(P<0.05)。两中切牙间唇腭向根间骨厚度最薄(P<0.05)。中切牙与侧切牙间、侧切牙与尖牙间的根间骨厚度差异无统计学意义(P>0.05)。在相邻两牙之间,唇侧根间皮质骨厚度随测量高度增加而增加(P<0.05)。两中切牙根间唇侧骨皮质最薄(P<0.05),侧切牙与尖牙间骨皮质厚度最厚(P<0.05)。结论牙根间近远中向骨厚度、唇腭向骨厚度和唇侧皮质骨厚度随高度增加而增加,且在侧切牙与尖牙间最厚。尖牙与侧切牙间的骨质区域可以考虑作为植入微种植钉的部位。

Objective To investigate the anatomical features of alveolar bone in gummy smile patients with cone beam computed tomography（ CBCT）, and provide the reference for miniscrews implanted in anterior alveolar crest. Methods A total of 63 cases of adults with gummy smile were selected for the study and the CBCT data of jaw bones were obtained.The mesiodistal interradicular distances, buccal-lingual thickness and buccal cortical bone thickness were measured at three different level which included 4 mm,6 mm and 8 mm above the alveolar crest. Results The mesiodistal interradicular distances increased along with distance between measure level and alveolar crest.（ P〈0. 05）. The interradicular distance were the least when measured between central incisor and lateral incisor（ P〈0. 05）. The interradicular space between central incisors presented the least buccal-lingual thickness（ P〈0. 05）. No significant differences were observed between the other thicknesses of anterior interradicular spaces（ P〉0. 05）. The buccal cortical bone thickness increased along with distance between measure level and alveolar crest（ P〉0. 05）. The thicknesses were the least between central incisors while the most between lateral incisor and canine（ P〈0. 05）. Conclusion The mesiodistal interradicular distances,buccal-lingual thickness and buccal cortical bone thickness are found increased with the height level. Given the most bone mass and cortical bone thickness, canine and lateral incisor interval can be recommended as the place for the miniscrews inserting.