正畸拔牙矫治病例中出现牙龈折痕的临床研究

Clinical Study on Gingival Invagination after Tooth Extraction and Orthodontic Treatment

目的:探讨正畸拔牙矫治病例出现牙龈折痕原因,为临床预防牙龈折痕的发生提供依据。方法:在拔除前磨牙进行固定矫治的错牙合畸形患者中,筛查出发生的牙龈折痕病例87例,选择其中一侧出现牙龈折痕,另一侧未出现的病例65例,将出现牙龈折痕的一侧作为实验侧,未出现牙龈折痕的一侧作为对照侧,通过CBCT测量分析,比较两侧牙槽骨宽度、高度及骨密度的变化与出现牙龈折痕的相关性。结果:牙龈折痕多发生在下颌,牙周探针牙龈折痕深度下颌均大于上颌。牙龈折痕侧牙槽骨宽度减小、高度降低以及密度减小均明显大于对照组,两组数据统计结果有显著性差(P<0.05)。结论:正畸拔牙矫治病例中牙龈折痕的出现与牙槽骨宽度、高度及骨密度的变化具有相关性,拔牙间隙关闭过程中牙槽骨吸收,对软组织支持的丧失,可能是出现牙龈折痕的解剖学因素。

Objective：To investigate the factors of gingival invagination and provide the basis for clinical prevention and treatment.Methods：87cases were chosen from edgewise fixed appliance cases who had premolars removed.Among them,65 cases who had gingival invagination on one side（experimental group）and no gingival invagination（control group）on the other side were selected.CBCT measurement was used to compare the alveolar bone width,height,the changes of bone mineral density,and the correlation of gingival invagination on both sides.The correlation of alveolar bone atrophy to the gingival invagination was also studied.Results：Gingival invagination was severe in the mandible than in the maxilla.The periodontal depth was deeper in the mandibular teeth than in the maxillary teeth.The height,width and density of alveolar bone in the experimental group decreased greater than in the control group（P〈0.05）.Conclusion：Gingival invagination was correlated to the change of alveolar bone width,height and bone mineral density.The alveolar bone resorption during the space closing and the loss of soft tissue support may be the anatomical factors associated with gingival invagination.