改良骨皮质切开术对下前牙牙周组织和基骨宽度影响的临床研究

Clinical Study on Periodontal Tissue and Alveolar Width of Lower Anterior Teeth by Modified Corticotomy

目的:研究改良骨皮质切开术前术后下前牙牙周组织和基骨宽度的变化,评估其手术的安全性,为临床提供参考。方法:选取轻中度安氏Ⅲ类错的健康成人,进行下前牙改良骨皮质切开术辅助正畸治疗,并对下前牙正畸矫治前后的各项牙周指数和基骨宽度进行比较。结果:下前牙正畸矫治前后探诊深度、出血指数、牙龈萎缩各项指标均无统计学差异;正畸治疗后角化龈宽度(5.8±2.4)mm大于术前(5.2±1.9)mm(P=0.041);下前牙根尖区基骨厚度治疗后(6.04±4.57)mm比治疗前(5.32±3.87)mm增厚(P=0.024),但其中下前牙根尖区唇侧基骨厚度治疗后(2.27±1.72)mm,比治疗前(2.88±2.35)mm减小(P=0.014),舌侧基骨厚度治疗后(3.97±3.49)mm则比治疗前(2.54±2.06)mm增大(P=0.040);下颌B点基骨厚度治疗后(7.17±5.21)mm比治疗前(6.47±3.99)mm增厚(P=0.042)。结论:改良骨皮质切开术辅助正畸治疗矫治中度安氏Ⅲ类错,对其下前牙牙周组织是安全的,甚至能刺激下前牙基骨的增生。

Objective：To evaluate the periodontal tissue and alveolar width changes of lower anterior teeth before and after modified corticotomy,and to assess the surgical safety and provide reference for clinic practice.Methods：Healthy adult cases with moderate Angle Class Ⅲ malocclusion were undergone orthodontic treatment combined with modified corticotomy.The various periodontal index and alveolar width of lower anterior teeth before and after orthodontic treatment were measured and compared with each other.Results：Probing depth,bleeding index and index of gingival atrophy before and after treatment showed no statistical difference.Keratosic gingival after orthodontic treatment（5.8±2.4mm）was thicker than pre-treatment（5.2±1.9mm）（P=0.041）.Alveolar bone at the apex area after treatment（6.04±4.57mm）was thicker than pre-treatment（5.32±3.87mm）（P=0.024）.Labial alveolar bone at the apex area after treatment（2.27±1.72mm）was thinner than pre-treatment（2.88±2.35mm）（P=0.014）.Lingual alveolar thickness at the apex area after treatment（3.97±3.49 mm）was thicker than pre-treatment（2.54±2.06mm）（P=0.040）.Thickness of mandible at B point after treatment（7.17±5.21mm）was thicker than pre-treatment（6.47±3.99mm）（P=0.042）.Conclusion：It is safe to treat moderate Angle ClassⅢ malocclusion by orthodontic treatment combined with modified corticotomy,which could even stimulate the alveolar proliferation of lower anterior teeth.