牙槽骨再生正畸技术治疗成人错[牙合]畸形伴原发性牙槽骨缺损的远期疗效评价

Long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect

目的:定量评价牙槽骨再生正畸技术治疗成人错[牙合]畸形伴原发性牙槽骨缺损的远期疗效。方法:从上海交通大学医学院附属第九人民医院口腔颅颌面科2014年1月起就诊的连续病例中,选择下前牙区存在原发性牙槽骨缺损且治疗结束后随访时间> 2年的成人错[牙合]畸形患者,将其中接受牙槽骨再生正畸治疗的30例患者作为研究对象。通过锥形束CT(cone-beam CT,CBCT)评价不同观察时间点术区的牙槽骨形态,采用SAS 9.1软件包对数据进行统计学处理。结果:牙槽骨再生正畸治疗成人错[牙合]畸形伴原发性牙槽骨缺损后,术区未见牙根吸收。根尖水平骨厚度增量效果最佳且远期疗效最为稳定,根长3/4水平次之,根长1/2水平未见骨厚度增量效果。术区唇舌侧出现少量牙槽骨高度降低。结论:牙槽骨再生正畸技术是治疗成人错[牙合]畸形伴原发性牙槽骨缺损的有效方式,但仍存在术区少量牙槽骨垂直丢失等局限。

PURPOSE:To quantitively investigate the long-term effectiveness of periodontal micro-osteotomy assisted orthodontic treatment of adult patients with primary alveolar defect.METHODS:The sample consisted of 30 adult cases with primary alveolar defect in the lower anterior region who accepted periodontal micro-osteotomy assisted orthodontic treatment with over 2 years of follow-up,selected from consecutive patients at the Department of Oral and Craniomaxillofacial Surgery,Shanghai Ninth People's Hospital since Jan.2014.Alveolar bone morphology of lower anterior teeth with primary alveolar defect was appraised with the help of cone-beam CT(CBCT)in the surgical sites at different time points.The data were processed using SAS 9.1 software package.RESULTS:Periodontal micro-osteotomy assisted orthodontic treatment in adult patients with primary alveolar defect showed stable long-term effect of bone augmentation and minimal root resorption.However,the effect of bone augmentation was less when approaching the alveolar bone crest,and vertical alveolar bone loss was observed on both labial and lingual side in the surgical sites.CONCLUSIONS:Periodontal micro-osteotomy assisted orthodontic treatment is a promising approach for the treatment of adult patients with primary and inflammatory alveolar defect;however,vertical alveolar bone loss could be observed in the surgical sites.