正畸拔牙矫治对AngleⅡ1类错[牙合]垂直骨面型患者牙槽骨厚度的影响

Effect of Orthodontic Extraction on Thickness of Alveolar Bone in AngleⅡClass 1 Malocclusion with Vertical Bone Surface

【目的】探讨正畸拔牙矫治对AngleⅡ1类错[牙合]垂直骨面型患者牙槽骨厚度的影响。【方法】选择2016年8月至2020年9月在宝鸡市中医院、宝鸡市口腔医院和渭南市人民医院就诊的80例AngleⅡ1类错[牙合]垂直骨面型患者,根据下颌平面角(MP-SN)角度及面高指数分为高角组、低角组、均角组,所有患者均给予正畸拔牙矫治处理,分析治疗前后患者牙槽骨厚度变化。【结果】矫治后,高角组、低角组患者右上[牙合]颌面距釉牙骨质界(Cemento-enamel junction,CEJ)6 mm、9 mm、根尖点处牙槽骨总厚度降低,且高角组低于低角组,差异均有统计学意义(P<0.05);高角组患者右侧下颌[牙合]颌面距CEJ 3 mm、6 mm、9 mm牙槽骨总厚度和唇侧牙槽骨厚度降低最多,左侧[牙合]颌面距CEJ 6 mm、9 mm,根尖点牙槽骨总厚度及距CEJ 9 mm唇侧和距CEJ 6 mm腭侧减少量最多(P<0.05)。高角组距CEJ 3 mm处腭侧牙槽骨厚度明显减少,低角组左侧上颌第一磨牙远中根距CEJ 3 mm、6 mm、9 mm处牙槽骨厚度明显减少(P<0.05)。矫治后,低角组近远中根颊舌侧牙槽骨厚度明显减少,高角组颊侧牙槽骨厚度明显减少(P<0.05);高角组近中根唇侧牙槽骨减少量高于低角组(P<0.05)。【结论】正畸拔牙矫治能减少AngleⅡ1类错[牙合]垂直骨面型高角患者牙槽骨厚度,应慎重选择治疗方案。

【Objective】To analyze the effect of orthodontic extraction on the thickness of alveolar bone in AngleⅡclass 1 malocclusion patients with vertical bone surface.【Methods】From August 2016 to September 2020,a total of 80 patients with vertical bone surface type of AngleⅡtype 1 malocclusion,who were treated in Baoji Hospital of Traditional Chinese Medicine,Baoji Hospital of Stomatology and Weinan People's Hospital,were selected in the study.According to the Angle of mandibular plane Angle(MP-SN)and facial height index,patients were divided into the high Angle group,low Angle group and average Angle group.All patients were treated with orthodontic extraction and the changes of alveolar bone thickness were analyzed.【Results】After treatment,the total thickness of alveolar bone at the maxillofacial distance of 6 mm and 9mm from the cementum enamel boundary(CEJ)in the high Angle group and the low Angle group decreased.The high Angle group was lower than the low Angle group;and the difference was statistically significant(P<0.05).In the high-angle group,the total alveolar bone thickness and labial alveolar bone thickness of the right mandibular occlusal surface from CEJ 3 mm,6 mm and 9 mm decreased the most,while the total apical point thickness and the total alveolar bone thickness from CEJ 9 mm and labial and palatal bone thickness from CEJ 6 mm decreased the most in the left occlusal surface(P<0.05).The thickness of palatal alveolar bone at 3 mm from CEJ in the high Angle group was significantly decreased,and the thickness of alveolar bone at 3 mm,6 mm and 9 mm from CEJ in the low Angle group was significantly decreased(P<0.05).After treatment,the buccal lingual thickness of the proximal and distal middle root in the low Angle group was significantly reduced,and the buccal alveolar bone thickness in the high Angle group was significantly reduced(P<0.05).The reduction in the labial side of the mesial root in the high Angle group was higher than that in the low Angle group(P<0.05).【Conclusion】Orthodontic extraction can reduce the alveolar bone thickness in AngleⅡtype 1 malocclusion patients with high angle of vertical bone surface.The treatment should be carefully chosen.