高转矩自锁托槽矫治双颌前突的疗效及对牙根形态及根尖外吸收的影响分析

Analysis of the Effect of High Torque Self-locking Bracket in the Treatment of Bimaxillary Protrusion and Its Infl uence on Root Morphology and External Apical Root Resorption

目的:研究高转矩自锁托槽用于双颌前突的正畸效果,以及对牙根形态及根尖外吸收的影响。方法:纳入2018年1月-2022年1月笔者医院收治的96例双颌前突患者为研究对象,按照随机数字表法分为观察组和对照组,每组48例。观察组采用Damon-Q金属高转矩自锁托槽进行系统矫治,对照组采用传统直丝弓金属托槽。比较两组矫治前后牙菌斑指数及牙周袋深度,检测两组矫治前后龈沟液炎症因子[白介素-1β(Interleukin-1β,IL-1β)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平;通过锥形束CT影像测量,比较两组矫治后根尖外吸收量、矫治前后尖牙间宽度、第一前磨牙间宽度、第二前磨牙间宽度及前牙凸度,比较两组矫正前后舌骨位置变化。结果:两组矫治后3个月牙菌斑指数、牙周袋深度均显著高于矫治前,矫治后6个月牙菌斑指数、牙周袋深度均显著高于矫治前及矫治后3个月;观察组矫治后3、6个月,牙菌斑指数、牙周袋深度均显著低于对照组,差异有统计学意义(P<0.05)。两组矫治后6个月IL-1β、TNF-α水平均显著高于矫治前,且观察组IL-1β、TNF-α水平均显著低于对照组,差异有统计学意义(P<0.05)。矫治后,观察组右上颌中切牙、左上侧中切牙、右上颌侧切牙、左上颌侧切牙根尖外吸收量均低于对照组(P<0.05);两组矫治后6个月第一前磨牙间宽度、第二前磨牙间宽度、前牙凸度显著高于矫治前,且观察组数据显著高于对照组,差异均有统计学意义(P<0.05)。两组矫治后舌骨垂直向距离较矫正前显著增加,水平向距离显著减小,观察组矫治后舌骨垂直向距离显著大于对照组,差异均有统计学意义(P<0.05)。结论:高转矩自锁托槽矫治双颌前突的效果显著,且在减轻根尖外吸收发生风险方面具有一定优势。

Objective To study the orthodontic effect,root morphology and external apical root resorption of high torque self-locking brackets used in bimaxillary protrusion.Methods 96 patients with bimaxillary protrusion treated from January 2018 to January 2022 were included as the research objects.They were divided into two groups according to the random number table method,with 48 cases in each group.The observation group was treated with damon-Q metal high torque self-locking bracket,and the control group was treated with traditional straight wire mental bracket.Plaque index and periodontal pocket depth were compared between the two groups before and after treatment.Gingival crevicularfluid inflammatory factor was measured before and after correction in the two groups IL-1βand TNF-αlevel,measure and compare the external apical root resorption,inter canine width,inter molar width of the first premolar,inter molar width of the second premolar and anterior tooth convexity between the two groups after correction by cone beam CT image.Compaird the hyoid position before and after correction between the two groups.Results The plaque index and periodontal pocket depth of the two groups at 3 months after treatment were significantly higher than those before treatment,and the plaque index and periodontal pocket depth at 6 months after treatment were significantly higher than those before and 3 months after treatment.The plaque index and periodontal pocket depth of the observation group at 3 and 6 months after correction were significantly lower than those of the control group,the differences were statistically significant(P<0.05).The levels of IL-1βand TNF-αin the two groups after 6 months of correction were significantly higher than those before correction,After 6 months of treatment,the levels of IL-1βand TNF-αin the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The external apical root resorption of right maxillary central incisor,left maxillary central incisor,right maxillary lateral incisor and left maxillary lateral incisor in the observation group were lower than those in the control group(P<0.05).The width between the first premolar,the width between the second premolar,anterior tooth convexity in the two groups were significantly higher than those before correction 6 months after treatment.The width between the first premolar,the width between the second premolar,anterior tooth convexity in the observation group were significantly higher than those in the control group 6 months after correction(P<0.05).After correction,the vertical distance of hyoid bone was significantly increased and the horizontal distance was significantly reduced in both groups.After correction,the vertical distance of hyoid bone in the observation group was significantly greater than that in the control group,the differences were statistically significant(P<0.05).Conclusion High torque self-locking bracket has significant orthodontic effect on bimaxillary protrusion,and has certain advantages in reducing the risk of external apical root resorption.