下颌完全埋伏阻生智齿引起邻近第二磨牙牙根外吸收及牙周改变的CBCT研究

A CBCT study of the external root resorption and bone loss(periodontal changes)of the adjacent teeth caused by mandibular completely embedded impacted wisdom teeth

目的:探讨下颌近中、水平、倒置完全埋伏阻生智齿与邻近第二磨牙牙根外吸收及牙周组织病变之间的关系。方法:收集2019~2022年我院收诊的140例患者共计251颗此类患牙的临床资料(CBCT影像资料),对下颌近中、水平、倒置完全埋伏阻生第三磨牙引起相邻第二磨牙牙根外吸收及局部牙周改变的相关情况进行检查并统计分析。结果:下颌近中、水平、倒置完全埋伏阻生智齿导致邻近下颌第二磨牙牙根外吸收的患病率为22.7%,远中边缘骨吸收(或牙周破坏)发生率为68.5%,多数情况下均存在下颌第二磨牙远中牙槽骨吸收,其中轻度占主要(36.2%)。不同年龄和性别及下颌第三磨牙阻生方向不同,第二磨牙远中牙槽骨吸收发生率差异有统计学意义(P<0.05);不同年龄、性别、下颌第三磨牙深度及角度不同,牙根外吸收发生率及严重程度差异均有统计学意义(P<0.05)。结论:下颌近中、水平、倒置智齿完全埋伏阻生时易导致第二磨牙牙根外吸收的发生及周围牙周组织的破坏,应给予足够重视,建议尽早拔除。

Objective:To investigate the relationship between mandibular completely obstructed wisdom teeth and adjacent second molars with root resorption and periodontal tissue lesions.Methods:The clinical data(CBCT image data)of 140 patients with a total of 251 affected teeth admited from 2019 to 2022 were collected,and the conditions related to extraroot resorption and local periodontal changes of adjacent second molars caused by completely buried and obstructed third molars in the mandible were examined and statistically analyzed.Results:The prevalence of mandibular second molar external root resorption(ERR)was 22.7%,and the incidence of distal marginal bone resorption(or periodontal destruction)was 68.5%,and in most cases with mandibular second molar distal alveolar bone resorption,which was mainly a mild alveolar bone defect(36.2%).The differences in the incidence of distal alveolar bone resorption of the second molar were statistically significant(P<0.05)by age,gender and angle of mandibular third molar,and the differences in the incidence and severity of ERR were statistically significant(P<0.05)by age,gender,the depth and angle of mandibular third molar.Conclusion:When the mandibular third molar is completely impacted,it is easy to cause the occurrence of ERR of the adjacent second molar and the destruction of the surrounding periodontal tissue.It is recommended that this kind of mandibular third molar should be removed as soon as possible in clinical practice.