基于锥形束CT的骨性Ⅲ类错患者牙槽骨骨开裂和骨开窗发生率研究

Prevalence of alveolar dehiscence and fenestration in patients with skeletal Class Ⅲ malocclusion by using cone beam CT

目的 应用锥形束CT(cone beam CT,CBCT)研究骨性Ⅲ类错患者牙位、性别及颈椎骨龄对牙槽骨骨开裂及骨开窗发生率的影响。方法 选择2018—2021年于中国医科大学附属口腔医院正畸二科及第一门诊就诊的骨性Ⅲ类错患者78例。头颅定位仪拍摄头颅侧位片确定患者的颈椎骨龄;再分析CBCT及三维重建图像,比较不同牙位及不同性别、颈椎骨龄患者的牙槽骨骨开裂及骨开窗发生率的差异。结果 72例(92.31%,72/78)患者牙槽骨出现骨缺损,骨开裂发生率92.31%(72/78),骨开窗发生率11.54%(9/78);502颗(24.44%,502/2054)牙齿牙槽骨出现骨缺损,其中489颗(97.41%,489/502)出现骨开裂,13颗(2.59%,13/502)出现骨开窗;下颌骨开裂发生率高于上颌,差异有统计学意义(χ^(2)=24.515,P <0.001);且上下颌不同牙位骨开裂及骨开窗发生率的比较,差异均有统计学意义(均P <0.01);男性患者牙槽骨骨开裂发生率高于女性,差异有统计学意义(χ^(2)=5.463,P=0.019);对同一性别患者进一步按照不同颈椎骨龄分析,不同颈椎骨龄男性及女性患者牙槽骨骨开裂发生率的比较,差异均有统计学意义(均P <0.01)。结论 骨开裂和骨开窗在正畸治疗前的骨性Ⅲ类错畸形患者中发生率较高,其可能与牙位、性别、颈椎骨龄等因素有关。

Objective To investigate the prevalence of alveolar dehiscence and fenestration in patients with skeletal Class Ⅲ malocclusion at different tooth sites,gender and cervical vertebral maturation by using cone beam CT(CBCT).Methods The samples included 78 patients with skeletal Class Ⅲ malocclusion,who visited the Second Department of Orthodontics and the First Dental Clinic,Hospital of Stomatology,China Medical University from 2018 to 2021. The patients were evaluated their cervical vertebral maturation by radiographic cephalometric projection through cephalometer and cervical vertebrae maturation system. Then three-dimensional CBCT reconstruction was performed and the images were analyzed to investigate the prevalence of alveolar dehiscence and fenestration at different tooth sites,gender and cervical vertebral maturation. Results Totally 72 patients(92.31%,72/78)had alveolar bone defects,among which the prevalence of dehiscence was 92.31%(72/78),and the prevalence of fenestration was 11.54%(9/78). The alveolar bone defects occurred in 502 teeth(24.44%,502/2054),among which 489 teeth(97.41%,489/502)had dehiscence,and 13teeth(2.59%,13/502)had fenestration. The prevalence of alveolar dehiscence in mandible was higher than that in maxilla,and the difference was statistically significant(χ^(2)=24.515,P<0.001). There were statistically significant differences in the prevalence of dehiscence and fenestration at different tooth sites(P<0.01). The prevalence of alveolar dehiscence in male patients was higher than that in female patients,and the difference was statistically significant(χ^(2)= 5.463,P = 0.019). Further analysis of patients with the same gender was made according to different cervical vetebral maturation,which showed that the prevalence of alveolar dehiscence in male and female patients at different cervical bone vetebral maturation had statistically significant difference(all P<0.01). Conclusion Alveolar dehiscence and fenestration are common in patients with skeletal Class Ⅲ malocclusion before orthodontic treatment,and the prevalence is related to tooth site,gender,cervical vetebral maturation and other factors.