成人骨型Ⅲ类矫治前后前牙区变化的临床研究

Clinical Study on the Changes of Anterior Dental Area Before and After Osteotype Ⅲ Orthosis in Adults

目的探讨成人骨型Ⅲ类患者矫治前后上下前牙区牙槽高度和宽度变化以及前牙区牙根位置变化。方法选取2020年5月—2022年11月在中山市小榄人民医院口腔科正畸掩饰治疗的成人骨型Ⅲ类患者50例,比较正畸治疗前后患者上下颌前牙牙槽骨厚度和高度,其中包括上前牙槽骨厚度(upper anterior alveolar bonethickness,UA)、上后牙槽骨厚度(upper posterior alveolar bone thickness,UP)、上牙槽骨总厚度(upper alveolar bone width,UW)、下前牙槽骨厚度(lower anterior alveolar bone thickness,LA)、下后牙槽骨厚度(lower posterior alveolar bone thickness,LP)、下牙槽骨总厚度(lower alveolar bone width,LW)、根中水平上前牙槽骨厚度(upper anterior alveolar bone thickness at the mid-root level,UA-m)、根中水平上后牙槽骨厚度(upper posterior alveolar bone thickness at the mid-root level,UP-m)、根中水平上牙槽骨总厚度(upper alveolar bone thickness at the mid-root level,UW-m)、根中水平下前牙槽骨厚度(lower anterior alveolar bone thickness at the mid-root level,LA-m)、根中水平下后牙槽骨厚度(lower posterior alveolar bone thickness at the mid-root level,LP-m)、根中水平下牙槽骨总厚度(lower alveolar bone thickness at the mid-root level,LW-m)以及上前牙槽骨高度(upper anterior alveolar bone height,UAH)和下前牙槽骨高度(lower anterior alveolarbone height,LAH)。结果正畸治疗前后患者UA、UP-m测量值比较,差异无统计学意义(P>0.05)。与正畸治疗前比较,正畸治疗后患者UP、UW、UA-m、UW-m测量值均显著降低(P<0.05)。正畸治疗后患者LP、LA-m测量值与正畸治疗前比较,差异无统计学意义(P>0.05)。与正畸治疗前比较,正畸治疗后患者LA、LW、LP-m、LW-m测量值均降低(P<0.05)。与正畸治疗前比较,正畸治疗后患者UAH、LAH测量值均显著降低(P<0.05)。正畸治疗后,患者上下颌前牙解剖牙根长度分别为(10.62±0.57)mm、(9.65±0.48)mm,正畸治疗前患者上下颌前牙解剖牙根长度分别为(11.01±0.58)mm、(10.37±0.48)mm,与正畸治疗前比较,患者上下颌前牙解剖牙根长度明显减小(P<0.05)。结论成人骨型Ⅲ类患者进行正畸掩饰治疗后,牙槽形态会发生相应改变,患者上下前牙牙槽骨厚度和高度会一定程度地减少。因此,在矫治过程中应当对患者牙槽形态的变化给予密切关注,尽量避免上下前牙发生代偿性移动,从而降低不良反应情况发生的风险。

Objective To explore the changes of alveolar height and width in upper and lower anterior area and root position in anterior area before and after orthodontic mask treatment in adult bone type Ⅲ patients.Methods A total of adult bone type Ⅲ patients who were treated with orthodontic masking in the Department of Orthodontics,Xiaolan People's Hospital of Zhongshan City from May 2020 to November 2022,they were selected to compare the thickness and height of the alveolar bone of the maxillary and mandibular anterior teeth of the patients before and after orthodontic treatment,which included the upper posterior alveolar bone thickness(UP)bone thickness(UA),upper posterior alveolar bone thickness(UP),upper alveolar bone width(UW),lower anterior alveolar bone thickness(LA),lower anterior alveolar bone thickness(LA),lower anterior alveolar bone thickness(LA),and lower anterior alveolar bone thickness(LA).bone thickness(LA),lower posterior alveolar bone thickness(LP),lower alveolar bone width(LW),upper anterior alveolar bone thickness at root mesial level(upper anterior alveolar bone thickness at the midroot level(UA-m),upper posterior alveolar bone thickness at the mid-root level(UP-m),upper alveolar bone thickness at the midroot level(upper alveolar bone thickness at the mid-root level(UW-m),lower anterior alveolar bone thickness at the mid-root level(LA-m),lower posterior alveolar bone thickness at the mid-root level(UW-m),and lower posterior alveolar bone thickness at the mid-root level(UW-m),alveolar bone thickness at the mid-root level(lower posterior alveolar bone thickness at the mid-root level,LP-m),total alveolar bone thickness at the midroot level(lower alveolar bone thickness at the mid-root level,LW-m),and upper anterior alveolar bone height(UAH)and lower anterior alveolarbone height(LAH)were aii compered.Results There was no statistically significant difference in UA and UP-m measurements between patients before and after orthodontic treatment(P>0.05).Compared with before orthodontic treatment,the measurement values of UP,UW,UA-m,and UW-m in patients after treatment were significantly reduced(P<0.05).There was no statistically significant difference in LP and LA-m measurements between patients after orthodontic treatment and before orthodontic treatment(P>0.05).Compared with before orthodontic treatment,the measured values of LA,LW,LP-m,and LW-m in patients decreased after treatment(P<0.05).Compared with before orthodontic treatment,the measured values of UAH and LAH in patients after treatment were significantly reduced(P<0.05).After orthodontic treatment,the anatomical root lengths of the patients'maxillary and mandibular anterior teeth were(10.62±0.57)mm and(9.65±0.48)mm,respectively,while the anatomical root lengths of the patients'maxillary and mandibular anterior teeth before orthodontic treatment were(11.01±0.58)mm and(10.37±0.48)mm,respectively;the anatomical root lengths of the patients'maxillary and mandibular anterior teeth were significantly decreased compared to those before orthodontic treatment(P<0.05).Conclusion The alveolar shape of adult bone type Ⅲ patients will be changed after orthodontic mask treatment,and the alveolar bone thickness and height of upper and lower anterior teeth will be reduced to a certain extent.Therefore,in the process of treatment,close attention should be paid to the changes of alveolar morphology of patients,and compensatory movement of upper and lower anterior teeth should be avoided as far as possible,so as to reduce the risk of adverse reactions.