三种不同形态上颌中切牙颈部穿龈轮廓形貌测量与分析

Measurement and analysis of maxillary central incisor neck gingival contours morphology among three different shapes

目的测量尖圆形、卵圆形、方圆形上颌中切牙颈部穿龈轮廓的三维形貌,为不同形态中切牙种植修复关键区数据库的建立提供参考依据。方法选取2020年1月~2022年12月于河北医科大学口腔医院修复科就诊并接受种植CBCT拍摄检查的患者100名,通过NewTom Viewer软件测量近远中穿龈轮廓高度、穿龈轮廓角度、顶部直径、唇侧釉牙牙骨质界以及其冠方1.5 mm周径。使用SPSS19.0软件包对测量结果进行分析。结果(1)卵圆形:龈乳头顶点近远中直径约7.61±0.67 mm、近中穿龈轮廓高度为3.56±0.38 mm、远中穿龈轮廓高度为3.17±0.25mm;近中穿龈轮廓角度为13.42±3.24°,远中轮廓穿龈角度19.19±3.28°;釉牙牙骨质界(CEJ处)周径为20.07±1.70mm;釉牙牙骨质线冠方1.5 mm周径为21.41±1.78 mm。(2)方圆组:龈乳头顶点近远中直径约7.43±0.45 mm;近中穿龈轮廓高度为3.21±0.60 mm、远中穿龈轮廓高度为2.70±0.60 mm;近中穿龈轮廓角度为11.80±5.31°,远中穿龈轮廓角度为18.81±3.45°;釉牙牙骨质(CEJ处)周径为20.58±1.27 mm;釉牙牙骨质线冠方1.5 mm周径为22.02±2.06 mm。(3)尖圆组:龈乳头顶点近远中直径约7.19±0.43 mm;近中穿龈轮廓高度为4.46±0.40 mm、远中龈乳头高度为3.66±0.55 mm;近中穿龈轮廓角度为11.16±2.07°,远中穿龈轮廓角度为18.52±3.68°;釉牙牙骨质界(CEJ处)周径为19.32±1.05 mm;釉牙牙骨质界冠方1.5 mm周径为21.03±1.59 mm。(4)组内近、远中牙龈轮廓高度、穿龈轮廓角度以及釉牙牙骨质界(CEJ处)周径与冠方1.5 mm(CEJ处)之间P值均小于0.05,均有统计学意义;而3组不同形态的近远中牙龈轮廓高度与穿龈角度不同,具有统计学差异。方圆形穿龈轮廓角度最大,穿龈轮廓高度最小。其余未见明显差异。结论所得数据为种植修复穿龈轮廓区成型基台与修复体颈部形态的设计研发数据库建立提供了参考意义,可以帮助临床种植修复医生提高前牙区美学效果。

Objective To measure the three-dimensional morphology of the cervical gingival contour of tapered,oval and square maxillary central incisor,and to provide references for the establishment of the database of the key areas of implant restoration in different shapes of central incisors.Methods treated in the prosthetics Department of Stomatology Hospital of Hebei medical university from January 2020 to December 2022,and underwent CBCT imaging examination.New Tom Viewer software was used to measure the height of proximal and distal gingival profile,angle of penetrating gingival profile,top diameter,labial enamel cementum and 1.5mm circumference diameter of crown square.The measurement results were analyzed using SPSS19.0 software.Results(1)Oval group:the diameter of the papilla apex was 7.61±0.67 mm,the height of the mesial papilla was 3.56±0.38 mm,and the height of the distal papilla was 3.17±0.25 mm.The mesial angle was 13.42±3.24°and the distal angle was 19.19±3.28°.The circumference of enamel cementum line(CEJ)was 20.07±1.70 mm;the outer 1.5 mm circumference diameter 21.41±1.78 mm.(2)Square group:the diameter of gingival papilla apex was about 7.43±0.45mm;the height of mesial papillae was 3.21±0.60 mm and distal papillae was 2.70±0.60 mm.The mesial penetration angle was 11.80±5.31°,and the distal penetration angle was 18.81±3.45°.The circumference of enamel cementum line(CEJ)was 20.58±1.27 mm,and the outer 1.5 mm circumference diameter 22.02±2.06 mm.(3)The tapered group:the diameter of gingival papilla apex was about 7.19±0.43 mm;The height of mesial papilla and distal were 4.46±0.40 mm and 3.66±0.55 mm.The mesial penetration angle was 11.16±2.07°and the distal was 18.52±3.68°.The circumference of enamel cementum line(CEJ)was 19.32±1.05 mm,and the outer 1.5mm circumference diameter was 21.03±1.59 mm.(4)The height of mesial and distal gingival papillae,the angle of gingival penetration,and the circumference of enamel cementum line(CEJ)and the outer 1.5 mm,(CEJ)in the groups were all less than 0.05,which had statistical significance.Among the 3 groups,the height of proximal and distal gingival papillae and the angle of gingival were different,and there were statistical differences.The angle of gingival perforation in square group shape was the largest and the distance between adjacent area and alveolar ridge was the smallest,there is no significant difference was found.Conclusion The obtained data provide references for the design and development database of the forming base of the gingival contour area and the neck shape of the prosthesis,which can help the clinical surgeons to improve the aesthetic effect of the anterior tooth area.