拔除第一前磨牙正畸治疗前后上下颌前牙骨开窗骨开裂的比较

Comparison of Fracture of Maxillary and Mandibular Anterior Teeth before and after Orthodontic Treatment with Extraction of the First Premolar

目的:比较拔除第一前磨牙正畸治疗前后上下颌前牙骨开窗骨开裂的变化。方法:选取我院在2020年1月-2023年1月拔除第一前磨牙接受正畸治疗的20例患者的240颗前牙作为研究对象,其中上中切牙,上侧切牙、上尖牙、下中切牙、下侧切牙、下尖牙各40颗,对比正畸治疗前后各牙位、患者、上下颌前牙骨缺损发生率的变化。结果:治疗前骨开裂、骨开窗和骨缺损程度最为严重的依次为:下尖牙、下侧切牙和下侧切牙;治疗后骨开裂、骨开窗和骨缺损程度最为严重的依次为:下中切牙、下侧切牙和下中切牙。除上中切牙和上尖牙外,其他前牙治疗前后骨开裂发生率差异具有统计学意义;上中切牙、上侧切牙和上尖牙治疗前后骨开窗发生率差异具有统计学意义;上中切牙、上侧切牙、下中切牙治疗前后骨缺损发生率差异具有统计学意义。治疗前40.00%的患者(8/20)存在牙槽骨开裂,90%的患者(18/20)存在牙槽骨开窗,95%的患者存在缺损(开裂或开窗)(19/20),并且40%(8/20)的患者存在两种缺陷(开窗合并开窗)。治疗后100%的患者(20/20)存在牙槽骨开裂,100%的患者(20/20)存在牙槽骨开窗,100%的患者存在缺损(开裂或开窗)(20/20),并且100%(20/20)的患者存在两种缺陷(开窗合并开窗)。治疗前后上下颌前牙骨缺损分别以骨开窗和骨开裂为主,而且骨开裂发生率和骨缺损发生率较治疗前显著增加,差异具有统计学意义(P<0.05),骨开窗发生率较治疗前无显著变化,差异无统计学意义(P>0.05)。结论:拔除第一前磨牙正畸治疗前后,除上中切牙和上尖牙外其他前牙骨开裂风险增加,应注意正畸治疗中骨开裂的防范。

Objective:To compare the changes of maxillary and mandibular anterior teeth fracture before and after orthodontic treatment with extraction of the first premolar.Methods:We selected 240 anterior teeth from 20 patients who had their first premolars extracted and received orthodontic treatment in our hospital from January 2020 to January 2023,including 40 upper central incisors,40 upper incisors,40 upper canines,40 lower central incisors,40 lower incisors,and 40 lower canines.We compared the changes in the incidence of bone defects in each tooth position,patient,and the upper and lower anterior teeth before and after orthodontic treatment.Results:Before treatment,the most severe degrees of bone cracking,bone fenestration,and bone defect were as follows:lower canine,lower incisor,and lower incisor;After treatment,the most severe degrees of bone cracking,bone fenestration,and bone defect were as follows:lower central incisor,lower lateral incisor,and lower central incisor.Except for the upper central incisor and upper canine,there was a statistically significant difference in the incidence of bone cracking before and after treatment for other anterior teeth;There was a statistically significant difference in the incidence of bone fenestration among upper central incisor,upper lateral incisor,and upper canine before and after treatment;There was a statistically significant difference in the incidence of bone defects between the upper central incisor,the upper central incisor,and the lower central incisor before and after treatment.Before treatment,40.00%of patients(8/20)had alveolar bone cracking,90%(18/20)had alveolar bone fenestration,95%(19/20)had defects(cracking or fenestration),and 40%(8/20)had two types of defects(fenestration combined with fenestration).After treatment,100%of patients(20/20)had alveolar bone cracking,100%of patients(20/20)had alveolar bone fenestration,100%of patients had defects(cracking or fenestration)(20/20),and 100%of patients(20/20)had two types of defects(fenestration combined with fenestration).Before and after treatment,the main bone defects in the maxillary and mandibular anterior teeth were bone fenestration and bone cracking,and the incidence of bone cracking and bone defects significantly increased compared to before treatment,with a statistically significant difference(P<0.05).The incidence of bone fenestration did not significantly change compared to before treatment,with no statistically significant difference(P>0.05).Conclusion:Before and after orthodontic treatment with extraction of the first premolar,the risk of bone cracking in other anterior teeth,except for the upper central incisor and upper canine,increases.Attention should be paid to the prevention of bone cracking during orthodontic treatment.