锥形束CT在辅助微种植体支抗植入及评价成人安氏Ⅱ类1分类错(牙合)畸形患者矫治效果中的应用研究

Investigation of the Value of CBCT on Assisting Micro-implant Anchorage Implantation and Evaluating the Correction Effect of Adult Class Ⅱ Division 1 Malocclusion

目的:探究锥形束计算机断层扫描(Cone-Beam Computed Tomography, CBCT)在辅助微种植体支抗植入及评价成人安氏Ⅱ类1分类错(牙合)畸形患者矫治效果中的应用价值。方法:选取2015年7月-2016年3月笔者医院正畸科收治的102例安氏Ⅱ类1分类错(牙合)畸形患者为研究对象。所有患者均在CBCT引导下进行微型种植体支抗拔牙矫治,并记录患者治疗前后CBCT扫描数据,观察患者牙槽骨开裂、开窗发生情况,比较治疗前后患者软组织和牙槽骨等各项指标的变化。结果:患者治疗后Ns-Sn-Pos、NLA等软组织指标均明显优于治疗前,有显著性差异,具有统计学意义(P<0.01),ULL、LLL优于治疗前,差异有统计学意义(P<0.05);UA、LA等牙槽骨指标明显优于治疗前,差异有统计学意义(P<0.01);上、下中切牙、侧切牙的牙根长度较治疗前明显缩短,有统计学意义(P<0.01),下颌尖牙牙根长度较矫治前稍有缩短,差异有统计学意义(P<0.05),上颌尖牙牙根长度较矫治前无明显变化,两组比较差异无统计学意义(P>0.05);患者矫治后均有前牙区牙槽骨开窗、开裂情况发生,但发生率较低,其中前牙区牙槽骨总开裂率为17.00%,总开窗率为7.76%。结论:CBCT在辅助微种植体支抗植入及评价成人安氏Ⅱ类1分类错(牙合)畸形患者矫治效果中作用显著,通过提高矫治方案的科学性、准确性有效提高了矫治效果,同时降低了患者牙槽骨开裂、开窗风险,值得临床推广使用。

Objective To investigate the value of Cone-Beam Computed Tomography(CBCT) in assisting micro-implant anchorage implantation and evaluating the correction effect of adult Class Ⅱ division 1 malocclusion. Methods A total of 102 patients with Class Ⅱ division 1 malocclusion were enrolled in the orthodontics department from July 2015 to March 2016. All patients underwent CBCT-guided micro-implant support for tooth extraction, and recorded CBCT scan data before and after treatment, and observed the occurrence of alveolar bone cracking and fenestration, and compared soft tissue and alveolar bone before and after treatment. The change. Results The soft tissue indexes of Ns-Sn-Pos and NLA were significantly better than those before treatment. The difference was statistically significant(P<0.01). ULL and LLL were better than before treatment,and the difference was statistically significant(P<0.05);the indexes of alveolar bone such as UA and LA were significantly better than those before treatment, and the difference was statistically significant(P<0.01). The length of roots of upper and lower incisors and lateral incisors was significantly shorter than that before treatment. The difference was statistically significant(P<0.01). The length of the mandibular canine was slightly shorter than that before the treatment. The difference was statistically significant(P<0.05). The length of the maxillary canine had no significant change before the correction. The difference was not statistically significant(P>0.05). After the correction, the anterior teeth alveolar bone fenestration and cracking occurred, but the incidence was low. The total cleavage rate of the alveolar bone in the anterior region was 17.00%.The window opening rate is 7.76%. Conclusion CBCT has a significant value in the application of micro-implant anchorage implantation and evaluation of the treatment of adult Class Ⅱdivision 1 malocclusion. It improves the correction and the accuracy and accuracy of the correction plan. The risk of alveolar bone cracking and window opening is worthy of clinical use.