口腔疾病防治2025,Vol.33Issue(1) :41-49.DOI:10.12016/j.issn.2096-1456.202440382

不同牙周表型成年患者上颌牙列远移前后中切牙区软硬组织的变化

Changes in soft and hard tissue of central incisor before and after distal migration of the maxillary dentition in adult patients with different periodontal phenotypes

陈瑞 韩爽 安琪
口腔疾病防治2025,Vol.33Issue(1) :41-49.DOI:10.12016/j.issn.2096-1456.202440382

不同牙周表型成年患者上颌牙列远移前后中切牙区软硬组织的变化

Changes in soft and hard tissue of central incisor before and after distal migration of the maxillary dentition in adult patients with different periodontal phenotypes

陈瑞 1韩爽 2安琪2
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作者信息

  • 1. 皖南医学院口腔医学系,安徽 芜湖(241002);安徽医科大学合肥口腔临床学院,合肥市口腔医院正畸二科,安徽 合肥(230001)
  • 2. 安徽医科大学合肥口腔临床学院,合肥市口腔医院正畸二科,安徽 合肥(230001)
  • 折叠

摘要

目的 探讨不同牙周表型成年患者在上颌全牙列远移后上颌中切牙牙周软硬组织参数的变化,为正畸治疗提供参考.方法 本研究获得医院伦理委员会审批,患者签署知情同意书.选取就诊于合肥市口腔医院正畸科的成年安氏Ⅱ类错患者52例,依据牙龈厚度分为厚龈组与薄龈组各26例.所有患者均在双侧上颌颧牙槽嵴处植入微种植钉远移上颌牙列,收集记录治疗结束前后两组上颌中切牙唇、腭侧牙槽骨参数以及牙周指标,应用SPSS 26.0统计软件对组内及组间差异进行统计分析.结果 正畸治疗后两组上齿槽座角(sella-nasion-subspinale angle,SNA)、下齿槽座角(sella-nasion-supramental angle,SNB)、上下齿槽座角(subspinale-nasion-supramental angle,ANB)变化量的差异均无统计学意义(P>0.05),而上中切牙倾斜度(the inclination of the upper middle incisor teeth,U1-NA)均减小,差异有统计学意义(P<0.05);治疗后两组间 SNA、SNB、ANB、U1-NA变化量差异无统计学意义(P>0.05).两组上颌中切牙唇侧牙槽骨在牙根颈1/3、中1/3处厚度增加(P<0.05),根尖1/3处厚度减少(P<0.05),腭侧牙槽骨在牙根颈1/3、中1/3处厚度减少(P<0.01),根尖1/3处厚度增加(P<0.01);治疗后两组上颌中切牙唇腭侧牙槽骨高度均发生不同程度的下降,薄龈组腭侧牙槽骨高度降低显著(P<0.05).治疗后两组上颌中切牙探诊深度(probing depth,PD)、唇侧角化龈宽度(keratinized tissue width,KTW)以及唇侧牙龈退缩(gingival recession,GR)差异均无统计学意义(P>0.05).结论 上颌中切牙在内收过程中唇腭侧牙槽骨改建并不均匀,腭侧牙槽骨以吸收为主,临床上需加以重视;薄龈型者正畸治疗后腭侧牙槽骨高度降低更明显,发生骨开窗、骨开裂的风险更大.

Abstract

Objective To explore the changes of periodontal soft and hard tissue parameters of the maxillary central in-cisors after the distant migration of the maxillary total dentition in adult patients with different periodontal phenotypes,so as to provide a reference for orthodontic treatment.Methods The study was approved by the hospital ethics committee,and the patients signed the informed consent form.Fifty-two adult patients in the orthodontic department of Hefei Stomatological Hospital were selected and divided into thick gingival and thin gingival groups,with 26 cases in each group.The labial and palatal alveolar bone parameters and various periodontal indexes of the maxillary central incisor teeth of the two groups were collected and recorded before and after treatment.SPSS 26.0 statistical software was used to statistically ana-lyze the intra-group and inter-group differences.Results After orthodontic treatment,the differences in sella-nasion-subspinale angle(SNA),sella-nasion-supramental angle(SNB),and subspinale-nasion-supramental angle(ANB)were not statistically significant(P>0.05).However,the inclination of the upper middle incisor teeth(U1-NA)decreased signifi-cantly(P<0.05),and there was no significant difference in SNA,SNB,ANB,and U1-NA between the two groups after treatment(P>0.05).The thickness of the labial alveolar bone of the maxillary central incisors in both groups increased at the labial neck 1/3 and labial middle 1/3(P<0.05),and decreased at the apical 1/3(P<0.05).The thickness of the palatal alveolar bone decreased at the labial neck 1/3 and labial middle 1/3(P<0.01),and increased at the apical 1/3(P<0.01).In both groups,the height of the lip and palate of the upper jaw decreased to different degrees,and the height of the palatal alveolar bone was lower in the thin gingival group(P<0.05).There were no significant differences in max-illary central incisor probing depth(PD),lip keratinized tissue width(KTW),or lip gingival recession(GR)between the two groups after treatment(P>0.05).Conclusion In the process of maxillary central incisor adduction,the labial-pala-tine alveolar bone remodeling is not uniform,and the alveolar bone of palatine side is mainly absorbed,which should be paid attention to clinically.Palatal alveolar bone height decreased more significantly in patients with thin gingiva after orthodontic treatment,and the risk of bone fenestration and bone dehiscence was greater.

关键词

Ⅱ类错/牙周表型/牙槽骨/牙龈退缩/探诊深度/角化龈宽度/软组织/逆向工程技术

Key words

Class Ⅱ malocclusion/periodontal phenotype/alveolar bone/gingival recession/probing depth/keratinized tissue width/soft tissue/reverse engineering technology

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出版年

2025
口腔疾病防治
广东省口腔医院,广东省牙病防治指导组

口腔疾病防治

影响因子:0.787
ISSN:1006-5245
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