中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (10): 1539-1544.doi: 10.3969/j.issn.2095-4344.3061

• 组织工程口腔材料 tissue-engineered oral materials • 上一篇    下一篇

两种托槽对双颌前突患者正畸性根尖外吸收影响的比较

王光平1，李明霞2，韩  雨1，徐晓梅1， 徐  洁1，黄素华1   

  1. 西南医科大学口颌面修复重建与再生实验室，西南医科大学附属口腔医院，1正畸科，2放射科，四川省泸州市  646000
  • 收稿日期:2020-04-24 修回日期:2020-04-28 接受日期:2020-07-10 出版日期:2021-04-08 发布日期:2020-12-18
  • 通讯作者: 李明霞，主治医师，西南医科大学口颌面修复重建与再生实验室，西南医科大学附属口腔医院放射科，四川省泸州市 646000
  • 作者简介:王光平，男，1984年生，四川省泸州市人，汉族， 2011年遵义医学院毕业，硕士，主治医师，主要从事口腔正畸生物学和生物力学方向研究。
  • 基金资助:
    西南医科大学校级创新训练项目(2019338)；西南医科大学附属口腔医院自科青年项目(201907)

Comparison of the impacts of two kinds of brackets on external apical root resorption in orthodontic treatment of bimaxillary protrusion patients

Wang Guangping1, Li Mingxia2, Han Yu1, Xu Xiaomei1, Xu Jie1, Huang Suhua1   

  1. 1Department of Orthodontics, 2Department of Oral Radiology, Oral & Maxillofacial Reconstruction and Regeneration Laboratory, Hospital of Stomatology of Southwest Medical University, Luzhou 646000, Sichuan Provence, China
  • Received:2020-04-24 Revised:2020-04-28 Accepted:2020-07-10 Online:2021-04-08 Published:2020-12-18
  • Contact: Li Mingxia, Attending physician, Department of Oral Radiology, Oral & Maxillofacial Reconstruction and Regeneration Laboratory, Hospital of Stomatology of Southwest Medical University, Luzhou 646000, Sichuan Provence, China
  • About author:Wang Guangping, Master, Attending physician, Department of Orthodontics, Oral & Maxillofacial Reconstruction and Regeneration Laboratory, Hospital of Stomatology of Southwest Medical University, Luzhou 646000, Sichuan Provence, China
  • Supported by:
    the Innovation Training Program of Southwest Medical University, No. 2019338; the Youth Program in Stomatological Hospital Affiliated to Southwest Medical University, No. 201907

PDF

64

摘要：

文题释义：
正畸性根尖外吸收：正畸治疗导致的牙根根尖外吸收，是正畸治疗常见的并发症之一，具有无菌性炎症反应特征，以往研究表明大部分患者会发生不同程度的牙根吸收，多无牙齿松动、脱落等明显临床症状，一般在X射线片检查时发现。
自锁托槽：拥有闭锁装置，可将正畸弓丝锁闭在托槽的槽沟内，避免使用结扎橡皮圈或钢丝对正畸弓丝进行固位，便于临床操作，同时极大降低了正畸弓丝与托槽之间的摩擦阻力，减轻牙齿受力，降低了患者不适程度，目前在正畸临床中得到广泛的应用。

背景：正畸治疗中会出现不同程度的根尖外吸收现象，严重的牙根吸收会减小根冠比例、降低牙齿稳定性，甚至引起牙齿松动、脱落。
目的：对比高转矩自锁托槽与传统直丝弓托槽矫治双颌前突患者上颌切牙正畸性根尖外吸收发生的差异。
方法：选择2016年1月至2019年12月在西南医科大学附属口腔医院收治的男性双颌前突患者49例，年龄13-16岁，其中24例采用高转矩自锁托槽进行正畸治疗(自锁托槽组)，25例采用传统直丝弓托槽进行正畸治疗(传统托槽组)。矫治前及矫治完成后拍摄锥形束CT，采用CS 3D Imaging Software软件观察矫治前后上颌中切牙及侧切牙牙根形态，测量牙根长度，计算上颌切牙与侧切牙间根尖外吸收量。研究获西南医科大学附属口腔医院医学伦理委员会批准。
结果与结论：①两组正畸治疗均取得了良好矫治效果，其中自锁托槽组矫治疗程短于传统托槽组(P < 0.05)；②锥形束CT显示，矫治后两组患者的牙根形态发生一定程度改变，大部分仅表现为轮廓的改变，个别牙齿根尖变短；③矫治后，所有切牙均发生了根尖外吸收，未发现牙根吸收量超过4 mm以上病例；自锁托槽组4颗上颌切牙的平均根尖外吸收量少于传统托槽组(P < 0.05)，上颌中切牙根尖外吸收量少于传统托槽组(P < 0.05)，上颌侧切牙根尖外吸收量与传统托槽组比较差异无显著性意义(P > 0.05)；使用同一托槽时，同侧中切牙根尖外吸收量少于侧切牙(P < 0.05)；④结果表明相较于传统直丝弓托槽，高转矩自锁托槽在矫治双颌前突的过程中可能具有缩短疗程及正畸性根尖外吸收风险低的优点。


关键词: 材料, 口腔, 正畸, 自锁托槽, 直丝弓托槽, 牙根尖外吸收, 双颌前突

Abstract: BACKGROUND:  In orthodontic treatment, there will be different degrees of external apical resorption. Severe root resorption will reduce the root/shoot ratio, reduce the stability of teeth, and even cause teeth to loosen and fall out.
OBJECTIVE: To compare the difference of external apical root resorption between high torque self-locking bracket and traditional straight wire bracket in orthodontic treatment of bimaxillary protrusion patients. 
METHODS: Forty-nine patients with bimaxillary protrusion, aged 13-16 years, who were treated in the Hospital of Stomatology of Southwest Medical University from January 2016 to December 2019, were enrolled in this study. The patients were divided into the high torque self-locking bracket group (n=24) and the traditional straight wire bracket group (n=25). Cone beam CT was taken before and after orthodontic treatment. The root morphology and length of maxillary central incisors and lateral incisors were observed by CS 3D Imaging Software. The amount of external apical root resorption between maxillary incisor and lateral incisor was calculated. This study was approved by the Medical Ethics Committee of Hospital of Stomatology of Southwest Medical University. 
RESULTS AND CONCLUSION: (1) The two groups after orthodontic treatment had achieved a good correction effect. The course of treatment was shorter in the high torque self-locking bracket group than that in the traditional straight wire bracket group (P < 0.05). (2) Cone beam CT showed that after treatment, the root morphology of the maxillary incisors had some changed. Most of them only showed the change of contour, and the apices of some teeth became shorter. (3) External apical root resorption occurred in all incisors after treatment. No cases with root resorption more than 4 mm were found. The amount of external apical root resorption of four maxillary incisors was less in the high torque self-locking bracket group than in the traditional straight wire bracket group (P < 0.05). The amount of external apical root resorption of maxillary central incisor was less in the high torque self-locking bracket group than in the traditional straight wire bracket group (P < 0.05). No significant difference was found in the amount of external apical root resorption of maxillary lateral incisor between the two groups (P > 0.05). In the same appliance group, the amount of external apical root resorption of the maxillary central incisors was less than the lateral incisors (P < 0.05). (4) Results indicate that compared with the traditional straight wire bracket, the high torque self-locking bracket may have the advantages of short treatment course and low risk of apical absorption in the orthodontic treatment of bimaxillary protrusion.


Key words: materials">, oral">, orthodontic">, self-locking bracket">, straight wire bracket">, root apex absorption">, bimaxillary protrusion

中图分类号: