中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (7): 1303-1306.doi: 10.3969/j.issn.1673-8225.2010.07.038

• 组织构建综述 tissue construction review • 上一篇    下一篇

正畸过程中的牙根吸收及其生物力学特征

涂伶俐   

  1. 重庆市江津区人民医院口腔科，重庆市  402260
  • 出版日期:2010-02-12 发布日期:2010-02-12
  • 作者简介:涂伶俐，女，1977年生，重庆市人，汉族，2002年泸州医学院口腔系毕业，主治医师，主要从事口腔医学方面的研究。 tll1977009@163.com

Biomechanical characteristics of root resorption during orthodontic treatment

Tu Ling-li    

  1. Department of Stomatology, Jiangjin People’s Hospital, Chongqing   402260, China
  • Online:2010-02-12 Published:2010-02-12
  • About author:Tu Ling-li, Attending physician, Department of Stomatology, Jiangjin People’s Hospital, Chongqing 402260, China tll1977009@163.com

PDF

758

被引次数

13

摘要：

背景：牙根吸收是错牙合畸形矫正治疗中的一种常见不良反应，与之相关的因素可分为生物和机械两方面。
目的：了解正畸治疗引起牙根吸收的生物及机械方面的各种因素，以降低治疗风险。
方法：以“root resorption, biomechanics”为检索词，检索PubMed数据库(1990-01/2009-05)；以“牙根吸收、生物力学”为检索词，检索CNKI数据库(1990-01/2009-05)。文献检索语种限制为英文和中文。以Levander & Malmgren牙根吸收评分体系为评价指标。纳入与正畸治疗相关的内容；排除其他方面研究。
结果与结论：计算机初检得到72篇文献，根据纳入排除标准，对31篇进行分析。牙根吸收是错牙合畸形矫正治疗中的一种常见不良反应，与之相关的因素可分为生物和机械两方面，均可能增加或降低正畸治疗中牙根吸收的危险性。接受正畸治疗的患者如果存在牙根吸收的高危因素应谨慎制定其治疗计划，包括既往史，药物摄入量，家族史，牙体及根系形态，口腔健康状况和不良习惯等。监测牙根吸收的标准程序是在治疗6个月后用X射线观察根尖影像，如果存在引起牙根吸收的高危因素，建议每治疗3个月即行X射线检查。虽然没有足够的研究结论为高危患者提供书面依据，但抗炎药物的使用可能抑制正畸治疗引起的牙根吸收。如果出现多发性牙根吸收，诊断程序应着眼于排除局部因素及可能导致牙根吸收的联合因素(如正畸力的大小，持续时间和加载类型；牙周疾病；根系形态等)。还应考虑与钙磷代谢失调相关的系统性疾病。提示正畸治疗可能引起一定的牙根吸收，特别是患者伴随一定的高危因素时，但通过对矫治力的控制和治疗过程的严密监测能将此风险降到最低。

关键词: 牙根吸收, 正畸治疗, 生物力学, 风险因素, 综述文献

Abstract:

BACKGROUND: Root resorption is the treatment of malocclusion deformity correction in a common adverse reaction, and associated factors can be divided into biological and mechanical factors.
OBJECTIVE: To explore the biological and mechanical factors of the root resorption caused by orthodontic treatment, so as to reduce the treatment risks.
METHODS: With key words “root resorption, biomechanics”, a computer-based online search of PubMed database (1990-01/2009-05) and CNKI database (1990-01/2009-05) was performed for articles published in English and Chinese. Root resorption in Levander & Malmgren rating system was used as the evaluation index. The orthodontic treatment-related content was included, and other aspects of research were excluded.
RESULTS AND CONCLUSION: A total of 72 articles were collected, and according to inclusion and exclusion criteria, 31 were included for analysis. Root resorption is a common phenomenon associated with orthodontic treatment. The factors relevant to root resorption can be divided into biological and mechanical factors, which are associated with an increased or decreased risk of root resorption during orthodontic treatment. Orthodontic therapy of patients with increased risk of root resorption should be carefully planned. Medical history, medication intake, family history, tooth and root morphology, oral health and habits must be considerate. The standard procedure to monitor apical root resorption is a radiographic examination after 6 months of treatment. In teeth with enhanced risk, a 3-month radiographic follow-up is recommended. The use of anti-inflammatory drugs might suppress root resorption induced by orthodontic therapy, although no study is conclusive enough to indicate a protocol for patients with enhanced risk. In the event of multiple external root resorption, the diagnostic procedure should focus on the exclusion of the local factors and its associations (such as magnitude, duration and type of orthodontic force, periodontal disease, root form) that might lead to external root resorption. Systemic disorders associated with phosphorus-calcium metabolic alterations are also suspected. Orthodontic treatment may cause a certain degree of root resorption, especially in patients with high-risk factors, but this risk can be minimized by the control of force and the close monitor of treatment process.

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