拔牙与非拔牙矫治前牙根吸收影响的比较研究

发布时间：2018-05-21 13:08

本文选题：牙根吸收 + 拔牙矫治　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:牙根吸收是口腔正畸治疗后常见的并发症,正畸治疗结束后牙根都会有或多或少的吸收。目前大量的临床病例及实验已证实影响牙根吸收的因素可以分为生物因素、环境因素、局部因素、机械因素。拔牙矫治在临床中的应用越来越多,他的作用主要为协调牙量和骨量一致,改变侧貌,为牙列排齐创造空间,令拥挤的牙列重新排列整齐。本次实验将探讨拔牙矫治与不拔牙矫治牙根吸收是否存在差异,并对其中某些影响因素进行分析。方法:从大连某口腔诊所选取正畸病例60例,分为拔牙矫治组和非拔牙矫治组,2组均为首次正畸治疗患者,矫治前牙根未见明显吸收,利用直丝弓矫正技术治疗,治疗过程中不采用任何种植钉、口外弓、TPA及Nance支抗手段。其中拔牙矫治组30例,均拔除4颗第一前磨牙,男15例,女15例。治疗时的平均年龄为24.3岁(14-36岁),治疗时间1年5个月至2年11个月,平均治疗时间2.53年。非拔牙矫治组30例,男15例,女15例,治疗时的平均年龄为22.1岁(14-34岁),治疗时间1年4个月至2年9个月,平均治疗时间2.39年。两组在治疗时间、年龄上无明显差异。治疗前后分别用同一曲面断层机拍摄清晰曲面断层片,用牙根吸收分级评估法对X片中上、下颌切牙的牙根进行测量正畸治疗前后的牙根等级。拔牙矫治组共240颗牙齿,非拔牙矫治组共240颗牙齿。将2组牙根等级及其等级改变频数用SPSS22.0软件进行统计学分析,进行χ~(2)检验,以P0.05为有统计学差异。结果:χ~(2)检验,2种方法分别在治疗前牙根吸收分布进行一致性检验,无明显差异(P0.05)。2组在矫治结束后,均发生了不同程度的根吸收,与矫治前比较,牙根吸收等级频数均明显增加,吸收量具有显著性差异(P0.05)。从2组根吸收量的对比中可以看出,2组造成的根吸收量有差异(P0.05),拔牙矫治组牙根吸收量大于非拔牙矫治组。2组中女性正畸患者牙根吸收量大于男性正畸患者(P0.05)。2组中上颌切牙根吸收量大于下颌切牙(P0.05)。结论:本研究结果显示在应用直丝弓矫治技术的前提下,拔除第一前磨牙矫治后前牙根吸收量多于非拔牙矫治。女性比男性正畸患者更易发生牙根吸收。上颌切牙区相对下颌切牙区更能反应也更易发生牙根吸收。
[Abstract]:Objective: root resorption is a common complication after orthodontic treatment. At present, a large number of clinical cases and experiments have proved that the factors affecting root resorption can be divided into biological factors, environmental factors, local factors, mechanical factors. The application of tooth extraction in clinic is more and more. His main function is to coordinate the amount of teeth and bone mass, change the profile, create space for dentition alignment, and make the crowded dentition rearrange neatly. In this experiment, the difference of root resorption between extraction and non-extraction is discussed, and some influencing factors are analyzed. Methods: sixty cases of orthodontic treatment were selected from a dental clinic in Dalian. The patients were divided into two groups: extraction group and non-extraction group. No implant nail, external arch TPA and Nance Anchorage were used during the treatment. The first premolars were extracted in 30 cases of extraction group, 15 male and 15 female. The average age of treatment was 24.3 years old and 14-36 years old. The treatment time was 1 year, 5 months to 2 years and 11 months, and the average treatment time was 2 53 years. There were 30 cases (15 males and 15 females) in the non-extraction group. The average age of treatment was 22.1 years old and 14-34 years old. The treatment time was 1 year, 4 months to 2 years and 9 months, and the average treatment time was 2.39 years. There was no significant difference in treatment time and age between the two groups. The root grades of upper and lower incisors were measured before and after orthodontic treatment by using the same curved surface tomograph before and after the treatment, and the root resorption grading method was used to evaluate the root level of the upper and lower incisors before and after orthodontic treatment. There were 240 teeth in extraction group and 240 teeth in non-extraction group. The root grade and its change frequency of two groups were analyzed statistically by SPSS22.0 software, 蠂 ~ (2) test was carried out, and there was statistical difference between the two groups (P0.05). Results: the results showed that there was no significant difference between the two methods in root resorption distribution before treatment. There was no significant difference in root resorption between P0.05and 2 groups after orthodontic treatment, and the frequency of root resorption grade increased significantly compared with that before orthodontic treatment. There was significant difference in absorption amount (P0.05A). From the comparison of root resorption between the two groups, we can see that there is a difference in root resorption between the two groups. The root resorption of female orthodontic patients is higher than that of male orthodontic patients (P0.05n.2). The root resorption of female orthodontic patients is higher than that of non-extraction orthodontic group (P 0.05). The root resorption of middle maxillary incisor was higher than that of mandibular incisor (P 0.05). Conclusion: the results showed that the root resorption of the first premolar was higher than that of the non-extraction after the first premolars were removed. Female orthodontic patients are more likely to develop root resorption than male orthodontic patients. The maxillary incisor region is more responsive and more prone to root resorption than the mandibular incisor region.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.5

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