上颌前牙正畸炎性牙根吸收可疑风险因素的临床研究

发布时间：2018-05-21 20:47

本文选题：正畸治疗 + 牙根吸收　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：本文旨在通过对临床病例的研究分析，探讨与上颌前牙正畸性炎症性牙根吸收（Orthodontically Induced Inflammatory Root Resorption，OIIRR）相关的部分可疑风险因素,并尝试确定OIIRR吸收倾向的预测因素。材料与方法：按照样本选择标准，选择符合条件的病例127例，共762颗牙齿。其中，男：38例，女：89例，平均年龄：16.38岁，，平均矫治疗程：19.75月。于患者矫治前后拍摄的曲面断层片上分别描画出上颌6颗前牙的轮廓，测量出牙冠和牙根的长度；另外测量出患者石膏模型上的牙冠长度，然后通过公式计算出每颗牙齿矫治后牙根吸收量。同时，根据患者病例资料记录其矫治开始年龄、矫治疗程、是否拔牙等信息。最后将所有数据输入spss17.0统计软件，应用t检验、方差分析、相关分析和多元回归分析对其进行检验。结果：矫治后上颌前牙牙根吸收量的最大值、最小值、均值分别为：中切牙3.99mm,-2.15mm，1.1898mm；侧切牙：4.13mm,-1.71mm，1.4327mm；尖牙：3.45mm,-4.76mm，0.3487mm。t检验和单因素方差分析结果显示：每颗牙齿矫治前后的牙根长度具有显著性统计学差异（P＜0.01）。上颌前牙的牙根吸收量在矫治开始年龄各亚组内有统计学差异；在是否拔牙各亚组内有统计学差异；在是否应用种植体支抗各亚组内有统计学差异；在矫治疗程各亚组内有统计学差异；在牙位各亚组内有统计学差异；在垂直骨面型各亚组内无统计学差异；在与下前牙的咬合接触情况各亚组内无统计学差异；上颌侧切牙的牙根吸收量在是否存在斜行牵引各亚组内有统计学差异；上颌切牙的牙根吸收量在是否存在根舌向转矩各亚组内有统计学差异；上颌尖牙的牙根吸收量在牙根发育是否完成各亚组内有统计学差异。Pearson相关分析显示：上颌前牙的牙根吸收量与矫治开始年龄、是否拔牙、是否应用种植体支抗还有矫治疗程、与下前牙的咬合接触情况具有很大相关性，与垂直骨面型、牙位不相关；上颌侧切牙的牙根吸收量与是否存在斜行牵引具有很大相关性；上颌切牙的牙根吸收量与是否施加根舌向转矩具有很大相关性；上颌尖牙牙根吸收量与牙根发育阶段具有极大相关性；多元回归分析结果显示：牙根发育阶段、矫治疗程和是否应用种植体支抗可作为上颌前牙牙根吸收倾向的预测因素。结论：1）上颌前牙的牙根吸收量与患者矫治开始年龄、是否拔牙、是否应用种植体支抗以及矫治疗程、与下前牙的咬合接触情况具有很大相关性； 2）上颌侧切牙的牙根吸收量与是否存在斜行牵引具有很大相关性； 3）上颌切牙的牙根吸收量与是否施加根舌向转矩具有很大相关性； 4）上颌尖牙牙根吸收量与牙根发育阶段具有极大相关性； 5）牙根发育阶段，矫治疗程和是否应用种植体支抗可作为上颌前牙牙根吸收倾向的预测因素。
[Abstract]:Objective: to investigate some suspicious risk factors associated with orthodontic Induced Inflammatory Root resorption of the maxillary anterior teeth and to determine the predictive factors of OIIRR absorption tendency. Materials and methods: according to the criteria of sample selection, 127 cases (762 teeth) were selected. Among them, 38 were male and 89 were female, with an average age of 16.38 years. The average treatment course was 19.75 months. The contours of the maxillary anterior teeth were drawn on the curved surface slices taken before and after the treatment, and the lengths of the crowns and roots were measured, and the length of the crowns on the plaster models of the patients were also measured. Then the root resorption of each tooth was calculated by formula. At the same time, according to the data of patients, the age of treatment, the course of treatment and the extraction of teeth were recorded. Finally, all the data were input into the spss17.0 statistical software and tested by t-test, ANOVA, correlation analysis and multivariate regression analysis. Results: the maximum and minimum of root resorption of maxillary anterior teeth were obtained after orthodontic treatment. The mean values were 3.99mm-2.15mm / 1.1898mm for central incisor, 1.4327mm for lateral incisor, 3.45mm-4.76mm for molar and 0.3487mm.t test and analysis of variance for single factor showed that there was significant difference in root length of each tooth before and after orthodontic treatment (P < 0.01). The root resorption of maxillary anterior teeth was significantly different in each subgroup at the beginning age of orthodontic treatment, in each subgroup with or without extraction of teeth, in the subgroup with implant Anchorage, and in the subgroup with implant Anchorage. There were statistical differences in the subgroups of orthodontic treatment course, in the tooth position subgroups, in the vertical bone facial type subgroups, in the occlusal contact with the lower anterior teeth, there was no statistical difference among the subgroups. The root resorption of maxillary lateral incisor was significantly different in each subgroup of oblique traction, and the root resorption of maxillary incisor was significantly different in each subgroup of root tongue torque. The root resorption of maxillary canine teeth was significantly different in each subgroup. Pearson correlation analysis showed that the root resorption of maxillary anterior teeth was related to the beginning age of orthodontic treatment, whether the tooth was extracted, whether the implant Anchorage was used or not, and whether the orthodontic course was used. There was a great correlation between the occlusal contact and the occlusal contact of the lower anterior teeth, but not with the vertical bone face and the tooth position, and the root resorption of the maxillary lateral incisor was significantly correlated with the existence of oblique traction. The root resorption of maxillary incisors was significantly correlated with the application of root tongue torque, the root resorption of maxillary canine teeth was highly correlated with the root development stage, and the results of multiple regression analysis showed that, The course of orthodontic treatment and implant Anchorage can be used as predictors of root resorption tendency of maxillary anterior teeth. Conclusion (1) the root resorption of maxillary anterior teeth is closely related to the onset age of orthodontic treatment, the extraction of teeth, the application of implant Anchorage and the course of orthodontic treatment, which is closely related to the occlusal contact of the lower anterior teeth. 2) the root resorption of maxillary lateral incisors was significantly correlated with the presence of oblique traction. 3) the root resorption of maxillary incisors is closely related to the torque of root tongue. 4) the root resorption of maxillary canine teeth was significantly correlated with the development stage of maxillary canine teeth. 5) at the stage of root development, the treatment course and implant Anchorage can be used as predictors of root resorption tendency of maxillary anterior teeth.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

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