拔牙矫治内收前牙引起的上下唇变化及软硬组织变化的相关性研究

发布时间：2019-01-27 20:09

【摘要】：双牙-双牙槽前突患者常需要拔除前磨牙，利用拔牙间隙内收前牙，改善过突的双唇，协调鼻-唇-颏软组织侧貌。拔牙矫治内收前牙引起的软硬组织变化是近年来的一个研究热点，阐明软硬组织的变化规律及二者的关联对于指导医生制定更为合理的治疗方案以及获得理想的预期治疗效果意义重大。 目的：通过测量采用拔牙矫治的39例双牙 牙槽前突女性患者矫治前后的侧位片，分析得出水平及垂直方向上治疗前后软硬组织发生的变化及二者之间的相关性，并且推算出利用硬组织预测软组织变化的公式。在二维方向上为预测双牙 牙槽前突患者拔牙矫治的软组织变化提供可靠依据，同时为选择拔除牙位、支抗类型提供理论依据。 方法：选取在吉林大学口腔医院正畸科门诊就诊，拔除四颗前磨牙矫治的双牙-牙槽前突的女性患者39例。入选对象无颌骨畸形，磨牙关系基本中性，轻度或中度拥挤，拔除四个前磨牙，治疗起始时，年龄≥15岁，无全身系统性疾病、颅面部畸形及先天缺牙，无正颌手术或面部整容史，治疗前后侧位片清晰。矫治前平均年龄为21.50±4.01岁，总疗程平均为18.56±4.23个月。将SN以S点为圆心顺时针旋转7o作为X轴，过S点做X轴的垂线为Y轴，建立参考坐标系。在矫治前及矫治后拍摄的X线侧位片上选取6个硬组织标记点，7个软组织标记点，分别测量治疗前后的16个线距测量值及两个角度测量值，共计18个测量值。运用SPSS19.0对治疗前后的18个测量值进行配对T检验，对相应的软硬组织进行相关性分析，并建立线性回归方程。 结果： 1：治疗后，水平向及垂直向上软硬组织线距发生显著变化，上下切牙及上下唇突度明显变小，鼻唇角明显减小，颏唇角变化无统计学意义，侧貌更加协调。治疗后，上、下唇长度及厚度变化无统计学意义。 2.水平及垂直方向上，软硬组织变化均存在较强的相关性，其中水平方向上相关性更强。 3.水平方向上，切牙颈点与上下唇相关性更强，上下中切牙点与上下唇相关性相对较弱。 4.上齿槽缘点水平向上内收1mm，上唇凸点内收0.643mm；下切牙切点及下齿槽缘点水平向上内收1mm，下唇凸点内收0.889mm；上切牙切点压低1mm，，上唇凸点上移0.503mm；下齿槽缘点压低1mm，下唇凸点下移0.376mm。
[Abstract]:Patients with double teeth and double alveolar protrusions often need to remove the premolars and use the extraction space to collect the anterior teeth to improve the protruding lips and coordinate the soft tissue profile of the nasal-labial and mental. The changes of soft and hard tissues caused by extraction of the adductive anterior teeth are a hot research topic in recent years. It is of great significance to clarify the changes of soft and hard tissue and their correlation to guide doctors to make more reasonable treatment plan and to obtain the desired therapeutic effect. Objective: to measure the lateral radiographs of 39 female patients with anterior alveolar protrusion treated by extraction of teeth, and to find out the changes of soft and hard tissues before and after treatment in horizontal and vertical directions and the correlation between them. The formula for predicting the change of soft tissue by hard tissue was deduced. It provides a reliable basis for predicting the change of soft tissue in the patients with anterior alveolar protrusion in two dimensional direction, and also provides theoretical basis for the selection of extraction position and the type of Anchorage. Methods: 39 female patients with double teeth and alveolar protrusions were selected from orthodontic department of Jilin University Stomatology Hospital. The subjects had no maxillary deformity, neutral molar relationship, mild or moderate crowding, extraction of four premolars, age 鈮

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