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目的:定量评估牙槽骨再生正畸治疗下前牙区牙槽骨发育不良的骨性Ⅲ类错成人患者对下前牙区牙周状况及下前牙去代偿的影响。方法:从上海交通大学医学院附属第九人民医院口腔颅颌面科2009年12月—2011年10月就诊的成人连续病例中,选取下前牙区牙槽骨菲薄且有正颌手术适应证的骨性Ⅲ类错畸形患者。在充分告知的前提下,将其中9例接受牙槽骨再生正畸治疗的患者作为研究对象。通过锥形束CT(conebeamcomputedtomography,CBCT)及头颅定位侧位片分别评价不同治疗阶段下前牙区牙周状况及下前牙去代偿的效果。采用SAS8.02软件包对数据进行统计学处理。结果:治疗前、术前正畸结束、治疗结束下前牙牙根长度及舌侧牙槽骨厚度无显著差异(P>0.05)。术前正畸阶段,下前牙区唇侧牙槽骨厚度及下前牙倾斜角度显著增加(P<0.01),术后正畸阶段,两者均未见改变(P>0.05)。下前牙区唇、舌侧牙槽骨高度在术前正畸阶段均显著降低(P<0.05),术后正畸阶段,唇、舌侧牙槽骨高度保持稳定(P>0.05)。结论:牙槽骨再生正畸治疗下前牙区牙槽骨发育不良的骨性Ⅲ类成人患者,下前牙去代偿完全,下前牙区牙周健康。
OBJECTIVE: To quantitatively evaluate the effect of alveolar bone regeneration orthodontic treatment on periodontal status and lower anterior teeth compensation in lower anterior teeth of patients with skeletal Class Ⅲ malformed alveolar bone dysplasia. Methods: From the continuous cases of oral craniofacial and maxillofacial surgery in the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine from December 2009 to October 2011, the alveolar bone in the lower anterior teeth area was selected and the orthognathic indications Of skeletal class Ⅲ malocclusion patients. On the premise of being fully informed, nine patients who underwent alveolar bone regeneration and orthodontic treatment were selected as the study subjects. The periodontal status of the anterior teeth and the effect of the lower anterior teeth compensation under different treatment stages were evaluated respectively by cone beam computed tomography (CBCT) and cranial positioning lateral radiographs. SAS8.02 software package for statistical analysis of the data. Results: Before treatment, orthodontic treatment was completed before treatment. There was no significant difference in tooth root length and lingual alveolar bone thickness at the end of treatment (P> 0.05). Preoperative orthodontic phase, lower anterior tooth area of the labial alveolar bone thickness and lower anterior oblique angle was significantly increased (P <0.01), postoperative orthodontic stage, both were unchanged (P> 0.05). The height of the alveolar bone in the lower lip and the lingual alveolus was significantly decreased in the preoperative orthodontic phase (P <0.05). The alveolar bone height remained stable at the orthodontic stage (P> 0.05). Conclusion: Alveolar bone regeneration orthodontic treatment of anterior alveolar bone dysplasia of skeletal class Ⅲ adult patients, the lower anterior teeth to complete compensatory periodontal health periodontal area.