骨性Ⅰ类错牙合不同垂直骨面型患者下颌横向关系研究

doi:10.12016/j.issn.2096-1456.2021.09.007

摘要/Abstract

摘要：

目的研究骨性Ⅰ类错牙合不同垂直骨面型与下颌牙弓宽度、基骨弓宽度及牙齿颊舌向倾斜度的相关性。方法收集62例骨性Ⅰ类错牙合患者的CBCT资料,根据GoGn-SN角分为3组,高角组19例、均角组22例、低角组21例,用Dolphin imaging进行三维重建,分别测量下颌尖牙、第一前磨牙、第一磨牙间的牙弓和基骨弓宽度及牙齿颊舌向倾斜度并进行统计学分析。结果 3组下颌各段牙弓宽度的差异无统计学意义(P>0.05);低角组患者的下颌尖牙间基骨弓宽度和第一前磨牙间基骨弓宽度大于均角组和高角组(P< 0.05);高角组患者的尖牙颊舌向倾斜度和第一前磨牙颊舌向倾斜度大于均角组和低角组(P< 0.05)。磨牙间基骨弓宽度与颊舌向倾斜度在3组间的差异无统计学意义(P>0.05)。Pearson检验表明:下颌尖牙间基骨弓宽度、第一前磨牙间基骨弓宽度与GoGn-SN角呈负相关;排除下颌牙弓宽度和基骨弓宽度的影响,下颌尖牙和第一前磨牙的颊舌向倾斜度与GoGn-SN角间仍然存在显著正相关关系(P<0.05)。结论骨性Ⅰ类错牙合不同垂直骨面型间的基骨弓宽度差异主要体现在尖牙段和前磨牙段,牙体颊舌向倾斜度的差异主要是对下颌平面角的不同进行代偿。临床中应针对差异采用个体化方案以达到矫治的长期疗效。

关键词: 骨性Ⅰ类错牙合, 垂直骨面型, 下颌骨, 基骨, 牙弓宽度, 颊舌向倾斜, 锥形束CT, 三维测量

Abstract:

Objective To analyze the correlation between skeletal vertical patterns and mandibular dental arch width, basal arch width and the dental buccolingual inclination of patients with skeletal ClassⅠ. Methods The CBCT data of 62 skeletal ClassⅠ malocclusion patients were collected and divided into a high-angle group with 19 cases, a mean-angle group with 22 cases, and a low-angle group with 21 cases according to the GoGn-SN angle. Mandible 3D reconstruction of the three groups was performed using Dolphin software, and dental arch widths, basal arch widths and buccolingual inclination of canines, first premolars and first molars, were measured and statistically analyzed respectively. Redults Mandibular dental arch width showed no significant difference among the three groups (P>0.05). The basal arch widths of mandibular canines and first premolars in low-angle group were larger than those in the other groups (P<0.05). The buccolingual inclinations of mandibular canines and first premolars in high-angle group were larger than those in the other groups (P<0.05). The buccolingual inclination and basal arch width of the first molars among the three groups showed no significant differences (P>0.05). Pearson correlation tests showed that the basal arch widths of mandibular canines and first premolars were negatively correlated with GoGn-SN angle. Excluding the influence of dental arch width and basal arch width, there was still a significant positive correlation between the buccolingual inclination of mandibular canines and first premolars and the GoGn-SN angle (P<0.05). Conclusion The width of the basal bone arch between different skeletal vertical patterns mainly differs in the canine segment and the premolar segment, and the difference in the buccolingual inclination of the teeth is mainly to compensate for the difference in the GoGn-SN angle. In clinical practice, individualized therapy should be adopted according to the differences to achieve the long-term efficacy of correction.

Key words: skeletal ClassⅠ malocclusion, vertical facial pattern, mandible, basal bone, arch width, buccolingual inclination, CBCT, three-dimensional measurement

中图分类号:

贾璟博,任娟,王小琴. 骨性Ⅰ类错牙合不同垂直骨面型患者下颌横向关系研究[J]. 口腔疾病防治, 2021, 29(9): 617-623.

JIA Jingbo,REN Juan,WANG Xiaoqin. Study on the transverse relationship of the mandible between different skeletal vertical patterns in patients with skeletal ClassⅠ malocclusion[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(9): 617-623.

图/表 8

图1 CBCT图像校准

Figure 1 Orientation of CBCT images a-c: anteroposterior and lateral calibration is performed through the FH plane; d: transverse calibration is performed according to the bilateral root of the zygoma points; FH plane: Frankfort horizontal plane

图2 牙弓宽度的测量

Figure 2 Measurement of the dental arch width a: locate the axial center of the clinical crown (FA); b: taking DW3 (indicated as the red arrow line segment) as an example, the dental arch width is distance between the FA points of the homonym teeth, DW3: distance between FA points of the canines on both sides of the mandible

图3 基骨弓宽度的测量

Figure 3 Measurement of the basal arch width a: locate the apical point on the transverse plane; b: locate the apical point on the sagittal plane; c: taking BW6 (indicated as the red arrow line ) as an example, the basal arch width is the distance between the points with which the line through the apical points of the homonym teeth on the coronal plane intersects the outer surface of the jaw; BW6: distance between apical points of the first molars on both sides of the mandible

图4 牙齿颊舌向倾斜度的测量

Figure 4 Measurement of the buccolingual inclination a: locate the center of the anatomical crown on the transverse plane; b: locate the center of the anatomical crown on the sagittal plane; c: taking BL6 (indicated as the red arrow line segment) as an example, the dental buccolingual inclination is the angle between the sagittal plane and the line through the center of anatomical crown and the center of dental cervix on the coronal plane; BL6: the buccolingual inclination of first molars

表1 骨性Ⅰ类错牙合患者不同垂直骨面型下颌牙弓宽度、基骨弓宽度比较

Table 1 Comparison of the mandibular dental arch widths or the basal arch widths of different skeletal vertical patterns in patients with skeletal ClassⅠ malocclusion x ± s,mm

Groups	n	DW3	DW4	DW6	BW3	BW4	BW6
Mean-angle group	22	29.84 ± 1.27	39.25 ± 1.37	54.88 ± 1.69	35.67 ± 2.82	43.29 ± 1.47	67.11 ± 1.78
Low-angle group	21	28.95 ± 1.25	39.35 ± 1.68	55.02 ± 1.87	37.39 ± 2.60 ¹⁾	45.02 ± 2.37 ¹⁾	67.94 ± 2.36
High-angle group	19	29.29 ± 1.49	39.42 ± 1.33	55.48 ± 1.43	35.28 ± 2.60 ²⁾	42.69 ± 3.13 ²⁾	66.89 ± 2.05
F		2.442	0.068	0.708	3.622	5.273	1.486
P		0.096	0.934	0.497	0.033	0.008	0.235

表2 骨性Ⅰ类错牙合患者不同垂直骨面型下颌牙齿倾斜度比较

Table 2 Comparison of the mandibular buccolingual inclinations of different skeletal vertical patterns in patients with skeletal ClassⅠ malocclusion x ± s,°

Groups	n	BL3	BL4	BL6
Mean-angle group	22	4.63 ± 1.09	5.85 ± 0.97	14.23 ± 2.80
Low-angle group	21	4.22 ± 1.02	5.57 ± 1.19	14.13 ± 3.07
High-angle group	19	7.88 ± 2.23 ¹⁾²⁾	11.35 ± 1.68 ¹⁾²⁾	15.09 ± 3.79
F		34.34	124.90	0.53
P		<0.01	<0.01	0.59

表3 骨性Ⅰ类错牙合患者下颌横向距离或牙齿颊舌向倾斜度与GoGn-SN角的相关性分析

Table 3 Pearson correlation analysis of the GoGn-SN angle with mandibular transverse width or dental buccolingual inclination in patients with skeletal ClassⅠ malocclusion

Measuring project	r	P
DW3(mm)	0.013	0.922
DW4(mm)	0.017	0.897
DW6(mm)	0.161	0.212
BW3(mm)	-0.291	0.022
BW4(mm)	-0.427	0.001
BW6(mm)	-0.187	0.146
BL3(°)	0.670	<0.001
BL4(°)	0.851	<0.001
BL6(°)	0.086	0.506

表4 骨性Ⅰ类错牙合患者牙齿颊舌向倾斜度与GoGn-SN角的偏相关性分析

Table 4 Partial correlation analysis between buccal lingual inclination of teeth and GOGN-SN angle in patients with skeletal ClassⅠ malocclusion

Measuring project	Partial correlation
Measuring project	R	P
BL3(°)	0.635	< 0.001
BL4(°)	0.842	< 0.001
BL6(°)	0.104	0.429

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