上颌磨牙倾斜度与上颌第三磨牙阻生位置及生长方向的相关性分析

doi:10.13701/j.cnki.kqyxyj.2022.06.007

摘要/Abstract

摘要： 目的:测量安氏Ⅰ类均角型患者上颌磨牙近远中倾斜度,探讨其与上颌第三磨牙阻生深度、阻生方向及生长方向的相关性,以期对临床诊疗提供参考。方法:选取67例安氏Ⅰ类均角型患者治疗前锥形束计算机断层扫描(cone-beam computed tomograghy,CBCT)资料,根据第三磨牙阻生深度分为正常萌出型、中位阻生型和低位阻生型3组;根据第三磨牙阻生方向分为近中型和远中型两组,以腭平面为基准平面,测量上颌磨牙的倾斜度,将数据进行统计学分析。结果:(1)不同性别各项测量数值无显著差异(P＞0.05);(2)上颌第三磨牙阻生深度不同及阻生方向不同时,上颌第一磨牙以及第二磨牙的倾斜度均存在显著差异(P<0.05);(3)上颌第一磨牙及第二磨牙倾斜度与第三磨牙阻生深度呈显著正相关(P<0.05),与第三磨牙生长方向相关性不显著(P>0.05),上颌第一磨牙倾斜度与第三磨牙阻生方向呈显著正相关(P<0.05);(4)上颌第三磨牙的阻生深度与其生长方向相关性不显著(P>0.05),与其阻生方向呈显著正相关(P<0.05)。结论:第三磨牙阻生越低位,上颌磨牙越向远中倾斜;第三磨牙阻生方向越向近中,上颌第一磨牙越向远中倾斜。

关键词: 磨牙倾斜度, 磨牙阻生, 第三磨牙, 锥形束计算机断层扫描

Abstract: Objective: To measure the mesial and distal inclination of maxillary molars in patients with class I, and to explore its correlation with the impacted depth and impacted direction and growth direction of maxillary third molars. Methods: The CBCT data of 67 patients with Angle class I were selected before treatment. According to the impacted depth of the third molar, they were divided into three groups: normal eruption type, medium position type, and low position type. According to the impacted direction of the third molar, it was divided into two groups: mesial type and distal type. Taking the palatal plane as the reference plane, the inclination of the maxillary molars were measured, and the data were statistically analyzed. Results: (1) There was no significant difference in the measured values between different gender groups (P>0.05). (2) When the impacted depth and impacted direction of maxillary third molars were different, there were significant differences in the inclination of maxillary first molars and second molars (P<0.05). (3) The inclination of maxillary first and second molars were positively correlated with the impacted depth of third molars (P<0.05), but not significantly correlated with the growth direction of third molars (P>0.05). The inclination of first molars was positively correlated with the impacted direction of third molars (P<0.05). (4) The impacted depth of maxillary third molar was not correlated with its growth direction (P>0.05), but positively correlated with its impacted direction (P<0.05). Conclusion: The lower the impacted of the third molar, the more distal inclination of the maxillary molar. The more mesial the impacted direction of the third molar, the more distally inclined the maxillary first molar.

Key words: molar inclination, molar interruption, third molar, CBCT

徐依山, 李真真, 吴瑶, 司超, 许竞予, 余岭, 张惠超, 杨陆一. 上颌磨牙倾斜度与上颌第三磨牙阻生位置及生长方向的相关性分析[J]. 口腔医学研究, 2022, 38(6): 518-522.

XU Yishan, LI Zhenzhen, WU Yao, SI Chao, XU Jingyu, YU Ling, ZHANG Huichao, YANG Luyi. Correlation Analysis of Maxillary Molars Inclination with Impacted Position and Growth Direction of Maxillary Third Molar[J]. Journal of Oral Science Research, 2022, 38(6): 518-522.

参考文献

[1] Andrews LF. The six keys to normal occlusion [J]. Am J Orthod, 1972, 62(3): 296-309.
[2] Zhang JN, Wang XD, Lin JX. Longitudinal quantitation of tooth displacement in Chinese adolescents with normal occlusion [J]. Curr Med Sci, 2019, 39(2): 317-324.
[3] Martinelli FL, de Oliveira Ruellas AC, de Lima EM, et al. Natural changes of the maxillary first molars in adolescents with skeletal Class Ⅱ malocclusion [J]. Am J Orthod Dentofacial Orthop, 2010, 137(6): 775-781.
[4] Su H, Han B, Li S, et al. Compensation trends of the angulation of first molars: retrospective study of 1403 malocclusion cases [J]. Int J Oral Sci, 2014, 6(3): 175-181.
[5] 李军,王紫仪,张晓东.骨性Ⅱ类错牙合女性患者上颌磨牙近远中倾斜度的CBCT分析[J].口腔医学研究,2018,34(8):896-901.
[6] 苏红,韩冰,陈贵,许天民.上颌第一磨牙倾斜度自然代偿的最主要影响因素研究[J].中华口腔正畸学杂志,2021,28(1):9-13.
[7] Björk A, Skieller V. Facial development and tooth eruption. An implant study at the age of puberty[J]. Am J Orthod, 1972, 62(4):339-383.
[8] Alqareer A, Nada R, Ghayyath A, et al. The suitability of panoramic radiographs for clinical decision making regarding root angulation compared to cone-beam computed tomography [J]. BMC Med Imaging, 2021, 21(1): 89.
[9] 雷巧玲,周力,雷蕾,等.传统全景片和锥形束CT重建全景片测量牙轴近远中倾斜度的对比研究[J].华西口腔医学杂志,2014,32(4):331-335.
[10] Bouwens DG, Cevidanes L, Ludlow JB, et al. Comparison of mesiodistal root angulation with posttreatment panoramic radiographs and cone-beam computed tomography [J]. Am J Orthod Dentofacial Orthop, 2011, 139(1): 126-132.
[11] Wang HH, Zhao N, Li PL, et al. A cone-beam computed tomography analysis of angulation and inclination of whole tooth and clinical crown in adults with normal occlusion [J]. Orthod Craniofac Res, 2019, 22(4): 337-344.
[12] Ferrario VF, Sforza C, Colombo A, et al. Three-dimensional inclination of the dental axes in healthy permanent dentitions-A cross-sectional study in a normal population [J]. Angle Orthod, 2001, 71(4): 257-264.
[13] 邓凯雄,刘进,郭鑫,等.正畸治疗中磨牙的拔除和保留(二十六)——第三磨牙发生和发育状况的研究[J].临床口腔医学杂志,2008,24(1):60-62.
[14] Carter K, Worthington S. Predictors of third molar impaction: A systematic review and meta-analysis [J]. J Dent Res, 2016, 95(3): 267-276.
[15] Jung YH, Cho BH. Assessment of maxillary third molars with panoramic radiography and cone-beam computed tomography [J]. Imaging Sci Dent, 2015, 45(4): 233-240.
[16] Bishara SE. Impacted maxillary canines: a review [J]. Am J Orthod Dentofacial Orthop, 1992, 101(2): 159-171.
[17] Iwata E, Hasegawa T, Kobayashi M, et al. Can CT predict the development of oroantral fistula in patients undergoing maxillary third molar removal?[J]. Oral Maxillofac Surg, 2021, 25(1): 7-17.
[18] 姚政铎,周林曦,沈刚.个别正常牙合牙齿近远中向倾斜度的CBCT测量分析[J].四川大学学报(医学版),2015,46(4):628-632.
[19] 郭鑫,刘进.正畸治疗中磨牙的拔除和保留(四十三)——上颌第三磨牙缺失或拔除后上颌结节骨量的对照研究[J].临床口腔医学杂志,2009,25(6):381-383.
[20] Loureiro RM, Sumi DV, Tames H, et al. Cross-sectional imaging of third molar-related abnormalities [J]. AJNR Am J Neuroradiol, 2020, 41(11): 1966-1974.
[21] Badawi Fayad J, Levy JC, Yazbeck C, et al. Eruption of third molars: relationship to inclination of adjacent molars [J]. Am J Orthod Dentofacial Orthop, 2004, 125(2): 200-202.
[22] Almpani K, Kolokitha OE. Role of third molars in orthodontics [J]. World J Clin Cases, 2015, 3(2): 132-140.
[23] Saputri RI, De Tobel J, Vranckx M, et al. Is third molar development affected by third molar impaction or impaction-related parameters? [J]. Clin Oral Investig, 2021, 25(12):6681-6693.
[24] Roth RH. The straight-wire appliance 17 years later [J]. J Clin Orthod, 1987, 21(9): 632-642.
[25] Su H, Han B, Li S, et al. Factors predisposing to maxillary anchorage loss: a retrospective study of 1403 cases [J]. PLoS One, 2014, 9(10): e109561.
[26] Isaacson JR, Isaacson RJ, Speidel TM, et al. Extreme variation in vertical facial growth and associated variation in skeletal and dental relations [J]. Angle Orthod, 1971, 41(3): 219-229.