口腔医学研究

口腔医学研究 ›› 2025, Vol. 41 ›› Issue (4): 332-337.DOI: 10.13701/j.cnki.kqyxyj.2025.04.011

• 牙周病学研究 • 上一篇    下一篇

高频超声测量对前牙牙龈厚度及形态的评估分析

贾晓凤1*, 张贤月2, 夏荣1, 姜凡2, 孙磊3   

  1. 1.安徽医科大学第二附属医院口腔科 安徽 合肥 230601;
    2.安徽医科大学第二附属医院超声科 安徽 合肥 230601;
    3.安徽医科大学附属口腔医院综合科 安徽 合肥 230032
  • 收稿日期:2024-10-23 发布日期:2025-04-24
  • 通讯作者: * 贾晓凤,E-mail:812224596@qq.com
  • 作者简介:贾晓凤(1989~ ),女,硕士,主治医师; 研究方向:口腔内科(牙周病学)。
  • 基金资助:
    安徽省学术和技术带头人后备人选科研活动经费资助项目(编号:2021H253)

Evaluation and Analysis on Gingival Thickness and Morphology of Anterior Teeth by High Frequency Ultrasound

JIA Xiaofeng1*, ZHANG Xianyue2, XIA Rong1, JIANG Fan2, SUN Lei3   

  1. 1. Department of Stomatology, The Second Hospital of Anhui Medical University, Hefei 230601, China;
    2. Department of Ultrasound, The Second Hospital of Anhui Medical University, Hefei 230601, China;
    3. Department of Comprehensive Medicine, Affiliated Stomatological Hospital of Anhui Medical University, Hefei 230032, China
  • Received:2024-10-23 Published:2025-04-24

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摘要： 目的: 探讨高频超声对前牙牙龈厚度(gingival thickness,GT)及形态的评估价值。方法: 选取35例志愿者(男15例,女20例,年龄19~34岁),共138颗牙齿,采用牙龈穿刺法、高频超声分别测定所有受试者前牙龈缘下2 mm的GT(GT0、GT2),采用超声测量分析前牙牙龈形态,包括唇侧中央嵴顶上牙龈(supraosseous gingiva,SOG)高度、釉牙骨质界(cemento-enamel junction,CEJ)到牙槽嵴顶(bone crest,BC)的距离,并测量角化龈宽度。重点分析高频超声对前牙GT及形态的评估价值。结果: 35例受试者右上中切牙、左上中切牙、左下中切牙、右下中切牙各牙位经牙龈穿刺法测定的GT0与高频超声测定的GT2比较,差异均无统计学意义(P＞0.05)。绘制受试者工作特征(receiver operating characteristic,ROC)曲线,结果显示,高频超声测量的GT2诊断牙龈生物型的曲线下面积(area under curve,AUC)为0.821(95%CI:0.752~0.891),特异度、灵敏度分别为71.8%、78.3%,诊断价值较高。经组内相关系数(intraclass correlation coefficien, ICC)分析显示,高频超声测定各牙位牙龈缘下2 mm厚度与牙龈穿刺法测定结果有较好的一致性(ICC＞0.6)。不同性别受试者应用高频超声测定所得的各牙位GT2结果及牙龈形态指标SOG、CEJ-BC结果比较,差异均无统计学意义(P＞0.05)。经Pearson相关性分析显示,各牙位GT2与SOG均呈正相关关系(r=0.719、0.426、0.489、0.597,P<0.05),同时与角化龈宽度也呈正相关关系(r=0.512、0.498、0.647、0.562,P＜0.05),而与CEJ-BC呈负相关关系(r=-0.485、-0.452、-0.382、-0.402,P＜0.05)。结论: 上前牙角化龈宽度较下前牙角化龈宽度更宽,高频超声测量前牙GT与牙龈穿刺法有较好的一致性,可作为临床测量GT、判断牙龈生物型的有效方法,且测量所得GT与牙龈形态SOG高度、CEJ-BC、角化龈宽度均相关。

关键词: 牙龈厚度, 牙龈形态, 高频超声, 釉牙骨质界

Abstract: Objective: To explore the evaluation value of high frequency ultrasound on gingival thickness (GT) and morphology of anterior teeth. Methods: A total of 138 teeth were selected from 35 volunteers. GT (GT0, GT2) of 2 mm below the gingival margin of anterior teeth were measured by gingival puncture and high frequency ultrasound. The gingival morphology of anterior teeth was analyzed by ultrasonic measurement, including the height of supraosseous gingiva (SOG) on the labial central crest, the distance from cemento-enamel junction (CEJ) to the alveolar crest (BC), and the width of keratinized gingiva. Results: There was no statistical significant difference between GT0 measured by gingival puncture and GT2 measured by high frequency ultrasound in 35 subjects with right upper central incisor, left upper central incisor, left lower central incisor, and right lower central incisor (P>0.05). The receiver operating characteristic (ROC) Curve was drawn, and the results showed that the area under curve (AUC) of GT2 for diagnosing gingival biotypes measured by high-frequency ultrasound was 0.821 (95%CI: 0.752-0.891), the specificity and sensitivity were 71.8% and 78.3%, respectively, indicating high diagnostic value. According to the analysis of intra class correlation coefficient (ICC), the thickness of 2 mm below the gingival margin measured by high-frequency ultrasound at each tooth position was consistent with the results obtained by gingival puncture method (ICC>0.6). There was no statistical significant difference in the results of GT2 and gingival morphology indexes SOG and CEJ-BC measured by high frequency ultrasound in different gender subjects (P>0.05). According to Pearson correlation analysis, GT2 at each tooth position was positively correlated with SOG (r=0.719,r=0.426,r=0.489,r=0.597,P<0.05), and also positively correlated with the keratinized gingival width (r=0.512,r=0.498,r=0.647,r=0.562,P＜0.05), while there was a negative correlation with CEJ-BC (r=-0.485,r=-0.452,r=-0.382,r=-0.402,P＜0.05). Conclusion: The width of keratinized gingiva in the upper front teeth is wider than that in the lower front teeth. High frequency ultrasound measurement of GT in the front teeth is consistent with gingival puncture method, and can be used as an effective method for clinical measurement of GT and determination of gingival biotype. The measured GT is correlated with gingival morphology, SOG height, CEJ-BC, and keratinized gingiva width.

Key words: gingival thickness, gingival morphology, high frequency ultrasound, enamel cementum boundary