牙囊在埋伏上颌中切牙唇侧微创开放式牵引中的作用探讨

doi:10.7518/hxkq.2023.2022413

华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (2): 197-202.doi: 10.7518/hxkq.2023.2022413

牙囊在埋伏上颌中切牙唇侧微创开放式牵引中的作用探讨

黄佳玥(), 刘显, 王艳, 包崇云()

口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院，成都 610041

收稿日期:2022-10-23 修回日期:2023-01-27 出版日期:2023-04-01 发布日期:2023-04-14
通讯作者: 包崇云 E-mail:113247239@qq.com;cybao9933@scu.edu.cn
作者简介:黄佳玥，医师，硕士，E-mail：113247239@qq.com
基金资助:
国家重点研发计划(2020YFC2009005);四川省科技计划项目(2021YJ0045);四川大学华西口腔医院探索与研发项目(LCYJ2020-YY-1);国家自然科学基金(82071166)

Effect of dental follicles in minimally invasive open-eruption technique of labially impacted maxillary central incisors

Huang Jiayue(), Liu Xian, Wang Yan, Bao Chongyun.()

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2022-10-23 Revised:2023-01-27 Online:2023-04-01 Published:2023-04-14
Contact: Bao Chongyun. E-mail:113247239@qq.com;cybao9933@scu.edu.cn
Supported by:
National Key R&D Program of China(2020YFC2009005);The Program Project of the Sichuan Science and Technology Department(2021YJ0045);The Research and Develop Program of West China Hospital of Stomatology Sichuan University(LCYJ2020-YY-1);The National Natural Science Foundation of China(82071166);Correspondence: Bao Chongyun, E-mail: cybao9933@scu.edu.cn

摘要/Abstract

摘要：

目的总结既往上前牙区埋伏牙开放式牵引方法的基础上，报告一种基于牙囊的软组织处理技术，并监测治疗后埋伏牙牙根长度变化和牙槽骨丢失量，探讨牙囊在埋伏上颌中切牙唇侧微创开放式牵引中的重要作用。方法选择单侧唇侧埋伏上颌中切牙并采用开放式牵引技术治疗的患者，将埋伏中切牙纳入试验组，将对侧未受影响的中切牙纳入对照组。在外科手术暴露埋伏上颌中切牙时，利用埋伏牙周围的牙囊组织进行术区软组织管理，最大程度地保存埋伏牙周围软硬组织量。在埋伏上颌中切牙牵引至𬌗平面后，记录其牙长、根长、骨丢失量、骨厚度等测量值。结果成功牵引了17例单侧唇侧埋伏上颌中切牙。牵引后试验组与对照组之间，牙长、根长、唇侧骨丢失量的差异有统计学意义（P<0.05），唇-腭釉牙骨质界处宽度、腭侧骨丢失量、唇侧骨厚度、腭侧骨厚度、根尖牙槽骨厚度的差异无统计学意义（P>0.05）。结论在外科手术暴露唇侧埋伏上颌中切牙时，本方法利用埋伏牙周围的牙囊组织进行术区软组织管理，最大程度地保存埋伏牙周围软硬组织量，尽可能在牵引萌出后获得更好的美学效果和健康的牙周组织。

关键词: 微创, 开放式牵引, 外科技术, 牙囊, 阻生牙

Abstract:

Objective To summarize the open-eruption technique of impacted anterior maxillary teeth, this study reports a technically improved operation on surgical exposure based on dental follicles and evaluates post-treatment periodontal health considering the effect of dental follicles. Methods Patients who underwent open-eruption technique with unilateral labially impacted maxillary central incisors were selected. The impacted teeth were assigned to the experimental group, and the contralateral unimpacted maxillary central incisors were assigned to the control group. In the surgical exposure, the new technique makes use of dental follicles to manage the soft tissue, so as to preserve soft tissue for better aesthetic results and healthier periodontal tissue. Tooth length, root length, alveolar bone loss, and alveolar bone thickness were recorded after the therapy. Results A total of 17 patients with unilateral maxillary central incisor impaction were successfully treated. The tooth length and root length of the two groups showed a statistically significant difference between the impacted and homonym teeth, with a shorter length in the impacted tooth (P<0.05). More labial alveolar bone loss was found in the experimental group compared with that in the control group (P<0.05). The outcomes of the cementoenamel junction width, pa- latal alveolar bone loss, and alveolar bone thickness did not indicate statistical significance between the experimental and control groups (P>0.05). Conclusion In the surgical exposure, the new technique uses dental follicles to manage the soft tissue and preserve it for better aesthetic results and healthier periodontal tissues.

Key words: minimally invasive surgery, open-eruption technique, surgical exposure, dental follicles, impacted tooth

中图分类号:

R 782.05

黄佳玥, 刘显, 王艳, 包崇云. 牙囊在埋伏上颌中切牙唇侧微创开放式牵引中的作用探讨[J]. 华西口腔医学杂志, 2023, 41(2): 197-202.

Huang Jiayue, Liu Xian, Wang Yan, Bao Chongyun.. Effect of dental follicles in minimally invasive open-eruption technique of labially impacted maxillary central incisors[J]. West China Journal of Stomatology, 2023, 41(2): 197-202.

图/表 5

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表 2

参考文献 19

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测量值	定义
牙长	1→8
根长	4→8
唇-腭釉牙骨质界宽度	2→3
唇侧牙槽骨丢失量	平行于长轴测量5→线2-3的距离
腭侧牙槽骨丢失量	平行于长轴测量6→线2-3的距离
唇侧牙槽骨厚度	7→8
腭侧牙槽骨厚度	8→9
根尖牙槽骨厚度	7→9
唇侧牙槽骨丢失量/根长百分比（%LaBL）	唇侧牙槽骨丢失量/根长×100%
唇侧牙槽骨丢失量/根长百分比（%LaBL）
腭侧牙槽骨丢失量/根长百分比（%PaBL）	腭侧牙槽骨丢失量/根长×100%
腭侧牙槽骨丢失量/根长百分比（%PaBL）

测量项目		试验组			对照组
测量项目		平均值	标准差	范围	平均值	标准差	范围
牙长/mm	术前	18.21	2.30	14.29~22.85	22.16	3.04	16.12~26.09
	牵引后	19.74	2.13	15.94~23.23	22.49	2.12	18.36~26.05
根长/mm	术前	7.45	2.00	3.22~12.24	10.52	2.68	4.93~13.09
	牵引后	8.71	1.67	5.16~11.06	11.20	1.60	7.37~13.4
唇-腭釉牙骨质界处宽度/mm	术前	6.70	0.56	5.91~7.58	6.62	0.54	5.65~7.41
	牵引后	6.78	0.60	6.05~7.96	6.76	0.50	6.13~7.71
唇侧骨丢失量/mm	牵引后	2.64	1.27	0.50~3.96	1.22	0.88	0.32~3.52
腭侧骨丢失量/mm	牵引后	1.31	0.71	0.51~2.60	1.36	1.07	0.1~4.17
唇侧骨厚度/mm	牵引后	4.48	2.05	2.20~8.86	5.68	2.36	2.31~10.29
腭侧骨厚度/mm	牵引后	7.33	2.79	2.66~11.54	6.58	1.89	3.45~8.97
根尖牙槽骨厚度/mm	牵引后	11.81	2.59	7.51~15.94	12.26	1.82	8.95~15.25
%LaBL/%	牵引后	31.19	0.16	5.95~55.54	10.42	0.06	4.34~26.73
%PaBL/%	牵引后	15.41	0.09	5.51~35.71	11.67	0.09	1.18~35.86

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牙囊在埋伏上颌中切牙唇侧微创开放式牵引中的作用探讨

Effect of dental follicles in minimally invasive open-eruption technique of labially impacted maxillary central incisors

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