成年正畸患者颧牙槽嵴区微种植钉植入的位点选择

doi:10.7518/hxkq.2024.2023282

摘要/Abstract

摘要：

目的对成年男性及女性正畸患者颧牙槽嵴区的骨皮质密度、骨皮质厚度及颊侧可利用的有效骨量进行分析，为微种植钉植入时的位点选择提供参考。方法采集200例年龄20~30岁患者（男女比例为1∶1）的锥形束CT扫描数据，从近中至远中依次将矢状面上右侧上颌后牙区分为6个层面，每个层面在垂直距离为颊侧骨皮质距离釉牙骨质界8、10、12 mm处分别设置3个测量位点，共计18个测量位点，测量其骨皮质密度、厚度及有效骨量，并进行统计分析。结果成年男性与女性正畸患者的骨皮质密度、厚度及有效骨量的最高值均位于平分第二前磨牙与第一磨牙根间区，其中骨皮质密度、厚度随着垂直高度增加而增大，而有效骨量随着垂直高度增加而减少。成年男性与女性患者之间的骨皮质密度、骨皮质厚度和颊侧有效骨量存在一定的差异。结论成年男性与女性正畸患者颧牙槽嵴区微种植钉的最佳植入位点均位于第二前磨牙与第一磨牙根间区，其中男性最佳植入位点的垂直高度可以适当高于女性。

关键词: 颧牙槽嵴, 微种植钉, 骨皮质密度, 骨皮质厚度, 有效骨量, 性别因素

Abstract:

Objective To determine the optimal placement of miniscrews, this study compared adult male and female patients in terms of cortical bone density, cortical bone thickness, and available bone width in the infrazygomatic crest region. Methods The cone beam computed tomography imaging data of 200 patients (20-30 years old; 100 males and 100 females) were collected. The right maxillary posterior teeth in the sagittal plane were divided into six levels from proximal to distal, and three measurement sites were positioned at vertical distances of 8, 10, and 12 mm from the cementum. Cortical bone density, cortical bone thickness, and available bone width were measured in 18 measurement sites in the infrazygomatic crest and analyzed statistically. Results The highest cortical bone density, cortical bone thickness, and available bone width in the infrazygomatic crest in adult male and female patients were at the level of the interradicular space between the maxillary second premolar and maxillary first molar. The bone cortical density and thickness increased with vertical height, whereas the available bone width decreased with increasing vertical height. Differences were observed in cortical bone density, cortical bone thickness, and available bone width between adult male and female patients. Conclusion The optimal implantation sites of the micro-implant anchorages in the infrazygomatic crest were at the level of the interradicular space between the maxillary second premolar and the maxillary first molar, and the vertical height of the optimal implantation site in males was appropriately higher than that in females.

Key words: infrazygomatic crest, miniscrews, cortical bone density, cortical bone thickness, effective bone mass, gender factor

中图分类号:

R783.5

陈芯伊, 蒋晓鸽, 陈嵩. 成年正畸患者颧牙槽嵴区微种植钉植入的位点选择[J]. 华西口腔医学杂志, 2024, 42(2): 207-213.

Chen Xinyi, Jiang Xiaoge, Chen Song. Site selection of micro-implant anchorages in the infrazygomatic crest in adult orthodontic patients[J]. West China Journal of Stomatology, 2024, 42(2): 207-213.

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测量位点	男性	女性	t值	P值
Aa	753.21±184.32	840.09±189.89	-3.267	0.001
Ab	826.35±209.08	939.00±193.99	-3.930	0.000
Ac	897.89±203.47	993.06±195.03	-3.360	0.001
Ba	748.70±184.38	830.42±206.45	-2.938	0.004
Bb	809.30±183.84	918.11±217.95	-3.797	0.000
Bc	870.81±214.47	968.94±194.16	-3.375	0.001
Ca	748.70±174.39	871.55±180.58	-4.869	0.000
Cb	824.22±199.14	946.00±184.41	-4.464	0.000
Cc	868.20±221.82	960.24±205.33	-3.030	0.003
Da	749.79±154.61	855.78±193.56	-4.257	0.000
Db	801.48±175.06	914.51±182.76	-4.444	0.000
Dc	844.88±218.71	913.54±185.09	-2.384	0.018
Ea	733.37±176.71	835.51±178.60	-4.045	0.000
Eb	789.74±189.83	881.00±185.46	-3.421	0.001
Ec	806.12±200.56	870.36±177.60	-2.386	0.018
Fa	707.62±172.82	813.93±203.00	-3.968	0.000
Fb	758.87±185.00	846.65±198.37	-3.220	0.001
Fc	763.23±198.88	816.53±191.14	-1.923	0.056

测量位点	男性	女性	t值	P值
Aa	1.61±0.36	1.61±0.39	0.030	0.976
Ab	1.70±0.30	1.77±0.52	-1.168	0.244
Ac	1.89±0.38	1.90±0.50	-0.101	0.920
Ba	1.32±0.38	1.21±0.38	2.105	0.037
Bb	1.35±0.42	1.39±0.44	-0.579	0.564
Bc	1.55±0.49	1.65±0.54	-1.382	0.168
Ca	1.40±0.32	1.42±0.39	-0.507	0.613
Cb	1.51±0.36	1.57±0.46	-1.000	0.318
Cc	1.65±0.45	1.62±0.46	-0.513	0.608
Da	1.35±0.30	1.33±0.39	0.431	0.667
Db	1.43±0.36	1.49±0.45	-1.141	0.255
Dc	1.67±1.00	1.59±0.53	-0.203	0.839
Ea	1.41±0.40	1.40±0.39	0.036	0.971
Eb	1.50±0.44	1.54±0.45	-0.507	0.612
Ec	1.53±0.41	1.59±0.49	-0.918	0.360
Fa	1.27±0.31	1.38±0.43	-2.001	0.047
Fb	1.37±0.38	1.48±0.46	-1.771	0.078
Fc	1.48±0.41	1.52±0.51	-0.527	0.599

测量位点	男性	女性	t值	P值
Aa	13.88±7.48	10.81±6.72	3.035	0.003
Ab	10.40±6.67	7.14±5.30	3.819	0.000
Ac	7.83±5.91	4.54±3.78	4.669	0.000
Ba	2.42±1.39	3.30±7.25	-1.181	0.239
Bb	3.05±3.04	2.99±3.02	0.150	0.881
Bc	3.99±4.67	3.24±2.93	1.349	0.179
Ca	9.71±6.42	7.50±5.56	2.587	0.010
Cb	6.96±5.92	4.75±3.88	3.106	0.002
Cc	4.89±4.66	3.41±3.40	2.563	0.011
Da	3.75±3.00	3.23±2.55	1.305	0.193
Db	4.17±4.38	3.91±4.51	0.407	0.684
Dc	4.12±4.62	2.98±2.97	2.050	0.042
Ea	8.94±6.36	7.39±5.07	1.886	0.061
Eb	6.38±5.90	4.80±3.88	2.219	0.028
Ec	4.13±4.36	3.24±3.36	1.603	0.110
Fa	4.49±2.58	3.89±2.19	1.751	0.082
Fb	4.06±3.54	3.41±2.51	1.485	0.139
Fc	3.30±3.49	2.64±2.24	1.564	0.119

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