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北京大学学报（医学版） ›› 2020, Vol. 52 ›› Issue (2): 339-345. doi: 10.19723/j.issn.1671-167X.2020.02.023

• 论著 • 上一篇    下一篇

牙龈退缩患牙的牙龈厚度评估

陈子圆1,钟金晟2,欧阳翔英2,△(),周爽英2,谢颖2,娄新哲2   

  1. 1. 北京大学口腔医学院·口腔医院,第二门诊部 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100101;
    2. 北京大学口腔医学院·口腔医院牙周科,北京 100081
  • 收稿日期:2019-09-23 出版日期:2020-04-18 发布日期:2020-04-18
  • 通讯作者: 欧阳翔英 E-mail:kqouyangxy@bjmu.edu.cn

Gingival thickness assessment of gingival recession teeth

Zi-yuan CHEN1,Jin-sheng ZHONG2,Xiang-ying OUYANG2,△(),Shuang-ying ZHOU2,Ying XIE2,Xin-zhe LOU2   

  1. 1. Second Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100101, China;
    2. Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2019-09-23 Online:2020-04-18 Published:2020-04-18
  • Contact: Xiang-ying OUYANG E-mail:kqouyangxy@bjmu.edu.cn

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摘要：

目的 评估牙龈退缩患牙的牙龈厚度及牙龈生物型.方法: 选择2015年2月至2016年12月34例患者共计112颗非磨牙牙龈退缩患牙,用直接测量法,锥形束CT (cone-beam computerized tomography,CBCT)法及牙周探针法分别评估牙龈退缩患牙的牙龈厚度及生物型,比较不同牙龈生物型,不同牙位及不同牙龈退缩类型患牙牙龈厚度的区别,比较CBCT法与直接测量法的数据结果,牙龈厚度测量位点为龈缘下2 mm.结果: 牙龈退缩患牙平均牙龈厚度为(1.17±0.41) mm.厚,薄牙龈生物型平均牙龈厚度分别为(1.38±0.4) mm与(0.97±0.30) mm,差异有统计学意义(P＜0.001).牙龈厚度的中位数为1.1 mm,以1.1 mm为牙龈厚度的厚,薄分界值,能良好地与牙周探针法评估的厚,薄牙龈生物型结果相匹配(P=1.000).上颌牙齿的平均牙龈厚度显著厚于下颌牙齿,分别为(1.39±3.44) mm及(1.01±0.31) mm(P＜0.001).Miller Ⅰ度,Ⅱ度及Ⅲ度牙龈退缩牙齿平均牙龈厚度分别为 (1.15±0.34) mm,(0.83±0.17) mm 及(1.26±0.56) mm,组间差异无统计学意义(P=0.205).CBCT测量法与直接测量法得到的牙龈厚度差异无统计学意义(P=0.206).结论: 在非磨牙牙龈退缩患牙中,区分中国人群厚,薄牙龈生物型牙龈厚度的分界值为1.1 mm,上颌牙的平均牙龈厚度显著厚于下颌牙,CBCT方法评估颊侧牙龈厚度具有良好的准确性.

关键词: 牙龈厚度, 牙龈生物型, 牙龈退缩

Abstract:

Objective: To evaluate the gingival thickness and gingival biotype of gingival recession teeth of Chinese population.Methods: A total of 112 non-molar teeth with gingival recession in 34 patients were included. Direct measurement, cone-beam computerized tomography (CBCT) measurement and periodontal probe method were used to evaluate gingival thickness and biotype. Gingival thickness was measured at 2 mm apical to the gingival margin. Direct measurement was performed with a caliper of 0.01 mm resolution and anesthesia needles attached to silicone disk stops. Gingival biotype was assessed by sulcus probing, if the periodontal probe was visible through the gingival tissue, the gingival biotype was thin; If not visible, the gingival biotype was thick. The differences of gingival thickness among different gingival biotype, tooth site and gingival recession type were analyzed respectively. Besides, the results of CBCT measurement was analyzed compared with the direct measurement.Results: The average gingival thickness of non-molar recession teeth was (1.17±0.41) mm. The average gingival thickness of thick and thin biotype group were (1.38±0.4) mm and (0.97±0.30) mm, respectively, with statistically significant difference (P＜0.001).The median of gingival thickness was 1.1 mm. Using 1.1 mm as the cut-off value of thick and thin gingival thickness group, the results matched well with the gingival biotype classification results by periodontal probe method (P=1.000). The average gingival thickness of maxillary teeth was significantly thicker than that of the mandibular teeth. They were (1.39±3.44) mm and (1.01±0.31) mm, respectively (P＜0.001). The mean gingival thickness of MillerⅠ, Ⅱ and Ⅲ degree gingival recession teeth were (1.15±0.34) mm, (0.83±0.17) mm and (1.26±0.56) mm, respectively, without statistically significant difference (P=0.205). The gingival thickness measurement results between CBCT method and direct measurement were without statistically significant difference (P=0.206).Conclusion: In the non-molar gingival recession teeth, the cut-off value of gingival thickness to classify thick and thin biotype of Chinese population was 1.1 mm. The average gingival thickness of the maxillary teeth was significantly thicker than that of the mandibular teeth. Besides, CBCT measurement was an accuracy method for evaluating facial gingival thickness.

Key words: Gingival thickness, Gingival biotype, Gingival recession

中图分类号: 

  • R781.4

图1

佩戴塑料开口器拍摄CBCT"

图2

CBCT图像上清晰的牙龈边界"

图3

CBCT矢状面图像上进行牙龈厚度测量"

表1

不同牙龈生物型的牙龈厚度($\bar{x}±s $)"

Gingival
biotype		 n Rec PD WKT GTDM
Thick 55 2.46±1.00 1.60±0.56 3.11±1.66 1.38±0.42
Thin 57 2.44±0.99 1.58±0.53 2.69±1.50 0.97±0.30
P 0.895a 0.839a 0.233b <0.001c

表2

牙龈生物型评估(频率分布)"

Gingival biotype
probe method		 Cut-off 1.0 mm Cut-off 1.1 mm
Thick
(>1.0 mm)		 Thin
(≤1.0 mm)		 Thick
(>1.1 mm)		 Thin
(≤1.1 mm)
Thick (55) 43 12 41 14
Thin (57) 21 36 15 42
Predictive value 43/55
(78.20%)		 36/57
(63.20%)		 42/55
(76.40%)		 42/57
(73.70%)
P 0.164 1.000

表3

不同牙位的牙龈厚度$\bar{x}±s $"

Tooth site n Rec PD WKT GTDM
Maxillary 48 2.34±0.96 1.71±0.54 3.42±1.66 1.39±0.44
Incisors 15 1.57±0.60 1.87±0.64 4.67±1.14 1.27±0.44
Canines 11 2.64±0.78 1.55±0.52 3.27±1.21 1.18±0.28
Premolars 22 2.73±0.96 1.68±0.48 2.64±1.68 1.57±0.46
Mandibular 64 2.53±1.02 1.50±0.54 2.44±1.38 1.01±0.31
Incisors 22 2.52±0.98 1.41±0.50 3.43±1.49 0.93±0.31
Canines 13 2.04±0.72 1.46±0.52 2.23±0.88 1.04±0.25
Premolars 29 2.76±1.11 1.59±0.57 1.74±0.97 1.06±0.33
P 0.326a 0.045a 0.001a <0.001b

表4

不同牙龈退缩类型的牙龈厚度$\bar{x}±s $"

Gingival
recession		 n Rec PD WKT GTDM
Miller Ⅰ 77 2.35±0.92 1.56±0.55 2.88±1.29 1.15±0.34
Miller Ⅱ 3 2.83±1.04 2.00±0.00 0 0.83±0.17
Miller Ⅲ 32 2.66±1.15 1.63±0.55 3.19±1.96 1.26±0.56
Total 112 2.45±1.00 1.59±0.55 2.89±1.58 1.17±0.41
P 0.189a 0.305b 0.012b 0.205b
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ISSN 1671-167X
CN 11-4691/R
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