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北京大学学报（医学版） ›› 2019, Vol. 51 ›› Issue (5): 931-936. doi: 10.19723/j.issn.1671-167X.2019.05.023

• 论著 • 上一篇    下一篇

正畸牙齿位置的移动对角化龈宽度的影响

王高南1,焦剑2,周彦恒1,施捷1,△()   

  1. 1. 北京大学口腔医学院·口腔医院,正畸科　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　100081
    2. 北京大学口腔医学院·口腔医院,牙周科　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　100081
  • 收稿日期:2018-01-31 出版日期:2019-10-18 发布日期:2019-10-23
  • 通讯作者: 施捷 E-mail:sjlily9@163.com

Effect of orthodontic tooth movement on keratinized gingival width

Gao-nan WANG1,Jian JIAO2,Yan-heng ZHOU1,Jie SHI1,△()   

  1. 1. Department of Orthodontics, 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 100081, China
    2. Department of Periodontology, 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 100081, China
  • Received:2018-01-31 Online:2019-10-18 Published:2019-10-23
  • Contact: Jie SHI E-mail:sjlily9@163.com

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摘要：

目的:通过测量28例患者正畸治疗前后角化龈宽度的变化以及牙齿位置的变化,分析正畸牙齿移动与角化龈宽度变化的关系。方法:对患者照片与模型进行匹配,通过测量牙冠长度而获得角化龈的宽度。在rapidform 2006上将治疗前后的上颌模型重叠,准确测量正畸移动前后牙齿(包括切牙、尖牙、前磨牙)的位置变化。统计牙齿压低伸长、内收与唇向移动、转矩变化与角化龈宽度的计量数据,分析其变化的关系。结果:对28例患者共213颗牙齿治疗前后数据的相关性进行分析发现,牙齿转矩角度的变化与角化龈宽度的变化有较强相关性(r=-0.47,P<0.001),并在多水平线性回归分析中验证了它们之间的相关性(回归系数<0,P<0.001),同时,牙齿内收和压低与角化龈宽度的变化没有显著相关性(P>0.05),尖牙和前磨牙回归系数为负(尖牙回归系数=-0.35,前磨牙回归系数=-0.38,P<0.05)。结论:正畸过程中的牙齿移动对角化龈的宽度会造成影响,唇向正转矩的增加更有可能引起角化龈宽度的减小;牙齿内收和压低与角化龈宽度的变化没有显著相关性;切牙相对于尖牙和前磨牙,在牙齿移动过程中更容易发生角化龈宽度的变化。正畸过程中,应该对牙齿位置变化可能对角化龈宽度造成的影响进行预判,关注角化龈宽度的变化。

关键词: 正畸学, 牙移动技术, 转矩, 角化龈宽度

Abstract:

Objective: The relationship between the orthodontic tooth movement and the change of keratinized gingival width was analyzed by measuring the keratinized gingival width and position of the teeth before and after 28 orthodontic treatments. Methods: The photos were matched to the model and the width of the keratinized gingival was obtained by measuring the length of the crown, and the keratinized gingiva. The pre- and post-treatment models were overlapped on rapidform 2006 and the change of tooth position before and after orthodontic movement could be accurately measured, and the relationship between tooth intrusion and extrusion, retraction and forward movement, torque variation and keratinized gingival width was statistically investigated. Results: Analysis of the correlation between data before and after treatments for 213 teeth in 28 patients revealed a strong correlation between changes in tooth torque angle and changes in keratinized gingiva width (r=-0.47, P<0.001). In the multi-level linear regression analysis, the correlation between them was verified (regression coefficient<0, P<0.001), and there was no significant correlation between the intrusion and retraction of the teeth and the change of the width of keratinized gingiva (P>0.05). Regression coefficient was negatively relative to the reference incisor between the teeth for the canines and premolars (canine regression coefficient=-0.35, premolar regression coefficient=-0.38, P<0.05). Therefore, the study found that there was a strong negative correlation between the changes in tooth torque angle and width of keratinized gingival (r=-0.41, P<0.001), that is, an increase in positive torque led to the reduction of width of keratinized gingiva, and on the contrary the increase of negative torque would cause the width of keratinized gingiva increase. There was no significant correlation between the intrusion and extrusion of the teeth for the width of keratinized gingiva. The sensitivity of different teeth for the width of keratinized gingiva differed, with incisor compared with canines and premolars that were more prone to keratinized gingiva width changes. Conclusion: Tooth movement during orthodontics affected the width of the keratinized gingiva width, and the increase in positive torque was more likely to cause a reduction in the width of keratinized gingiva. There was no significant correlation between the intrusion and retraction of the teeth and the change in the width of keratinized gingiva. Incisors were more prone to changes in the width of keratinized gingiva relative to the cuspids and premolars during tooth movement. In the orthodontic process, it is possible to predict the effect of changes in the position of the teeth on the keratinized gingiva width, and attention shoud be to the changes in the keratinized gingiva width.

Key words: Orthodontics, Tooth movement techniques, Torque, Keratinized gingival width

中图分类号: 

  • R783.5

图1

实际角化龈宽度的计算"

图2

坐标轴设置、模型重叠和标记选择"

表1

患者资料信息"

Items n %
Gender
Male 11 39.3
Female 17 60.7
Tooth position
Incisor 107 50.2
Canine 49 23.0
Premolar 57 26.8

表2

牙齿位置及角化龈宽度变化的配对t检验"

Items Pre-treatment/mm Post-treatment/mm t P
WKG 4.11±1.15 3.99±1.20 -1.520 0.060
Torque 0.30±12.3 3.30±10.46 -6.006 <0.001
Distance away from occlusion plane 0.83±1.87 0.14±2.31 -5.007 <0.001
Distance from gingiva reference plane 1.69±2.17 0.83±0.86 -5.783 <0.001

表3

正畸治疗前后牙齿压低量、内收量、转矩变化与角化龈宽度变化的相关分析"

Items r P
Intrusion -0.210 0.002
Retraction 0.119 0.082
Torque variation -0.470 <0.001

图3

转矩增大时前磨牙区角化龈宽度减小"

表4

正畸治疗前后牙齿压低量、内收量、转矩变化与角化龈宽度变化的多元线性回归分析"

Items Coefficient 95%CI P
Intercept 1.942 1.340 to 2.544 <0.001
Tooth postition
Canines -0.351 -0.631 to -0.071 0.014
Premolars -0.383 -0.696 to -0.070 0.017
Incisors 0
Intrusion 0.010 -0.036 to 0.058 0.659
Retraction -0.029 -0.095 to 0.035 0.373
Torque variation -0.051 -0.067 to -0.036 <0.001
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ISSN 1671-167X
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