CBCT测量不同骨面型患者下颌骨结构特征和磨牙后间隙的影响因素

doi:10.13481/j.1671-587X.20230620

Abstract

Abstract:

Objective To discuss the influence factors of retromolar space in the patients with different osteofacial types， and to analyze the correlation between the mandibular bone structure and retromolar space and craniofacial structure. Methods A total of 200 adult orthodontic patients with fully erupted dentition except the third molars and crowding less than 5 mm were chosen and divided into skeletal type Ⅰ low angle group， skeletal type Ⅰ average angle group， skeletal type Ⅰ high angle group， skeletal type Ⅱ average angle group， and skeletal type Ⅲ average angle group. The sella nasion A point angle（SNA）， sella nasion B point angle（SNB）， AB plane angle（ANB）， skull base anterior-mandibular plane angle（SN-MP），facial height index（FHI），mandibular ramus length（Go-Co），and mandibular body length（Go-Gn） of all the patients were detected. Cone-beam computed tomography （CBCT） technology was used to detect the shortest distances C0 and C2 from the mandibular second molar to the anterior border of the ramus at the planes parallel to the cuspid line with a depth of 0 and 2 mm form the occlusal plane， and the shortest distances R2， R4， R6， R8， and R10 from the tooth root to the lingual cortical bone of the mandible at the enamel-bone junction in the root direction 2， 4， 6， 8， and 10 mm planes.The correlation was analyzed by using Spearman correlation analysis. Results Compared with skeletal type Ⅰ low angle group， the SN-MP of the patients in skeletal type Ⅰ average angle group and skeletal type Ⅰ high angle group was increased significantly （P<0.01）， and the FHI was decreased significantly （P<0.01）. Compared with skeletal type Ⅰ average angle group， the SN-MP of the patients in skeletal type I high angle group was increased significantly （P<0.01），FHI was decreased significantly （P<0.01）. Compared with skeletal type Ⅰ average angle group， the ANB of patients in skeletal type Ⅱaverage angle group was significantly increased （P<0.01）， while the ANB of the patients in skeletal type Ⅲ average angle group were significantly decreased （P<0.01）. Compared with skeletal type Ⅱ average angle group， the ANB of the patients in skeletal type Ⅲ average angle group was significantly decreased （P<0.01）. Under the C2， R2， R4， R6， R8， R10 planes and in the Go-Co and Go-Gn， compared with skeletal type Ⅰ low angle group， the retromolar spaces of the patients in skeletal type Ⅰ average angle group and the skeletal type Ⅰ high angle group were significantly decreased （P<0.01）； compared with skeletal type Ⅰ average angle group， the retromolar space of the patients in skeletal type Ⅰ high angle group was significantly decreased （P<0.01）. Under the C0 plane， compared with skeletal type Ⅰ low angle group and the skeletal type Ⅰ average angle group， the retromolar space of the patients in skeletal type Ⅰ high angle group was decreased （P<0.01）. Under the C0， R2， R4， R6， R8， and R10 planes， compared with skeletal type Ⅰ average angle group， the retromolar space of the patients in skeletal type Ⅱ average angle group was significantly decreased （P<0.01）， the retromolar space of the patients in skeletal type Ⅲ average angle group was increased （P<0.01）； compared with skeletal type Ⅱ average angle group， the retromolar space of the patients in skeletal type Ⅲ average angle group was increased （P<0.01）.Under the C2 plane and in the Go-Co and Go-Gn， compared with skeletal type Ⅰ average angle group and skeletal type Ⅱ average angle group， the retromolar space of the patients in skeletal type Ⅲ average angle group was increased （P<0.01）. The retromolar space，Go-Co and Go-Gn of the patients in skeletal type Ⅰ low angle group， skeletal type Ⅰ average angle group， and skeletal type Ⅰ high angle group under all planes had positive correlations with the SNB and FHI （P<0.01）， and a negative correlation with SN-MP （P<0.01）；the retromolar space at all levels had a positive correlation with Go-Co （P<0.01）； except for the C2 plane， the remaining retromolar space under all planes had positive correlations with Go-Gn （P<0.01）；there was a positive correlation between Go-Co and Go-Gn （P<0.01）；there was a negative correlation between Go-Gn and ANB（（P<0.01）.The retromolar space and Go-Co and Go-Gn of the patients in skeletal type Ⅰ average angle group， skeletal type Ⅱ average angle group， and skeletal type Ⅲ average angle group under all planes had positive correlations with SNB （P<0.01），and the retromolar space had positive correlations with Go-Co and Go-Gn （P<0.01）； there was a positive correlation between Go-Co and Go-Gn （P<0.01）；there was a positive correlation between Go-Co and FHI（P<0.01）. Conclusion The skeletal type is an important influence factor of the retromolar space of mandible， when the molar distalization plan is formulated， the skeletal type of the patient should be considered； CBCT should be used to evaluate the available space for mandibular molar distalization.

Key words: Retromolar space, Molar distalization, Vertical osteofacial type, Sagittal osteofacial type, Cone-beam computed tomography

CLC Number:

R783.5

Yunyun SUN,Yuguang YAO,Han ZHANG,Hanyi LI,Xianchun ZHU. Structural characteristics of mandible in patients with different osteofacial types measured by CBCT and influencing factors of mandibular retromolar space[J].Journal of Jilin University(Medicine Edition), 2023, 49(6): 1561-1568.

Figures/Tables 9

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References 21

1	BURNS N R， MUSICH D R， MARTIN C， et al. Class Ⅲ camouflage treatment： what are the limits？［J］. Am J Orthod Dentofacial Orthop， 2010， 137（1）：9-11.
2	NAKADA T， MOTOYOSHI M， HORINUKI E，et al. Cone-beam computed tomography evaluation of the association of cortical plate proximity and apical root resorption after orthodontic treatment［J］. J Oral Sci， 2016， 58（2）： 231-236.
3	刘莉萍，杨彤彤，程佳秀. 骨性Ⅱ类上颌磨牙后间隙解剖特征分析［J］. 上海口腔医学， 2021， 30（4）： 410-413.
4	田玲，周诺，宋少华. 下颌第三磨牙倾斜度及磨牙后间隙与骨性Ⅲ类错畸形的相关性探讨［J］. 临床口腔医学杂志， 2018， 34（9）： 533-535.
5	KIM S J， CHOI T H， BAIK H S， et al. Mandibular posterior anatomic limit for molar distalization［J］. Am J Orthod Dentofacial Orthop， 2014， 146（2）： 190-197.
6	ZHAO Z D， WANG Q Y， YI P， et al. Quantitative evaluation of retromolar space in adults with different vertical facial types［J］. Angle Orthod， 2020， 90（6）： 857-865.
7	FAN Z， ZHANG Q， JIANG Y J， et al. Mandibular retromolar space in adults with different sagittal skeletal patterns［J］. Angle Orthod， 2022， 92（5）： 606-612.
8	HORNER K A， BEHRENTS R G， KIM K B， et al. Cortical bone and ridge thickness of hyperdivergent and hypodivergent adults［J］. Am J Orthod Dentofacial Orthop， 2012， 142（2）： 170-178.
9	MASUMOTO T， HAYASHI I， KAWAMURA A，et al.Relationships among facial type， buccolingual molar inclination， and cortical bone thickness of the mandible［J］. Eur J Orthod， 2001， 23（1）： 15-23.
10	郭学强，刘新强，王铮，等. 成人下颌磨牙后间隙与第三磨牙关系的三维研究［J］. 中华口腔正畸学杂志， 2021， 28（2）： 74-79.
11	贺红. 种植体支抗辅助牙列整体远移的疗效及长期稳定性的研究进展［J］. 中华口腔医学杂志， 2018，53（9）： 594-598.
12	RICHARDSON M E. Development of the lower third molar from 10 to 15 years［J］.Angle Orthod，1973，43（2）： 191-193.
13	乔峰，左志刚，张健. 不同矢状骨面型患者下颌磨牙后间隙特征分析［J］.天津医药，2014，42（3）：268-270.
14	CHOI Y T， KIM Y J， YANG K S， et al. Bone availability for mandibular molar distalization in adults with mandibular prognathism［J］. Angle Orthod， 2018， 88（1）： 52-57.
15	KIM S H， CHA K S， LEE J W， et al. Mandibular skeletal posterior anatomic limit for molar distalization in patients with Class Ⅲ malocclusion with different vertical facial patterns［J］.Korean J Orthod，2021，51（4）： 250-259.
16	HUI V L Z， XIE Y X， ZHANG K W， et al. Anatomical limitations and factors influencing molar distalization［J］. Angle Orthod， 2022， 92（5）： 598-605.
17	SATO H， KAWAMURA A， YAMAGUCHI M，et al. Relationship between masticatory function and internal structure of the mandible based on computed tomography findings［J］. Am J Orthod Dentofacial Orthop， 2005， 128（6）： 766-773.
18	SELLA-TUNIS T， POKHOJAEV A， SARIG R，et al. Human mandibular shape is associated with masticatory muscle force［J］. Sci Rep， 2018， 8（1）： 6042.
19	KILIARIDIS S. Masticatory muscle influence on craniofacial growth［J］.Acta Odontol Scand，1995，53（3）： 196-202.
20	INGERVALL B， MINDER C. Correlation between maximum bite force and facial morphology in children［J］.Angle Orthod，1997，67（6）：415-422.
21	HWANG S， SONG J， LEE J， et al. Three-dimensional evaluation of dentofacial transverse widths in adults with different sagittal facial patterns［J］. Am J Orthod Dentofacial Orthop， 2018， 154（3）： 365-374.

Group	Age（year）	ANB(θ/°)	SN-MP(θ/°)	FHI（η/%）
Class Ⅰ hypodivergent	23.50（20.25，26.75）	2.86（1.36，4.06）	25.50（21.85，26.21）	70.61（69.82，73.70）
Class Ⅰ normodivergent	22.00（20.00，26.00）	3.43（2.79，3.87）	33.81（31.38，35.74）^*	65.54（64.22，66.84）^*
Class Ⅰ hyperdivergent	20.50（19.00，25.75）	3.52（2.02，4.33）	40.10（38.30，42.79）^*△	60.79（59.76，61.13）^*△
P	0.365	0.260	<0.01	<0.01

Group	Age（year）	ANB(θ/°)	SN-MP(θ/°)	FHI（η/%）
Class Ⅰ normodivergent	22.00（20.00，26.00）	3.43（2.79，3.87）	33.81（31.38，35.74）	65.54（64.22，66.84）
Class Ⅱ normodivergent	26.50（21.00，32.75）	6.04（5.35，7.00）^*	33.79（31.38，36.97）	65.55（63.10，67.24）
Class Ⅲ normodivergent	23.00（20.00，28.00）	－1.53（－3.15，－0.94）^*△	33.43（30.55，36.55）	65.89（63.52，66.95）
P	0.056	<0.01	0.368	0.992

Group	C0		C2	R2		R4		R6
Class Ⅰhypodivergent	8.47±2.64		7.37±2.42	7.19±2.33		6.31±2.09		5.45±1.77
Class Ⅰnormodivergent	7.33±2.49		5.63±2.85^*	5.31±2.02^*		4.27±2.08^*		3.46±1.95^*
Class Ⅰhyperdivergent	4.58±2.39^*△		4.05±2.41^*△	3.68±1.88^*△		2.89±1.77^*△		2.48±1.66^*△
F	25.444		16.790	28.405		29.953		28.465
P	<0.01		<0.01	<0.01		<0.01		<0.01
Group	R8	R10			Go-Co		Go-Gn
Class Ⅰhypodivergent	4.40±1.51	3.27±1.26			55.36±3.86		68.76±3.35
Class Ⅰnormodivergent	2.75±1.57^*	2.11±1.23^*			53.17±2.83^*		66.45±3.18^*
Class Ⅰhyperdivergent	1.66±1.09^*△	1.32±0.99^*△			50.65±3.34^*△		64.65±3.13^*△
F	38.803	28.373			19.567		16.339
P	<0.01	<0.01			<0.01		<0.01

Group	C0		C2	R2		R4		R6
Class Ⅰ normodivergent	7.33±2.49		5.63±2.85	5.31±2.02		4.27±2.08		3.46±1.95
Class Ⅱ normodivergent	5.56±2.54^*		4.38±2.45	3.83±1.97^*		2.92±1.75^*		2.10±1.65^*
Class Ⅲ normodivergent	9.04±3.26^*△		7.56±3.05^*△	7.15±2.46^*△		5.87±2.16^*△		5.26±2.12^*△
F	15.623		13.117	23.640		21.814		27.315
P	<0.01		<0.01	<0.01		<0.01		<0.01
Group	R8	R10			Go-Co		Go-Gn
Class Ⅰ normodivergent	2.75±1.57	2.11±1.23			53.17±2.83		66.45±3.18
Class Ⅱ normodivergent	1.58±1.17^*	1.16±0.86^*			51.73±3.39		65.40±3.22
Class Ⅲ normodivergent	4.23±1.66^*△	3.14±1.31^*△			55.44±3.90^*△		70.75±4.20^*△
F	32.197	29.569			12.045		25.342
P	<0.01	<0.01			<0.01		<0.01

Measurement indicator	r_C0	r_C2	r_R2	r_R4	r_R6	r_R8	r_R10	r_Go-Co	r_Go-Gn
SNB	0.366^*	0.322^*	0.368^*	0.377^*	0.370^*	0.387^*	0.381^*	0.403^*	0.385^*
ANB	－0.034	－0.073	－0.071	－0.118	－0.143	－0.121	－0.162	－0.153	－0.313^*
SN-MP	－0.504^*	－0.426^*	－0.519^*	－0.523^*	－0.513^*	－0.566^*	－0.533^*	－0.545^*	－0.511^*
FHI	0.512^*	0.443^*	0.537^*	0.545^*	0.537^*	0.594^*	0.539^*	0.596^*	0.427^*
Go-Co	0.356^*	0.339^*	0.377^*	0.411^*	0.450^*	0.467^*	0.425^*	1.000	0.482^*
Go-Gn	0.235^*	0.165	0.226^*	0.273^*	0.263^*	0.274^*	0.281^*	0.482^**	1.000

Structural characteristics of mandible in patients with different osteofacial types measured by CBCT and influencing factors of mandibular retromolar space

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Measurement indicator	r_C0	r_C2	r_R2	r_R4	r_R6	r_R8	r_R10	r_Go-Co	r_Go-Gn
SNB	0.278^*	0.249^*	0.358^*	0.354^*	0.403^*	0.405^*	0.410^*	0.325^*	0.385^*
ANB	－0.429^*	－0.404^*	－0.489^*	－0.497^*	－0.565^*	－0.599^*	－0.608^*	－0.366^*	－0.549^*
SN-MP	0.113	0.079	0.006	0.049	0.049	0.055	0.046	－0.087	－0.158
FHI	－0.156	－0.106	－0.018	－0.069	－0.055	－0.080	－0.076	0.343^*	－0.036
Go-Co	0.405^*	0.376^*	0.416^*	0.375^*	0.394^*	0.395^*	0.391^*	1.000	0.434^*
Go-Gn	0.319^*	0.259^*	0.299^*	0.303^*	0.350^*	0.398^*	0.394^*	0.434^*	1.000
^*P<0.01.