- 學位論文
台灣人的牙冠外型和牙齦特徵之間的關係
Relationship between crown forms and gingival characteristics in Taiwanese
摘要
在1990年代，就有學者開始研究高加索人種上顎前牙的牙齦特徵和牙冠外型之間的關係。同時也建立了合適的牙冠外型比例、及牙齦特徵之資料庫，以便於在重建前牙齒列時，能給予美觀上的指導原則。但因為種族之間的差異性，常會使得著基因的表現型有所不同，由文獻回顧得知，對於前牙美觀上的考量，仍以西方國家較具完整的資料統計，尚無亞洲人種的參考準則。基於上述因素，建立屬於台灣人種的前牙齒列之軟組織及硬組織的代表性資料庫，是有其絕對的必要性。 本研究從112位標準受試對象中，收集了牙冠和牙齦的資料。以印模的方法，整理台灣人種之上顎前牙的牙冠平均長度、寬度，及寬度/長度比例；同時也對健康的台灣人種之上顎前牙的牙齦特色，如齒間乳頭高度、牙齦厚度、牙齦角度和角化牙齦寬度，作臨床的測量。最後再以集群分析的方法，對台灣人種的牙冠外型和牙齦結構間的關係，作出新的三種分類：細長型(Slender type)、綜合型(Comprehensive type)和方型(Quadratic type)。細長型的牙冠寬度/長度比例、牙齦厚度和角化牙齦寬度分別為：0.66、0.9公厘和4.88公厘；綜合型的牙冠寬度/長度比例、牙齦厚度和角化牙齦寬度分別為：0.73、1.27公厘和6.79公厘；方型的牙冠寬度/長度比例、牙齦厚度和角化牙齦寬度分別為：0.79、1.02公厘和5.58公厘，而這三組資料均達到統計的顯著差異(p<0.05)。上述資料，除了可明白台灣人和高加索所人，因種族不同，所呈現出迥異的結果之外，也可作為牙周治療、牙體復形、矯正治療、補綴治療、乃至於前牙植體治療時的美觀考量，以及台灣人前牙美學的治療目標及準則。
並列摘要
In 1990s, Olsson M and Lindhe J started to investigate the relationship between crown forms and gingival characteristics in Caucasians. At the same time, they collected abundant data to make an esthetic guideline for upper anterior teeth reconstruction. However, there seemed different biotypes or phenotypes among different ethnicity. In addition, only a few papers mention about esthetic consideration over upper anterior dentition of Asian ethnic group. Based on the aforementioned aspects, we realize the importance of collecting data over Taiwanese adults about the relationship between soft and hard tissues in upper anterior dentition. This investigation collects the data of clinical crowns in maxillary anterior sextant of permanent dentition and clinical characteristics of gingiva in 112 adult Taiwanese. We get clinical crowns of maxillary anterior sextant with respect to width, length and width/length ratio by impression; and we measure interdental papilla height, gingival thickness, gingival angle and width of keratinized gingiva. When we employ cluster analysis on standardized parameters including mean gingival thickness, width of keratinized gingiva and crown width/ length ratio of upper central incisor, lateral incisor and canine, 3 clusters were identified: Slender, Comprehensive and Quadratic types. CW/CL, GTH, and WG in Slender, Comprehensive, Quadratic types were 0.66、0.9mm and 4.88mm; 0.73、1.27mm and 6.79mm; 0.79、1.02mm and 5.58mm. With abundant data about gingiva and crown of maxillary anterior sextant in Taiwanese adults, it could be a valuable esthetic guideline and reference for anterior teeth rehabilitation when clinicians perform periodontal, operative, orthodontic, prosthodontic treatment and anterior implants placement procedures.