電腦斷層分析齒間牙嵴寬度及皮質骨厚度－於矯正用迷你骨釘之應用

Computed Tomographic Analysis of Interdental Ridge Width and Cortical Plate Thickness at Orthodontic Miniscrew Sites

顏瑞瑩(Jui-Ying Yen) ； 李士元(Shyh-Yuan Lee) ； 林怡君(Yi-Chun Lin) ； 陳恆理(Heng-Li Chen) ； 賴玉玲(Yu-Lin Lai)

《臺灣牙周病醫學會雜誌》 14卷2期 (2009/06) Pp. 79-91

摘要

近年來，迷你骨釘已被廣泛應用於矯正治療，其穩定度可幫助牙齒作有效率的移動，迷你骨釘放置處的解剖構造會影響骨釘的穩定性，繼而影響牙齒移動的效果。然而有關迷你骨釘放置處解剖構造的研究很少，本研究的目的爲評估上、下顎齒間區的牙嵴寬度及皮質骨厚度予以量化做爲放置迷你骨釘的參考。本研究針對22位臺灣人的三維重組電腦斷層的影像分析，上、下顎各齒間自牙嵴下2毫米起至11毫米，分別測量其頰舌方向的牙嵴竟度及皮質骨厚度。結果顯示上、下顎的牙嵴寬度於臼齒區明顯較寬；下顎牙嵴竟度根尖部大於根冠部，上顎牙嵴的寬度於根冠、根尖處則無明顯差異。在皮質骨厚度方面，上顎頰側皮質骨最薄，下顎皮質骨最厚；上顎頰、錥側前牙區皮質骨厚度大於後牙區的皮質骨厚度，下顎頰側皮質骨厚度卻是後牙區較厚。上下顎根尖部皮質骨厚度大於根冠部。本研究認爲上、下顎牙嵴竟度及皮質骨厚度有區域性的差異，矯正用迷你骨釘的放置需配合解剖構造上的考量以達到治療效果的可預利性。

關鍵字

皮質骨厚度 ； 牙嵴寬度 ； 電腦斷層分析 ； 迷你骨釘 ； 齒間區解剖構造

並列摘要

Titanium miniscrews have been widely used for an absolute anchorage during orthodontic treatment recently. The stability of the miniscrew plays an important role in the efficient orthodontic tooth movement. The anatomical factors have been proven to have an impact on the miniscrew stability. However, there have been few human studies reporting on the anatomical studies of orthodontic miniscrew. The aim of this study is to quantitatively evaluate the width of alveolar ridge and the thickness of cortical plate in the interdental region of the maxilla and mandible. Three-dimensional reformed computed tomographic images of 22 Taiwanese patients were analyzed. For each interdental space, the buccolingual ridge width and cortical plate thickness were measured at 2 to 11 mm from the alveolar crest of maxillary and mandibular regions. The results showed that the mean ridge width between the maxilla & mandible was no significantly different. The width of alveolar ridge was significantly wider at the molar region in the both jaw bone. In the mandible, the mean ridge width in the apical level is greater than that in the crestal level but there was no significant difference between the different level in the maxilla. In the thickness of cortical plate, the least thickness in the buccal surface of maxilla was observed and the greatest thickness was found in the buccal surface of mandible. In the maxilla, the buccal and palatal cortical plates were thicker in the anterior tooth regions than those in the posterior tooth region whereas in the mandible, the buccal cortical plate was thicker in the posterior tooth area. Cortical plate thickness increased gradually from crestal level toward the apical level in both maxillary and mandibular regions.
This study suggests that there is a regional variation in the ridge width and cortical thickness of maxilla and mandible. The miniscrew placement for orthodontic anchorage in the jaw bone area requires consideration of anatomical characteristics for a predictable treatment outcome.

並列關鍵字

cortical plate thickness ； ridge with ； computed tomography ； miniscrew ； interdental anatomy