利用3D數位齒列模型及側顱分析評估台灣成人各類型異常咬合與史畢氏曲線之關係

The study of the relationship between curve of Spee and malocclusions in Taiwanese adults using 3D digital dental models and lateral cephalogram

李祐欣(Yu-Hsin Lee)

指導教授 ： 曾于娟

高雄醫學大學/口腔醫學院/牙醫學系碩士班/碩士(2018年)

摘要

目的:本研究之目的為評估台灣成年人口內史畢氏曲線(Curve of Spee)深度與各 級異常齒列咬合之間的相關性。
材料與方法:本研究選取90位從未做過齒顎矯正的台灣成年人，依安格氏異常 咬合分類(Angle’s Classcification)分成3類。並收集影像清晰之數位側顱分析片及 構造完整之齒列模型。利用光學口內掃描機將齒列模型轉換成數位模型，並且 測量下顎兩側史畢氏曲線深度以及相關變項。數位側顱片則用來測量矯正側顱 分析數據。最後利用多重線性迴歸等統計方法找出側顱分析與各級異常咬合史 畢氏曲線深度之相關性。
結果:史畢氏曲線深度在男女、左右兩側上皆無顯著性差異。安格氏各級異常 咬合中，以二級異常咬合之史畢氏曲線深度最大，其次為一級異常咬合，曲線 最淺為三級異常咬合。經統計分析後，發現一級異常咬合之側顱分析數值與曲 線深度無顯著性相關，但在二級異常咬合中，SNA和SN-FH則是與曲線深度有 顯著相關性存在，而Cd-Gn則是與三級異常咬合之曲線深度有顯著相關。最 後，在數位齒列模型測量數值當中，垂直覆咬(overbite)是唯一與各級異常咬合 皆有顯著相關之數值;同時，水平覆合(overjet)則是與二級異常咬合有顯著相 關。
結論:各級異常咬合當中，史畢氏曲線深度最大者為二級異常咬合，其次為一 級異常咬合，最淺者為三級異常咬合。經分析後發現，史畢氏曲線深度受到顱 顏型態影響程度輕微;而與顱顏型態相比，曲線深度受到牙齒排列層面的影響 更大。

關鍵字

史畢氏曲線 ； 口內掃瞄機 ； 數位齒列模型 ； 數位側顱片

並列摘要

Purpose: The purpose of this study was to evaluate the relationship between the depth of the curve of Spee (CoS) and the different type of malocclusion in the adult population of Taiwanese, to determine whether the depth of the CoS is affected by different skeletal pattern or dental relation.
Material and methods: Ninety lateral cephalograms and digital models of untreated patients were included and assigned to 3 malocclusion groups as Angle’s Class I, Class II and Class III malocclusion. The depth of the CoS and dental measurement were measured on digital models by 3shape OrthoAnalyzerTM. Liner and angular measurements on digital lateral cephalograms by Viewbox3® will also be carried out. Multiple liner regression and other statical analysis were used to detect the correlation between CoS and lateral cephalometric analysis.
Results: No significant differences were found in the depth of CoS between male and female or right and left side in all malocclusion. The depth of CoS was greatest in the Class II malocclusion followed by Class I and Class III malocclusion. There’s no significant correlation between cephalomateric analysis and the depth of CoS in Class I malocclusion. However, in Class II malocclusion, SNA and SN-FH were significant associated with CoS; In Class III malocclusion, Cd-Gn was significantly correlated with the CoS. In dental model analysis, overbite was the only one which significantly correlated with CoS in all malocclusion. Overjet also significantly associated with CoS in Class II malocclusion.
Conclusion: The depth of CoS was greatest in the Class II malocclusion followed by Class I and Class III malocclusion. The CoS is influenced only to a minor extent by dentofacial morphology. Multiple linear regression analysis showed that the curve of Spee in the mandibular arch is significantly influenced by overbite.

並列關鍵字

curve of Spee ； digital model ； intra-oral scanner ； digital lateral cephalogram

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