CAJ | 학술논문

背景：牵引成骨应用于患者的尖牙远中移动，能大幅度提高牙齿的移动速度，同时保护磨牙支抗。但关于牵引的速率、尖牙的牙髓活力、尖牙的牙周组织改建及该技术的生物学机制目前研究甚少。目的：在成人患者中，评估使用牙周膜牵张成骨快速远中移动尖牙的可行性，同时监测牙髓活力、牙根吸收及尖牙牙周组织改建情况。方法：选取9例成年错牙合患者，拔除上颌两侧第一双尖牙，通过改良牵张装置快速远中移动尖牙至预定的位置。利用头颅定位片及根尖片测量尖牙远中移动距离、支抗丧失、根尖吸收及牙槽间隔改建情况；并监测尖牙的牙髓及牙周情况。结果与结论：通过牙周膜牵张成骨能在12-16 d内快速远中移动上颌尖牙至预定位置，尖牙远中移动7.18 mm 及远中倾斜(13.24±2.87)°；支抗丧失为0.5 mm；未见明显根尖吸收及牙周组织丧失；尖牙的牙髓活力在牵引后迅速下降，但3个月后明显恢复。结果显示牙周膜牵引成骨可显著加快尖牙移动速度，缩短矫治时间，同时保护磨牙支抗；未见牙根明显吸收、牙齿松动、牙髓坏死及牙周组织丧失等不良反应。提示牙周膜牵引成骨能够快速有效移动尖牙。
배경：견인성골응용우환자적첨아원중이동，능대폭도제고아치적이동속도，동시보호마아지항。단관우견인적속솔、첨아적아수활력、첨아적아주조직개건급해기술적생물학궤제목전연구심소。목적：재성인환자중，평고사용아주막견장성골쾌속원중이동첨아적가행성，동시감측아수활력、아근흡수급첨아아주조직개건정황。방법：선취9례성년착아합환자，발제상합량측제일쌍첨아，통과개량견장장치쾌속원중이동첨아지예정적위치。이용두로정위편급근첨편측량첨아원중이동거리、지항상실、근첨흡수급아조간격개건정황；병감측첨아적아수급아주정황。결과여결론：통과아주막견장성골능재12-16 d내쾌속원중이동상합첨아지예정위치，첨아원중이동7.18 mm 급원중경사(13.24±2.87)°；지항상실위0.5 mm；미견명현근첨흡수급아주조직상실；첨아적아수활력재견인후신속하강，단3개월후명현회복。결과현시아주막견인성골가현저가쾌첨아이동속도，축단교치시간，동시보호마아지항；미견아근명현흡수、아치송동、아수배사급아주조직상실등불량반응。제시아주막견인성골능구쾌속유효이동첨아。
BACKGROUND:Distraction osteogenesis applied in patient’s canine distal movement, can greatly improve the speed of tooth movement, and protect the molar anchorage. But the researches on the traction rate, canine pulp vitality, canine periodontal tissue remodeling and the biological mechanisms of the technology are rare recently. OBJECTIVE:To evaluate the feasibility of rapid canine retraction through distraction osteogenesis of the periodontal ligament in adult patients and to monitor the pulp vitality, root resorption and periodontal remodeling of the canine. METHODS:Nine malocclusion patients were selected, and the bilateral maxil ary canine in adult patients were rapidly retracted and moved to the scheduled position using modified distraction devices. The canine distal movement distance, anchorage loss, root resorption and alveolar interval alterations were measured through intraoral radiographs, and lateral cephalograms. The pulp and periodontal of canine were mointrored. RESULTS AND CONCLUSION:The canines could be rapidly retracted to the schedualed position through distraction osteogenesis of the periodontal ligament in 12-16 days, the average amount of retraction was 7.18 mm and the canines tipped distal y (13.24±2.87)°. The anchorage loss was 0.5 mm. There was no obvious root resorption and periodontal tissue loss. The pulp vitality of the canines was decreased significantly right after distraction, but it recovered significantly after 3 months. The results indicated that periodontal ligament distraction osteogenesis can significantly accelerate canine movement speed, shorten treatment time, while protecting the molar anchorage;there was no significant adverse reaction of root resorption, loose teeth, pulp necrosis and loss of periodontal tissue. Indcating that distraction osteogenesis of periodontal ligament can move canines rapidly and effectively.