国际口腔医学杂志

国际口腔医学杂志 ›› 2024, Vol. 51 ›› Issue (2): 164-171.doi: 10.7518/gjkq.2024029

• 解剖学专栏 • 上一篇    下一篇

切牙管影响上中切牙三维移动的研究进展

陈韫欣1(),李舒舒2,黄梓澄1,孔卫东2()   

  1. 1.暨南大学口腔医学院 广州 510630
    2.暨南大学附属第一医院口腔正畸科 广州 510630
  • 收稿日期:2023-07-25 修回日期:2023-12-20 出版日期:2024-03-01 发布日期:2024-03-11
  • 通讯作者: 孔卫东
  • 作者简介:陈韫欣，医师，硕士，Email：cyxlawuu@163.com
  • 基金资助:
    暨南大学附属第一医院临床前沿新技术项目(JNU1AF-CFTP-2022-A01229)

Progress in research into the influence of the incisive canal on the three-dimensional movement of maxillary central incisors

Yunxin Chen1(),Shushu Li2,Zicheng Huang1,Weidong Kong2()   

  1. 1.School of Stomatology, Jinan University, Guangzhou 510630, China
    2.Dept. of Orthodontics, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
  • Received:2023-07-25 Revised:2023-12-20 Online:2024-03-01 Published:2024-03-11
  • Contact: Weidong Kong
  • Supported by:
    Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University(JNU1AF-CFTP-2022-A01229)

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摘要：

上中切牙的位置在面部美学中有十分重要的意义。在正畸治疗过程中，为获得理想的矫正效果，上中切牙会根据实际情况进行三维方向上的移动。以往观点认为上中切牙移动的范围只受到上颌骨唇、腭侧骨皮质的限制，但随着锥形束计算机体层成像（CBCT）的应用，发现在上颌骨内存在着解剖形态不规则的切牙管，其外侧壁由致密的皮质骨围绕而成，若上中切牙与之发生碰撞不仅会导致接触部位的牙根吸收，还可导致骨开窗、骨开裂，引发牙周问题，甚至还可能压迫鼻腭管神经等。因此，上中切牙三维移动的边界与切牙管的形态及位置关系密切，应引起重视，以避免临床工作中对上中切牙的牙根造成不必要伤害。本文就切牙管对上中切牙三维移动的影响做一综述。

关键词: 切牙管, 上中切牙, 移动限制, 牙根吸收

Abstract:

The position of the maxillary central incisor is essential in facial aesthetics. In orthodontic treatment, the maxillary central incisor moves in three-dimensional directions according to actual situations although the range of its movement is usually assumed to be restricted by the labial and palatal cortices. An incisive canal with an irregular anato-mical shape in the maxilla can be detected through cone beam computed tomograph (CBCT), and the wall of this canal is surrounded by dense cortical bones. If the maxillary central incisor invades it, the root will be absorbed. Therefore, the range of movement is closely related to the shape and position of the incisive canal and should be considered for the prevention of unnecessary injury to the tooth root. This article reviews the effect of the incisive canal on the three-dimensional movement of the maxillary central incisor.

Key words: incisive canal, maxillary central incisor, movement restriction, root absorption

中图分类号: 

  • R783.5

图1

上中切牙与切牙管和上颌骨腭侧骨板的位置关系及测量项目A：矢状面上，上中切牙牙根、切牙管与上颌骨腭侧骨板三者间的位置关系；B：矢状面上，L1表示上中切牙的根尖到上颌骨前部腭侧骨板的牙槽骨厚度；C：水平切面上，L2表示上中切牙根尖至切牙管外侧壁的距离。"

图2

测量平面、测量标记点及测量项目A：正中矢状面上，L1为根尖水平面，L2为切牙孔水平面；B：Rm为上中切牙牙根近中的最内侧点，Dm为两Rm之间的距离Rm-Rm，即双侧上中切牙的根间距离；Cl为切牙管外侧壁的最外点，Dc为两Cl之间的距离Cl-Cl，即切牙管的直径；C：Cat表示通过切牙管最前点的切线，Lml上中切牙近中缘Rm到切牙管切线Cat的距离，即上中切牙到切牙管的矢状距离；D：切牙孔水平面；E：根尖水平面。"

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