骨皮質(zhì)切開術(shù)對Beagle犬前磨牙壓入移動(dòng)影響的三維形態(tài)學(xué)研究
發(fā)布時(shí)間：2019-03-02 07:56
【摘要】：組牙的壓入移動(dòng)是正畸治療的難點(diǎn)之一。正畸臨床中常見由于對合牙早失引起的磨牙過度萌出、骨性開合等錯(cuò)合畸形，其矯治均需對后牙進(jìn)行組牙的壓入移動(dòng)。以往缺乏穩(wěn)定的支抗是造成組牙壓入困難的主要原因，微螺釘種植體支抗（Mini-implant anchorage MIA）的出現(xiàn)為組牙的持續(xù)壓入提供了良好的解決方案。然而，有研究報(bào)道應(yīng)用種植體支抗壓低磨牙會(huì)導(dǎo)致根尖以及根分叉區(qū)域的牙根吸收。 骨皮質(zhì)切開術(shù)通過對牙齒周圍的皮質(zhì)骨進(jìn)行牙槽外科手術(shù)松解以達(dá)到加速牙移動(dòng)的目的，具有創(chuàng)傷小、操作簡單等特點(diǎn)。有臨床報(bào)道應(yīng)用骨皮質(zhì)切開術(shù)輔助微種植體支抗進(jìn)行磨牙壓低可以有效加快牙齒移動(dòng)的速率。目前關(guān)于骨皮質(zhì)切開加速正畸牙移動(dòng)的動(dòng)物實(shí)驗(yàn)研究主要集中在前牙的內(nèi)收和矢狀向移動(dòng)，而對于骨皮質(zhì)切開輔助組牙壓入在牙根吸收以及牙槽骨改建方面的三維形態(tài)學(xué)研究尚未見報(bào)道。 因此，有必要建立骨皮質(zhì)切開輔助組牙壓入移動(dòng)的動(dòng)物實(shí)驗(yàn)?zāi)Ｐ�，對比研究單純使用微種植體支抗和骨皮質(zhì)切開結(jié)合微種植體支抗輔助組牙壓入對于牙齒壓低速率，牙根吸收以及牙槽骨改建的影響。 目的：建立骨皮質(zhì)切開輔助組牙壓入的Beagle犬實(shí)驗(yàn)動(dòng)物模型，采用自身對照設(shè)計(jì)對比研究骨皮質(zhì)切開對于組牙壓入效應(yīng)的三維形態(tài)學(xué)影響，同時(shí)通過縱向比較不同時(shí)間節(jié)點(diǎn)的三維形態(tài)學(xué)變化，探討骨皮質(zhì)切開對壓入移動(dòng)的牙齒牙根吸收及牙槽骨改建的影響。 方法：1.建立骨皮質(zhì)切開輔助組牙壓入的動(dòng)物實(shí)驗(yàn)?zāi)Ｐ�。成年雄性Beagle犬8只，隨機(jī)分為4組，每組2只。隨機(jī)分配每只Beagle犬的下頜左右側(cè)為實(shí)驗(yàn)側(cè)及對照側(cè)，實(shí)驗(yàn)側(cè)采用骨皮質(zhì)切開輔助，微種植體作為支抗對P3，P4進(jìn)行壓低，對照側(cè)則直接應(yīng)用微種植體支抗壓低P3，P4，四個(gè)組分別在加力后2周，4周，8周，12周處死，獲取標(biāo)本。 2.牙齒移動(dòng)速率的大體測量。植入不加力的微種植體作為標(biāo)記，，對Beagle犬加力后2周、4周、6周、8周、10周、12周牙齒壓低量進(jìn)行大體測量，對比分析實(shí)驗(yàn)側(cè)及對照側(cè)的壓入移動(dòng)量；繪制壓入量時(shí)間曲線，對比分析實(shí)驗(yàn)側(cè)及對照側(cè)的牙齒移動(dòng)速率。 3.牙齒壓入量，牙根吸收情況及牙槽骨改建的CBCT研究。每只Beagle犬分別在加力前及處死后拍攝CBCT，并將相關(guān)數(shù)據(jù)導(dǎo)入三維測量軟件INVIVO5.0，對比分析實(shí)驗(yàn)側(cè)與對照的牙齒壓入量，牙根長度及根分叉變化、近遠(yuǎn)中牙槽骨高度變化，探究二者在牙齒壓入、牙根吸收及牙槽骨改建方面的差異。 4.壓入移動(dòng)后根分叉下牙根之間特定區(qū)域牙槽骨骨小梁結(jié)構(gòu)的Micro-CT檢測。處死后取材，固定，適當(dāng)修整后對骨塊進(jìn)行Micro-CT掃描，對比分析實(shí)驗(yàn)側(cè)與對照側(cè)根分叉下特定區(qū)域牙槽骨骨小梁的三維結(jié)構(gòu)。 結(jié)果：1.本實(shí)驗(yàn)成功建立了骨皮質(zhì)切開輔助組牙壓入的動(dòng)物實(shí)驗(yàn)?zāi)Ｐ�，為后期的三維形態(tài)學(xué)檢測，組織學(xué)及免疫組織化學(xué)分析奠定了基礎(chǔ)。 2.大體測量的結(jié)果提示：2周時(shí)實(shí)驗(yàn)側(cè)及對照側(cè)的牙齒壓入量無明顯差異，其余時(shí)間點(diǎn)包括4、6、8、（P＜0.05）；10、12周余下動(dòng)物實(shí)驗(yàn)側(cè)的壓入量均高于對照側(cè)，提示骨皮質(zhì)切開可加速組牙的壓入移動(dòng)。 3.CBCT測量結(jié)果提示：除兩周組外，其余三組實(shí)驗(yàn)側(cè)牙齒壓入量均大于對照側(cè)，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。12周組近遠(yuǎn)中牙根吸收量（MRRDRR）實(shí)驗(yàn)側(cè)小于對照側(cè)，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。8周組及12周組近遠(yuǎn)中牙槽骨高度降低量（MACDAC）實(shí)驗(yàn)側(cè)大于對照側(cè)（P＜0.05），但結(jié)合壓入量進(jìn)行分析，實(shí)驗(yàn)側(cè)牙槽骨高度降低量占壓入量的比例明顯小于對照側(cè)。實(shí)驗(yàn)側(cè)及對照側(cè)根分叉牙根吸收量均無明顯差異。提示：骨皮質(zhì)切開輔助牙齒壓入移動(dòng)可能減輕了牙根吸收的程度并使牙槽骨高度得到更好的保留。 4.Micro-CT結(jié)果提示：加力4周組及加力8周組骨小梁體積分?jǐn)?shù)實(shí)驗(yàn)側(cè)小于對照側(cè)（P＜0.05）。另外，加力4周組實(shí)驗(yàn)側(cè)骨小梁數(shù)目小于對照側(cè)（P＜0.05）,加力8周組實(shí)驗(yàn)側(cè)骨小梁間隙大于對照側(cè)（P＜0.05），差異有統(tǒng)計(jì)學(xué)意義。其余各組實(shí)驗(yàn)側(cè)及對照側(cè)各測量指標(biāo)之間無明顯差異。 綜上所述：骨皮質(zhì)切開聯(lián)合應(yīng)用微種植體支抗可加速正畸牙的壓入移動(dòng)，并可獲得更大的壓入移動(dòng)量。同時(shí)，輔助骨皮質(zhì)切開可能在一定程度上減少了牙根吸收、并對維持牙齒周圍骨量有積極作用。這可能與輔助骨皮質(zhì)切開手術(shù)后牙槽骨骨改建更加活躍有關(guān)。
[Abstract]:The press-in movement of the teeth is one of the difficulties in the treatment of orthodontic treatment. In the clinical of orthodontics, the malocclusion of the molar due to the early loss of the tooth and the bone opening and closing of the molar is often caused by the press-in movement of the teeth in the posterior teeth. The lack of stable anchorage in the past is the main cause of the difficulty in the press-in of the group, and the appearance of the mini-screw implant MIA provides a good solution for the continuous press-in of the group teeth. However, it has been reported that the application of an implant-supported low-pressure molar leads to root-tip and root resorption in the root-bifurcation region. The osteotomy of the cortical bone around the teeth is performed to achieve the purpose of accelerating the movement of the tooth, having a small wound, a simple operation, and the like. Point. There are clinical reports that the use of a cortical cut-assisted microimplant-assisted microimplant support for molar depression can effectively speed up the speed of tooth movement The results of the present study on the animal experimental study on the accelerated orthodontic tooth movement in the bone cortex were mainly focused on the internal and sagittal movement of the anterior teeth, while the three-dimensional morphological study on the root resorption and the reconstruction of the alveolar bone was not reported. Therefore, it is necessary to establish an animal experiment model of the tooth-in movement of the bone-cortex cut-off auxiliary group. The comparative study uses the micro-implant support and the bone-cortical cut-in combination with the micro-implant support-assisted group to press in the tooth-down rate, the root resorption, and the alveolar bone remodeling. Objective: To establish a model of Beagle dog experimental animal model for bone-cortical cut-in and to study the three-dimensional morphological effect of cortical cut on the press-in effect of the group and to compare the three-dimension of the different time nodes in the longitudinal direction. Morphological changes, and the absorption and the alveolar bone of the tooth root in the press-in movement of the cortical cut Impact of alteration . Methods:1. To establish a bone-cortical cut-off auxiliary group of teeth. Animal experiment model.8 adult male Beagle dogs were randomly divided into two groups: 4 groups,2 in each group. The left and right side of the lower jaw of each Beagle dog were randomly assigned to the experimental side and the control side. The depression of P3, P4 and the four groups were 2 weeks,4 weeks,8 weeks and 12 weeks after the application of the booster, respectively. kill, get the specimen.2. Teeth Gross measurement of the rate of movement. The non-stressed micro-implant was implanted as a marker, and the amount of press-in movement of the experimental side and the control side was compared with that of the two-week, four-week,6-week,8-week,10-week, and 12-week tooth depression of the Beagle dog. Draw the time curve of the pressure and pressure, and compare and analyze the experimental side and the pair. the rate of tooth movement on the side of the tooth.3. tooth pressure, tooth root absorption and tooth CBCT was used to study the alteration of the alveolar bone. The CBCT was taken and the relevant data were introduced into the three-dimensional measurement software, INVIVO 5.0, before and after the application, and the height of the alveolar bone in the near-distal region was changed. To study the effect of the two in the tooth press and root resorption 4. The difference in the reconstruction of alveolar bone.4. The bone trabecula of the alveolar bone in the specific area between the root and the root in the root bifurcation after the press-in movement Micro-CT (Micro-CT) of the structure was performed. After being killed, the bone mass was scanned by the Micro-CT, and the contrast between the experimental side and the control-side root was specific. alveolar bone The three-dimensional structure of the bone trabecula was successfully established in this experiment. 2. The results showed that there was no significant difference between the experimental side and the control side in 2 weeks, and the remaining time points were 4,6,8, (P <0.05), and the pressure on the experimental side of the remaining animals in the 10 and 12 weeks was higher than that of the control. 3. The results of CBCT showed that the tooth pressure in the other three groups was higher than that of the control (P <0.05) except for the two-week group (P <0.05). The experimental side of the absorption amount (MRRDRR) was less than that of the control side (P <0.05). The experimental side of the alveolar bone height reduction (MACD) in the 8-week group and the 12-week group was higher than that of the control (P <0.05). However, the experimental side of the experimental-side alveolar bone was the same as that of the control side (P <0.05). and the ratio of the height-decreasing amount to the pressure-reducing agent is obviously smaller than that of the control side, and the experiment There was no significant difference in the absorption of root in the lateral and control side. The degree of absorption and the height of the alveolar bone were better preserved. The experimental side of the beam volume fraction was less than that of the control (P <0.05). In addition, the number of bone trabeculae in the experimental side of the 4-week group was less than that of the control (P <0.05). The difference was of statistical significance on the control side (P <0.05). The rest There was no significant difference between the measurement indexes of the experimental side and the control side of each group. In conclusion, the combined application of the micro-implant support to the fracture of the bone cortex It is possible to accelerate the press-in movement of the orthodontic tooth and to obtain a greater amount of press-in movement. reduces the absorption of the root and has a positive effect on the bone mass surrounding the teeth, which may
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.5
本文編號：2432853
[Abstract]:The press-in movement of the teeth is one of the difficulties in the treatment of orthodontic treatment. In the clinical of orthodontics, the malocclusion of the molar due to the early loss of the tooth and the bone opening and closing of the molar is often caused by the press-in movement of the teeth in the posterior teeth. The lack of stable anchorage in the past is the main cause of the difficulty in the press-in of the group, and the appearance of the mini-screw implant MIA provides a good solution for the continuous press-in of the group teeth. However, it has been reported that the application of an implant-supported low-pressure molar leads to root-tip and root resorption in the root-bifurcation region. The osteotomy of the cortical bone around the teeth is performed to achieve the purpose of accelerating the movement of the tooth, having a small wound, a simple operation, and the like. Point. There are clinical reports that the use of a cortical cut-assisted microimplant-assisted microimplant support for molar depression can effectively speed up the speed of tooth movement The results of the present study on the animal experimental study on the accelerated orthodontic tooth movement in the bone cortex were mainly focused on the internal and sagittal movement of the anterior teeth, while the three-dimensional morphological study on the root resorption and the reconstruction of the alveolar bone was not reported. Therefore, it is necessary to establish an animal experiment model of the tooth-in movement of the bone-cortex cut-off auxiliary group. The comparative study uses the micro-implant support and the bone-cortical cut-in combination with the micro-implant support-assisted group to press in the tooth-down rate, the root resorption, and the alveolar bone remodeling. Objective: To establish a model of Beagle dog experimental animal model for bone-cortical cut-in and to study the three-dimensional morphological effect of cortical cut on the press-in effect of the group and to compare the three-dimension of the different time nodes in the longitudinal direction. Morphological changes, and the absorption and the alveolar bone of the tooth root in the press-in movement of the cortical cut Impact of alteration . Methods:1. To establish a bone-cortical cut-off auxiliary group of teeth. Animal experiment model.8 adult male Beagle dogs were randomly divided into two groups: 4 groups,2 in each group. The left and right side of the lower jaw of each Beagle dog were randomly assigned to the experimental side and the control side. The depression of P3, P4 and the four groups were 2 weeks,4 weeks,8 weeks and 12 weeks after the application of the booster, respectively. kill, get the specimen.2. Teeth Gross measurement of the rate of movement. The non-stressed micro-implant was implanted as a marker, and the amount of press-in movement of the experimental side and the control side was compared with that of the two-week, four-week,6-week,8-week,10-week, and 12-week tooth depression of the Beagle dog. Draw the time curve of the pressure and pressure, and compare and analyze the experimental side and the pair. the rate of tooth movement on the side of the tooth.3. tooth pressure, tooth root absorption and tooth CBCT was used to study the alteration of the alveolar bone. The CBCT was taken and the relevant data were introduced into the three-dimensional measurement software, INVIVO 5.0, before and after the application, and the height of the alveolar bone in the near-distal region was changed. To study the effect of the two in the tooth press and root resorption 4. The difference in the reconstruction of alveolar bone.4. The bone trabecula of the alveolar bone in the specific area between the root and the root in the root bifurcation after the press-in movement Micro-CT (Micro-CT) of the structure was performed. After being killed, the bone mass was scanned by the Micro-CT, and the contrast between the experimental side and the control-side root was specific. alveolar bone The three-dimensional structure of the bone trabecula was successfully established in this experiment. 2. The results showed that there was no significant difference between the experimental side and the control side in 2 weeks, and the remaining time points were 4,6,8, (P <0.05), and the pressure on the experimental side of the remaining animals in the 10 and 12 weeks was higher than that of the control. 3. The results of CBCT showed that the tooth pressure in the other three groups was higher than that of the control (P <0.05) except for the two-week group (P <0.05). The experimental side of the absorption amount (MRRDRR) was less than that of the control side (P <0.05). The experimental side of the alveolar bone height reduction (MACD) in the 8-week group and the 12-week group was higher than that of the control (P <0.05). However, the experimental side of the experimental-side alveolar bone was the same as that of the control side (P <0.05). and the ratio of the height-decreasing amount to the pressure-reducing agent is obviously smaller than that of the control side, and the experiment There was no significant difference in the absorption of root in the lateral and control side. The degree of absorption and the height of the alveolar bone were better preserved. The experimental side of the beam volume fraction was less than that of the control (P <0.05). In addition, the number of bone trabeculae in the experimental side of the 4-week group was less than that of the control (P <0.05). The difference was of statistical significance on the control side (P <0.05). The rest There was no significant difference between the measurement indexes of the experimental side and the control side of each group. In conclusion, the combined application of the micro-implant support to the fracture of the bone cortex It is possible to accelerate the press-in movement of the orthodontic tooth and to obtain a greater amount of press-in movement. reduces the absorption of the root and has a positive effect on the bone mass surrounding the teeth, which may
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.5
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本文編號：2432853
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