【作者】 陈敏；

【导师】 王建国；

【作者基本信息】 天津医科大学 ， 口腔临床医学， 2007， 硕士

【摘要】 目的：调查天津地区错(牙合)畸形患者全口埋伏牙(除第三磨牙外)及埋伏多生牙的患病情况及埋伏状况，探讨用全颌曲面断层片定位埋伏上颌尖牙的准确性，并对埋伏上颌尖牙的患病情况、病因、方向、位置等进行分析。方法：收集2005年11月1日～2006年10月31日天津市口腔医院正畸科就诊的4106例患者的全颌曲面断层片和头颅侧位片，其中男性1783例，女性2323例，年龄为2～47岁，平均年龄为18.7岁。通过分析X线片来确诊埋伏牙和埋伏多生牙，调查埋伏牙和埋伏多生牙的患病情况及埋伏状况。按纳入标准选择埋伏上颌尖牙为研究对象，探讨用全颌曲面断层片定位埋伏上颌尖牙的准确性，并对埋伏上颌尖牙的患病情况、病因、方向、位置等进行分析。结果：1天津地区错(牙合)畸形患者埋伏牙的患病率为7.33％，在400枚埋伏牙中，各牙位所占比例为：上颌尖牙为34.00％、上颌中切牙为16.25％、上颌第二双尖牙为14.75％、下颌第二磨牙为12.25％、下颌第二双尖牙为11.50％、上颌侧切牙为4.00％、下颌尖牙为2.50％、下颌第一双尖牙为2.50％、上颌第二磨牙为1.00％、下颌第一磨牙为1.00％、上颌第一双尖牙为0.25％，按其顺序依次递减。其发生，上颌多于下颌，上、下颌之比为2.36：1。前牙区多于后牙区，前、后牙区之比为1.31：1。好发于上前牙区，上前牙区埋伏牙枚数占埋伏牙总枚数的54.25％。其发生，男女性别之比为1：1.08，其差异无统计学意义(P＞0.05)。其在颌骨中的方向、位置以斜位最多，占54.50％，数目以1枚单发为主，占74.42％。其病因以牙胚异常、牙间隙不足和乳牙滞留为主。2天津地区错(牙合)畸形患者埋伏多生牙的患病率为2.51％，上颌多于下颌，上、下颌之比为9.73：1。前牙区多于后牙区，前、后牙区之比为6.38：1，好发于上前牙区，位于上前牙区埋伏多生牙枚数占埋伏多生牙总枚数的86.44％。其发生，男女性别之比为1.94：1，其差异有统计学意义(P＜0.05)。其在颌骨中的方向、位置以倒置位最多，占30.51％，数目以1枚单发为绝大多数，占90.29％。其对邻近恒牙造成的影响，以邻牙的移位、扭转和相邻两牙间出现间隙为最多。3对于位于邻牙牙冠部和根中部的非扭转埋伏上颌尖牙，可以利用全颌曲面断层片准确判断其唇腭向位置，而不需要其他的X线检查。但是对于位于邻牙根尖部的埋伏上颌尖牙仅用这种方法不能准确判断其唇腭向位置。4上颌尖牙埋伏的病因以乳牙滞留为最多见，占37.74％，埋伏上颌尖牙与中线的角度以大于30°最多，占41.51％，埋伏上颌尖牙牙尖以位于上颌中切牙的釉牙骨质界水平以下但小于等于上颌中切牙牙根1／2的区域最多，占64.15％，埋伏上颌尖牙牙尖以与同侧中切牙牙根无水平重叠最多，占73.58％，埋伏上颌尖牙牙冠以位于上颌侧切牙长轴线与上颌第一双尖牙长轴线之间的区域最多，占71.70％。结论：天津地区错(牙合)畸形患者埋伏牙的患病率为7.33％，好发于上前牙区，以上颌尖牙患病率最高，上颌多于下颌，前牙区多于后牙区，其发生在性别之间的差异无统计学意义，病因以牙胚异常、牙间隙不足和乳牙滞留为主；埋伏多生牙的患病率为2.51％，好发于上前牙区，上颌多于下颌，。前牙区多于后牙区，男性患病明显高于女性，其对邻近恒牙的正常发育、位置造成影响；对于位于邻牙牙冠部和根中部的非扭转埋伏上颌尖牙，利用全颌曲面断层片判断其唇腭向位置是准确的；上颌尖牙埋伏的病因以乳牙滞留为最多见，其方向、位置有一定特异性。更多还原

【Abstract】 Objective: To investigate prevalence and impacted condition of impacted teeth ofall teeth except the third molar and impacted supernumerary teeth of patients withmalocclusion in Tianjin. To discuss the reliability of the location of impactedmaxillary canines with the orthopantomograph. To analyse the prevalence, etiologicalfactor, direction and position of impacted maxillary canines.Methods: To collect orthopantomographs and lateral skull radiographs of 4106patients in Tianjin Stomatological Hospital from Nov.1 2005 to Oct.31 2006. Thepatients included 1783 males and 2323 females. The age of patients was from 2 to 47and the mean age was 18.7. Impacted teeth and impacted supernumerary teeth werediagnosed by radiographs. And the prevalence and impacted condition of them wereinvestigated. We chose patients with impacted maxillary canines by inclusivecriterion as object. The reliability of the location of impacted maxillary canines withthe orthopantomograph was to be discussed. And the prevalence, etiological factor, direction and position of impacted maxillary canines were to be analysed.Results:1 The prevalence rate of impacted teeth of patients with malocclusion in Tianjin was7.33％. Among the 400 impacted teeth, the teeth in order of frequency weremaxillary canines(34.00％), maxillary central incisors(16.25％), maxillary secondbicuspids(14.75％), mandibular second molars(12.25％), mandibular secondbicuspids(11.50％), maxillary lateral incisors(4.00％), mandibular canines(2.50％), mandibular first bicuspids(2.50％), maxillary second molars(1.00％), mandibularfirst molars(1.00％) and maxillary first bicuspids(0.25％). Impacted teeth ofmaxilla were more than that of mandible and its ratio was 2.36: 1. Impactedanterior teeth were more than impacted posterior teeth and its ratio was 1.31: 1.Impacted teeth occurred most frequently in maxillary-anterior teeth. The ratio of the number of impacted maxillary-anterior teeth to the number of the all impactedteeth was 54.25％. The ratio of males to females was 1: 1.08. The difference ofgender wasn’t statistically significant (P＞0.05). The direction and position ofimpacted teeth occurred mostly frequently in oblique position and the ratio was54.50％. The number of impacted teeth was mostly single and the ratio was74.42％. The etiological factor was mostly abnormity of tooth germ, insufficiencyof diastemata and retained primary tooth.2 The prevalence rate of impacted supernumerary teeth of patients withmalocclusion in Tianjin was 2.51％. Impacted supernumerary teeth of maxilla weremore than that of mandible and its ratio was 9.73: 1. Impacted supernumerary teethof anterior segment were more than that of posterior segment and its ratio was6.38: 1. Impacted supemumerary teeth occurred most frequently inmaxillary-anterior segment. The ratio of the number of impacted supernumeraryteeth of maxillary-anterior segment to the number of the all impactedsupernumerary teeth was 86.44％. The ratio of males to females was 1.94: 1. Thedifference of gender was statistically significant (P＜0.05). The direction andposition of impacted supemumerary teeth occurred mostly frequently in invertedposition and the ratio was 30.51％. The number of impacted supernumerary teethwas mostly single and the ratio was 90.29％. The associated complications to thepermanent teeth were mostly displacement, rotation and diastemata of adjacentteeth.3 The bucco-palatal position of those non-rotation impacted maxillary canines thatoverlapped the coronal or middle zones of the adjacent teeth could be accuracyachieved from orthopantomographs solely, but without other radiographs. But thebucco-palatal position of the impacted maxillary canines that overlapped the apicalzone of the adjacent teeth couldn’t be accuracy diagnosed fromorthopantomographs solely.4 The etiological factor of impacted maxillary canines was mostly retained primarytooth and the ratio was 37.74％. The canine angulation to the midline was mostly more than 30°and the ratio was 41.51％. The vertical canine crown height wasmostly above the cemento-enamel junction, but less than half way up the root andthe ratio was 64.15％. The canine overlap of the adjacent incisor root was mostlyno horizontal overlap and the ratio was 73.58％. The canine crown was mostlybetween the axis of maxillary lateral incisor and that of maxillary first bicuspidand the ratio was 71.70％.Conclusion: The prevalence rate of impacted teeth of patients with malocclusion inTianjin was 7.33％. Impacted teeth occurred most frequently in maxillary-anteriorteeth. The prevalence rate of impacted maxillary canine was the highest. Impactedteeth of maxilla were more than that of mandible and impacted anterior teeth weremore than impacted posterior teeth. The difference of gender wasn’t statisticallysignificant. The etiological factor was mostly abnormity of tooth germ, insufficiencyof diastemata and retained primary tooth. The prevalence rate of impactedsupernumerary teeth was 2.51％. Impacted supernumerary teeth occurred mostfrequently in maxillary-anterior segment. Impacted supernumerary teeth of maxillawere more than that of mandible and impacted supernumerary teeth of anteriorsegment were more than that of posterior segment. The prevalence rate of male washigher than that of female obviously. The impacted supernumerary teeth couldinfluence the normal growth and position of adjacent permanent teeth. It was exactthat the bucco-palatal position of those non-rotation impacted maxillary canines thatoverlapped the coronal or middle zones of the adjacent teeth judged fromorthopantomographs. The etiological factor of impacted maxillary canines was mostlyretained primary tooth. The direction and position of impacted maxillary teeth hadspecificity to some extent.更多还原