矯正前後骨密度的變化

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 牙醫學院 > 牙醫學系暨碩博士班、口腔醫學產業碩士班 > 博碩士論文 > Item 310903500/32550

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题名:	矯正前後骨密度的變化 Research on the bone density change during orthodontic treatment
作者:	張馨文;Hsing-Wen Chang
贡献者:	醫學院牙醫學系碩士班
关键词:	矯正;骨密度;牙科用電腦斷層掃描;orthodontics;bone density;CBCT
日期:	2010
上传时间:	2010-09-29 12:12:12 (UTC+8)
摘要:	齒顎矯正利用牙齒的移動來達到改變咬合及牙齒排列的目的。矯正的機制、力量大小、方向、牙周支持組織中骨密度和骨重塑的過程都會影響牙齒移動方向和距離。在過去的研究中，已經發現骨密度會影響矯正的速度，並且由傳統的組織切片證明在矯正牙齒移動的方向上的壓力側會造成骨密度吸收，相反方向的張力側會造成骨沉積的現象。由最新的有限元素分析法也可以從電腦中模擬矯正期間骨頭和牙周韌帶的變化。但對於真實人體上的骨生理並沒有實際的臨床人體試驗數據。在牙科用電腦斷層掃描的發明下，減少了斷層掃描影像的輻射劑量，以方便利用影像來做判讀及分析的工作。因此本實驗可以利用降低輻射的牙科用電腦斷層掃描影像實際運用在真實人體身上來探討微觀下骨頭在矯正前後的密度變化。本實驗就是利用牙科用電腦斷層掃描影像來探討牙根周圍骨密度在矯正前後變化的情形與牙齒移動方向的相關性。本實驗利用牙科用電腦斷層掃描儀器(i-CAT)照射八位中國醫藥大學矯正科患者口內上顎右上犬齒到左上犬齒六顆前牙在矯正前和單純leveling and alignment七個月後牙根周圍骨密度，並用Mimics軟體將測量的六顆前牙每顆牙分成上、中、下三段，每一段又分成頰、顎、近心、遠心面，分別記錄，再比較前後兩次測量結果分析牙根周圍骨密度改變情形，與牙齒移動方向的相關性。本實驗結果發現在矯正七個月後牙根周圍骨密度會降低。並且有57%的牙齒在牙齒移動的壓力側方向上的骨密度改變量會大於其他面，此結論符合矯正壓力側會造成骨吸收的理論。 In orthodontic theory, the ideal occlusion can be achieved by bone remodeling during orthodontic treatment. In the previous studies, most of them are histological studies on animal or human bone blocks. In the recent years, Finite Element Method (FEM) has adopted to show the details of bone remodeling during orthodontic treatment, however, none of them can exactly prove the real bone biology in the human body. In this study, we used dental cone beam computed tomography (CBCT) to evaluate the bone biology during orthodontic treatment. The most advantage of CBCT is that its radiation dose is much less than that of computed tomography. Therefore, we can get the bone density data in 7 months to analyze the bone density variations during orthodontic treatment. The purposes of this study were (a) to measure the variations of bone density before and after the orthodontic leveling and alignment, and (b) to find the correlation between the bone density and direction of tooth movement. Eight patients were selected from the Department of Orthodontics, China Medical University Hospital, Taiwan in this study. Six upper anterior teeth from canine to canine were chosen, and each tooth was divided into three levels (coronal, middle, apex) and four parts (buccal, palatal, mesial, and distal). The above data were collected before and after the orthodontic treatment by CBCT machine (i-CAT), and were further detected via the Mimics software approach. The results indicated that (1) the bone density around these teeth decreased during orthodontic treatment, and (2) the reducing amount of the bone density were more obviously on the direction of tooth movement in almost 57% of the observed teeth. The discoveries of this study coincided with “the pressure-tension theory”, which stated the bone resorption mainly occurred at the pressured side.
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