The cone-beam CT was used to compare the hardness of enamel between mesiodens and maxillary lateral incisors
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摘要:
目的 基于锥形束CT(CBCT)比较额外牙和上颌侧切牙的牙釉质硬度，分析两者之间的关系，寻求一种自体牙移植的方法。 方法 使用PLANMECA ROMEXIS Viewer软件对2015年8月—2017年7月于蚌埠医科大学第一附属医院口腔科就诊的75例多生牙患者共计104颗额外牙进行数据采集，采用HU值评估额外牙和上颌侧切牙的牙釉质硬度。测量5个牙面的HU值，分别为切缘(A)、唇中1/2(B1)、唇颈交界处(B2)、舌中1/2(L1)和舌颈交界处(L2)。 结果 共检测到104颗额外牙, 其中有98颗埋伏阻生(94.2%)，6颗萌出(5.8%)。46例(61.3%)为单颗额外牙，29例(38.7%)为两颗额外牙。左右上颌侧切牙之间牙釉质硬度比较差异无统计学意义(A、B1、B2、L1、L2位点，P>0.05)，其中额外牙与右上颌侧切牙L1、L2面牙釉质硬度相近(P>0.05), 右上颌侧切牙A、B1、B2面牙釉质硬度略高于额外牙(P < 0.001)。 结论 额外牙与上颌侧切牙牙釉质硬度相近，形态正常的额外牙可能是上颌侧切牙先天缺失的一种理想替代物。 Abstract:Objective The cone-beam CT (CBCT) was used to compare the hardness of enamel between mesiodens and maxillary lateral incisors and analyze the relationship between the two teeth, seeking a method of autologous tooth grafting. Methods PLANMECA ROMEXIS Viewer software was used to collect a total of 104 mesiodens from 75 supernumerary tooth patients in the stomatology department of the First Affiliated Hospital of Bengbu Medical University from August 2015 to July 2017. Then, the enamel hardness of mesiodens and maxillary lateral incisors were evaluated by Hounsfield units (HU). The HU values of five tooth surfaces were detected, including the incisal edge (A), the labial midpoint (B1), the midpoint of the cervical margin in the labial surface (B2), the lingual midpoint (L1) and the midpoint of the cervical margin in the lingual surface (L2). Results A total of 104 mesiodens were detected, of which 98 were impacted (94.2%) and 6 were erupted (5.8%). Forty-six (61.3%) had a single mesiodens, while 29 (38.7%) had two mesiodens. No significant difference was observed in the enamel hardness between the right and left maxillary lateral incisors and right and left mesiodenses (A, B1, B2, L1, L2 site, P>0.05). The enamel hardness of L1 and L2 surfaces was similar between mesiodens and the right maxillary lateral incisor (P>0.05). While, there were differences in the enamel hardness of the right maxillary lateral incisor and mesiodens at the A, B1, and B2 surfaces. It is observed that the enamel hardness of the right maxillary lateral incisor were higher than mesiodens (P < 0.001). Conclusion The enamel hardness is similar between mesiodens and maxillary lateral incisor. Mesiodens with normal shapes may be an ideal substitute for missing maxillary incisors. -
图 1 上颌侧切牙及额外牙需测量的5个特殊位点
注：切缘(A)、唇中1/2(B1)、唇颈交界处(B2)、舌中1/2(L1)和舌颈交界处(L2)。
Figure 1. Five special landmarks to measure on the maxillary lateral incisors and mesiodens
表 1 上颌侧切牙和额外牙各位点间ICC系数的比较
Table 1. Comparison of ICC coefficients at sites of the maxillary lateral incisors and mesiodens
位点 上颌侧切牙 额外牙 ICC值 P值 ICC值 P值 B2位点 0.875 0.001 0.841 < 0.001 B1位点 0.806 0.005 0.849 < 0.001 A位点 0.786 0.007 0.832 < 0.001 L1位点 0.921 < 0.001 0.902 < 0.001 L2位点 0.829 0.003 0.822 < 0.001 
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表 2 左右上颌侧切牙以及左右额外牙5个位点的HU值比较
Table 2. Comparison of HU values at five sites of left and right maxillary lateral incisor teeth and left and right extra teeth
位点 右上颌侧切牙(n=75) 左上颌侧切牙(n=75) 统计量 P值 左侧额外牙(n=29) 右侧额外牙(n=29) 统计量 P值 B2 1 505.680±192.358 1 536.810±195.691 -0.704a 0.484 1 282.308±244.855 1 299.385±190.444 -0.198a 0.844 B1 1989.389(1 736.250, 2 240.500) 1 969.000(1 788.000, 2 272.000) -0.367b 0.714 1 478.923±285.379 1 726.077±371.286 -1.903a 0.069 A 2 220.240±270.011 2 250.530±198.627 -0.564a 0.574 1 675.308±328.267 1 772.077±355.802 -0.721a 0.478 L1 1 497.800±201.132 1 567.370±228.084 -1.440a 0.154 1 486.385±202.982 1 534.846±161.802 -0.673a 0.507 L2 1 222.892±134.037 1 224.181±120.680 -0.479a 0.634 1 191.615±167.982 1 330.539±164.709 -2.129a 0.707 注：a为t值，b为U值。符合正态分布的计量资料以 x±s表示，非正态分布的计量资料以M(P25, P75)表示。
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表 3 右侧上颌侧切牙和额外牙的HU值比较
Table 3. Comparison of HU values between the right maxillary lateral incisor and mesiodens
位点 右上颌侧切牙(n=75) 额外牙(n=104) 统计量 P值 B2 1 490.500(1 351.250, 1 668.000) 1 275.000(1 190.000, 1 413.000) 3.988a < 0.001 B1 1 989.500(1 736.250, 2 240.500) 1 575.000(1 418.000, 1 744.000) 4.893a < 0.001 A 2 259.000(2 048.000, 2 430.500) 2 234.000(1 550.500, 1 922.000) 6.789a < 0.001 L1 1 497.800±201.132 1 530.782±202.024 0.628b 0.430 L2 1 222.892±134.037 1 280.255±171.074 0.430b 0.928 注：a为U值，b为t值。符合正态分布的计量资料以 x±s表示，非正态分布的计量资料以M(P25, P75)表示。
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