目的 分析错𬌗患者正畸后切牙炎症相关牙根吸收风险因素,构建基于锥形束CT(CBCT)的风险预测模型。方法 回顾性纳入2018-01至2023-01联勤保障部队第904医院口腔科行正畸治疗错𬌗患者共110例及上颌切牙401颗,根据治疗后随访期间是否出现切牙炎症相关牙根吸收分为严重吸收组和非严重吸收组;患者均采用常规正畸加力,根据错𬌗情况采用固定矫治或隐形矫治。收集患者资料,二元logistic回归分析和受试者工作特性曲线(ROC)进行数据分析。结果 110例患者上颌切牙401颗治疗后随访期间出现切牙炎症相关牙根吸收84颗,发生率为20.95%。单因素分析结果显示,初诊年龄、治疗时间,治疗前牙根长度及牙根垂直方向移动长度均与错𬌗患者正畸后切牙炎症相关牙根吸收有关(P＜0.05)。二元logistic回归分析结果显示,初诊年龄(OR=1.327,95%CI:1.191~1.477,P=0.000)、治疗周期(OR=1.003,95%CI:1.000~1.005,P=0.008)是发生正畸后切牙炎症相关牙根吸收风险的独立危险因素,治疗前牙根长度(OR=0.285,95%CI:0.204~0.397,P=0.000)、牙根垂直方向移动长度(OR=0.114,95%CI:0.052~0.251,P=0.003)是发生正畸后切牙炎症相关牙根吸收风险的独立保护因素。初诊年龄预测错𬌗患者正畸后切牙炎症相关牙根吸收的AUC(95%CI)为0.768(0.700,0.836),治疗周期的AUC为0.633(0.561,0.704),治疗前牙根长度的AUC为0.874(0.839,0.910),牙根垂直方向移动长度的AUC为0.799(0.754,0.843),约登指数为0.519,最佳截断值为0.62。结论 错𬌗患者正畸后切牙炎症相关牙根吸收与初诊年龄、治疗时间,治疗前牙根长度及牙根垂直方向移动长度关系密切,其中初诊年龄、治疗前牙根长度、牙根垂直方向移动长度作为预测指标的诊断效能良好。
Abstract
Objective To analyze the risk factors of root resorption related to inflammation of incisors in patients with malocclusion after orthodontic treatment and to construct a risk prediction model based on cone-beam CT (CBCT). Methods A total of 110 patients (including 401 maxillary incisors) who underwent orthodontic treatment for malocclusion in the Department of Stomatology of the 904th Hospital of PLA Joint Logistics Support Force from January 2018 to January 2023 were retrospectively included, and were divided into severe resorption and non-severe resorption groups based on the presence or absence of root resorption associated with inflammation of the incisors during the follow-up period after the treatment. All the patients were treated with conventional orthodontic weighting, and fixed orthodontics or invisibles were used according to the degree of malocclusion. The data of patients were collected, which were analyzed by binary logistic regression analysis and subject work characteristic curves (ROC). Results Eighty-four incisors with inflammation-related root resorption occurred during the follow-up period after treatment of 401 maxillary incisors in 110 patients, with an incidence rate of 20.95%. The results of univariate analysis showed that age at initial consultation, treatment time, pre-treatment root length and length of root movement in the vertical direction were associated with inflammation-related root resorption of incisors after orthodontic treatment in patients with malocclusion (P<0.05). The binary logistic regression analysis showed that the initial diagnosis age (OR=1.327, 95% CI:1.191-1.477, P=0.000), and treatment period (OR=1.003, 95% CI:1.000-1.005, P=0.008) were the independent risk factors for the risk of inflammation-associated root resorption of post-orthodontic incisors, while the pre-treatment root length (OR=0.285, 95% CI:0.204-0.397, P=0.000), and length of root movement in the vertical direction (OR=0.114, 95% CI:0.052-0.251, P=0.003) were independent protective factors for the risk of developing root resorption associated with inflammation of post-orthodontic incisors. The AUC of the initial diagnosis age for predicting inflammation-related root resorption of post-orthodontic incisors in patients with malocclusion was 0.768 (0.700-0.836), the AUC for the treatment period was 0.633 (0.561-0.704), the AUC for the length of the roots before treatment was 0.874 (0.839-0.910), and the AUC for the length of the roots moving in the vertical direction was 0.799(0.754-0.843). The Yoden index was 0.519, and the optimal cutoff value was 0.62. Conclusions Root resorption associated with inflammation of the incisors in patients after orthodontic treatment is closely related to the initial diagnosis age, duration of treatment, pre-treatment root length and length of root movement in the vertical direction, with good diagnostic efficacy of age at initial consultation, pre-treatment root length, and length of root movement in the vertical direction as predictors.
关键词
错𬌗 /
正畸 /
炎症 /
牙根吸收 /
锥形束CT
Key words
malocclusion /
orthodontics /
inflammation /
root resorption /
cone-beam CT
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