切牙管影响上中切牙三维移动的研究进展

Progress in research into the influence of the incisive canal on the three-dimensional movement of maxillary central incisors

摘要

上中切牙的位置在面部美学中有十分重要的意义。在正畸治疗过程中，为获得理想的矫正效果，上中切牙会根据实际情况进行三维方向上的移动。以往观点认为上中切牙移动的范围只受到上颌骨唇、腭侧骨皮质的限制，但随着锥形束计算机体层成像（CBCT）的应用，发现在上颌骨内存在着解剖形态不规则的切牙管，其外侧壁由致密的皮质骨围绕而成，若上中切牙与之发生碰撞不仅会导致接触部位的牙根吸收，还可导致骨开窗、骨开裂，引发牙周问题，甚至还可能压迫鼻腭管神经等。因此，上中切牙三维移动的边界与切牙管的形态及位置关系密切，应引起重视，以避免临床工作中对上中切牙的牙根造成不必要伤害。本文就切牙管对上中切牙三维移动的影响做一综述。

Abstract

The position of the maxillary central incisor is essential in facial aesthetics. In orthodontic treatment, the maxillary central incisor moves in three-dimensional directions according to actual situations although the range of its movement is usually assumed to be restricted by the labial and palatal cortices. An incisive canal with an irregular anato-mical shape in the maxilla can be detected through cone beam computed tomograph (CBCT), and the wall of this canal is surrounded by dense cortical bones. If the maxillary central incisor invades it, the root will be absorbed. Therefore, the range of movement is closely related to the shape and position of the incisive canal and should be considered for the prevention of unnecessary injury to the tooth root. This article reviews the effect of the incisive canal on the three-dimensional movement of the maxillary central incisor.

关键词

切牙管 / 上中切牙 / 移动限制 / 牙根吸收

Key words

incisive canal / maxillary central incisor / movement restriction / root absorption

Author summay

陈韫欣，医师，硕士，Email：[e-mail]