○要約 (任意): | □ | (英) The purpose of this study was to investigate etiologic factors for enlargement of gingival embrasure, which could be a clinical problem in adult orthodontic treatment. The gingival embrasures between the central incisors in the maxilla and mandible in 83 adult orthodontic patients (11 males, 72 females, age at pretreatment : 23.1±3.9 years old, treatment period : 2.5±1.6 years) were analyzed at pre and post-treatment stages by oral photographs, and were divided into the enlarged and non-enlarged groups. The direction and degree of the tooth movement, the crown shape of the central incisor and the skeletal pattern were analyzed by lateral cephalograms and study models, and the correlation with the prevalence of the enlarged gingival embrasure was evaluated. The following results were obtained ; 1) The prevalence of the enlargement of the gingival embrasure in the maxilla was 33.7% and that in the mandible was 47.0%. 2) The degrees of the lingual inclination and the extrusion of the maxillary incisors were significantly greater in the enlarged group as compared with the non-enlarged group. 3) The prevalence of the enlargement in skeletal 3 patients was lower than that in the skeletal 1 or skeletal 2 patients. 4) There were no significant differences in the shapes of the central incisors between the enlarged and non-enlarged groups. These results suggest that the enlargement of gingival embrasure might be an important problem in adult orthodontic patients. (日) 歯間乳頭の欠落により下部鼓形空隙(以下, 鼓形空隙と略する)が暗影となり, 審美障害や発音障害を惹起することから, この空隙は矯正治療において臨床的問題となる場合がある.そこで本研究では, 成人矯正治療患者の術前・術後における前歯部の歯間乳頭部歯肉の変化に着目し, 検討を行うことを目的とした.徳島大学歯学部附属病院矯正科を受診した成人不正咬合患者83名(男性11名, 女性72名, 動的治療開始時年齢18.1∿34.1歳, 平均年齢23.1±3.9歳, 平均治療期間2.5±1.6年)の上下顎中切歯間の鼓形空隙を対象とした.矯正治療の術前・術後の口腔内写真を用いて中切歯間の鼓形空隙の拡大の有無を上下顎それぞれについて判定を行い, 拡大群と非拡大群の2群に分類を行った.さらに石膏口腔模型, 側面頭部X線規格写真を用いて両群間の歯の移動様相, 骨格型, 中切歯歯冠形態を比較検討したところ, 以下の結果を得た.1)鼓形空隙拡大発生率は, 上顎中切歯と比較して下顎中切歯のほうが高い傾向を示した.2)歯の移動様相と鼓形空隙拡大との関連性については, 上顎中切歯の唇舌的歯軸変化量, および垂直的移動量において, 拡大群と非拡大群との間に有意差を認めた.3)骨格型と鼓形空隙拡大との関連性については, 上下顎ともにskeletal 3では鼓形空隙拡大発生頻度が低い傾向が認められた.4)歯冠形態と鼓形空隙拡大との関連性については, 拡大群と非拡大群との間に有意差を認めなかった.以上の結果より, 成人矯正治療においては鼓形空隙への十分な配慮が治療計画の立案において重要であることが示唆された.
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