口腔疾病防治2025，Vol.33Issue(5)：393-400,8.DOI:10.12016/j.issn.2096-1456.202440472
正畸治疗中前牙牙槽骨唇侧骨性凸起1例报道及文献回顾
Labial protuberances of anterior alveolar bone in orthodontic treatment:a case report and literature review
摘要
Abstract
Objective This study aims to explore the influencing factors,formation mechanisms,and treatment methods of labial protuberance in the anterior maxilla during orthodontic treatment,providing a reference for clinical practice.Method This study reports a case where the absence of upper anterior teeth 11 and 21,and the retraction tilting movement of teeth 12 and 22,resulted in labial protuberance and gingival hyperplasia.Alveolar osteoplasty and gingivoplasty were performed.The specific changes in the alveolar bone during the retraction of the anterior teeth and the characteristics of its remodeling were analyzed.Combined with relevant literature,the factors influencing the forma-tion of labial protuberance in orthodontic patients,mechanisms,and methods for prevention and treatment were summa-rized.Results After periodental surgery follow-up for 6 months,the gingival color and shape of teeth 12 and 22 were good,the labial alveolar bone was normal,and the overall condition was stable.A review of the literature showed that la-bial protuberance is more common in adult orthodontic patients,and the distance(＞4 mm)and speed of retraction of anterior teeth are related to its formation,with the main mechanism likely being differential remodeling of the alveolar bone.In adult patients,the number of active osteoblasts and osteoclasts in the alveolar bone decreases,along with a re-duction in metabolic activity and overall cellular activity,which diminishes the reactivity of the alveolar bone.After treatment of anterior teeth retraction,there is insufficient labial bone resorption.Moreover,the lack of mechanical stress-mediated periodontal ligament in the interdental space leads to reduced bone remodeling stimulation in this area,result-ing in thickening of the labial alveolar bone of the upper anterior teeth.The remodeling rates of cortical and trabecular bone differ,with active trabecular bone proliferation near the tooth root surface and slow cortical bone resorption near the outer surface,which ultimately results in increased bone thickness at the labial cervical region.Specific case analy-sis indicates that the retraction distance of the upper anterior teeth in this case was about 6 mm.The alveolar bone at the missing sites of teeth 11 and 21,lacking periodontal ligament stimulation,showed less remodeling and absorption,likely appearing as hyperplasia.The prevention of labial bone protrusion mainly involves controlling the speed and dis-tance of retraction of anterior teeth.Smaller labial protuberances generally do not require treatment,but those affecting function and aesthetics can be addressed with periodontal alveolar osteoplasty.Conclusion After the retraction of an-terior teeth in orthodontics,a prominent,hard bone protuberance on the labial side can sometimes occur,which may be due to differential remodeling efficiency in different regions of the alveolar bone.For bone protuberance that influences aesthetics or function,periodontal alveolar osteoplasty can be a reliable option.关键词
唇侧骨性凸起/骨疣/正畸治疗/内收前牙/内收距离/骨改建/牙槽骨/牙龈成形术/牙槽骨修整术Key words
labial protuberance/exostosis/orthodontic treatment/anterior teeth retraction/extent of retrac-tion/bone remodeling/alveolar bone/gingivoplasty/alveolar osteoplasty分类
口腔医学引用本文复制引用
周伟,汤雅,肖健平,郝静,谭葆春..正畸治疗中前牙牙槽骨唇侧骨性凸起1例报道及文献回顾[J].口腔疾病防治,2025,33(5):393-400,8.基金项目
国家重点研发计划项目(2022YFC2504200) （2022YFC2504200）
南京大学医学院附属口腔医院2015学科带头人后备人才资助项目(JSDW202246) This study was supported by the grants from the National Key R&D of Program of China(No.2022YFC2504200) （JSDW202246）
"2015"Cultivation Program for Reserve Talents for Academic Leaders of Nanjing Stomatological School,Medical School of Nanjing University(No.JSDW202246). （No.JSDW202246）
