Objective: To evaluate the factors associated with the gingival papilla deficiencies of different degrees between maxillary anterior teeth showing alveolar ridge absorption. Methods: A total of 64 gingival papillae between maxillary anterior teeth of 14 patients with periodontitis, who received periodontal treatment and regular review in the Department of Periodontology, Peking University School and Hospital of Stomatology from June 2019 to December 2019, were observed in the present study. Indices were measured by using standardized clinical photographs and cone-beam CT images. The correlations between the gingival papilla deficiencies of different degrees and the distance from contact point to bone crest (CP-BC), the distance from proximal cemento-enamel junction to bone crest (pCEJ-BC), interproximal distance between roots (RD), the width of bone crest (BCW) and the height of gingival papilla (PH) were evaluated. Statistical analyses such as t-test, ANOVA, Pearson correlation coefficient and so on were conducted. Results: The rate of maxillary anterior gingival papilla completely filled the adjacent spaces between anterior teeth was 28% (18/64) and the rate of gingival papilla with deficiencies was 72% (46/64). The mild, moderate and severe deficiencies were 36% (23/64), 27% (17/64) and 9% (6/64) respectively. When CP-BC≥7.0 mm or pCEJ-BC≥4.5 mm, only moderate or severe deficiencies appeared. However, when CP-BC<5.0 mm or pCEJ-BC<1.5 mm, only completely filled adjacent tooth space or mild deficiency appeared. There was a strong positive correlation between CP-BC and pCEJ-BC. The Pearson correlation coefficient was 0.812 (P<0.01), and the linear fitting coefficient was 0.93 (R2=0.659) (64 gingival papillae). There was no significant difference of RD for gingival papilla deficiencies of different degrees between maxillary anterior teeth (P>0.05). BCW at the crest level increased slightly with the increase of the degree of gingival papilla deficiency, and the difference was statistically significant between completely filled adjacent tooth space and moderate or severe deficiency (P<0.05). However, PH at the crest level decreased slightly with the increase of the degree of gingival papilla deficiency, and the difference was statistically significant between completely filled adjacent tooth space and moderate or severe deficiency (P<0.05). Conclusions: When the alveolar ridge is absorbed, the rate of deficiency is significantly higher than the completely filled adjacent tooth space. The gingival papilla deficiencies of different degrees between maxillary anterior teeth are mainly associated with the absorption of bone crest.
目的： 探讨有牙槽嵴吸收时上前牙不同程度龈乳头缺陷的相关影响因素。 方法： 选择2019年6至12月就诊于北京大学口腔医学院·口腔医院牙周科，且经治疗后牙周炎控制稳定并定期进行牙周维护的14例牙周炎患者的64个上前牙龈乳头，通过标准化临床图像及锥形束CT影像资料综合分析，评价邻接触点至骨嵴顶的距离（distance from contact point to bone crest，CP-BC）、邻面釉质牙骨质界至骨嵴顶的距离（distance from proximal cemento-enamel junction to bone crest，pCEJ-BC）、骨嵴顶水平的根间距（distance between roots，RD）、骨嵴顶水平龈乳头高度（height of gingival papilla，PH）、骨嵴顶水平颊舌向骨宽度（width of bone crest，BCW）等指标与龈乳头充满和轻中重度缺陷的关系。 结果： 纳入研究的64个上前牙龈乳头，充满率为28%（18/64），缺陷率为72%（46/64），其中轻、中、重度缺陷率分别为36%（23/64）、27%（17/64）和9%（6/64）。当CP-BC≥7.0 mm或pCEJ-BC≥4.5 mm时，龈乳头均为中、重度缺陷；而当CP-BC<5.0 mm或pCEJ-BC<1.5 mm时，龈乳头为充满或轻度缺陷。上前牙CP-BC与pCEJ-BC存在显著正相关关系，Pearson相关系数为0.812（P<0.01），线性拟合系数为0.93（R2=0.659）。64个上前牙龈乳头不同程度缺陷时，其骨嵴顶水平RD差异无统计学意义（P>0.05）。骨嵴顶水平BCW随龈乳头缺陷程度增加略有增加，龈乳头充满与中重度缺陷时BCW差异有统计学意义（P<0.05）。骨嵴顶水平PH随龈乳头缺陷程度增加略有减少，龈乳头充满与中重度缺陷时PH差异有统计学意义（P<0.05）。 结论： 伴牙槽嵴吸收的牙周炎控制稳定患者的龈乳头缺陷率高，且主要与龈乳头根方骨嵴顶的吸收有关。.