INTRODUCTION:This study evaluated the labial and lingual cortical bone remodeling characteristics of mandibular central incisors after retraction, which remain controversial among orthodontists. METHODS:Cortical bone remodeling and central incisor movement of 33 patients (aged 23.64 ± 4.30 years) who underwent mandibular first premolar extraction and incisor retraction at the crestal (S1), midroot (S2), and apical (S3) levels were analyzed using superimposed cone-beam computed tomography images on the basis of voxel-based registration of the mandibular stable region. Multivariate linear regression was used to explore the relationships between labial bone remodeling/tooth movement (BT) ratios and factors such as the ANB angle, mandibular plane angle (Mp-SN), and incisor movement patterns. The patients were divided into 4 groups according to the lingual cortical bone remodeling condition and the relationship between posttreatment incisor roots and the original lingual cortical bone border. At the 3 levels (S1, S2, and S3), the classifications of cortical bone remodeling of the mandibular incisors were calculated; t tests were used to compare the amount of labial and lingual bone remodeling, BT ratios, and lingual bone remodeling/root over the original border (BRo) ratios. RESULTS:The mean labial BT ratios at all 3 levels were close to 1. Multivariate linear regression indicated that the tooth movement pattern negatively correlated with the BT ratio at the S2 and S3 levels (P <0.05). Lingual bone apposition occurs when the root penetrates the original lingual cortical bone border in most patients. BRo ratios can more accurately reflect the inherent remodeling ability of the lingual cortical bone than BT ratios. The mean lingual BRo ratios were (1) S1 level: mandibular left central incisor (T31), 0.87 ± 0.25 and mandibular right incisor (T41), 0.86 ± 0.25; (2) S2 level: T31, 0.81 ± 0.12 and T41, 0.80 ± 0.22; and (3) S3 level: T31, 0.76 ± 0.20 and T41, 0.83 ± 0.26. There was no significant difference between labial BT ratios and lingual BRo ratios at the S2 and S3 levels. CONCLUSIONS:The amount of labial cortical bone resorption caused by mandibular incisor retraction showed varied relationships with the amount of tooth movement. Bodily retraction may decrease the labial BT ratios at the S2 and S3 levels. Active lingual cortical bone apposition occurred when the roots penetrated the original lingual border and exhibited strong remodeling ability.
专科进修是继续医学教育的重要形式,有力地促进了医师职业发展.口腔正畸专科教育在我国起步相对较晚,一般作为口腔医学本科教育后的专科课程,医师对于正畸继续医学教育需求较高.北大口腔医院正畸科自上世纪70年代开始一直承担医学进修培训职责,来科进修医师累计超过500人.针对正畸学科发展新进展、医师临床新需求,北大口腔医院正畸科在进修医师培训教育中引入"导师制"模式,倡导理论学习、学术研究和临床特色有机融合,改革教学和考核方式,全方位提升医师的学习能力、科研能力和临床能力.