黑三角 (牙科)

黑三角(英语:Black triangle拉丁语Angularis nigra),也称为开放性牙龈楔状隙开放性牙间楔状隙(英语:open gingival embrasures),是位于齿颈侧齿斜隙、位于牙齿接触点下方的空间或和间隙,因牙龈乳头不能完全填满空间,而导致相邻牙齿之间出现的缝隙。 [1]这种间隙有很多成因,包括牙龈萎缩、矫齿治疗后牙龈退缩。 [2]黑三角被评为龋齿牙冠高度之外最令人讨厌的美观问题。 [3]治疗黑三角通常涉及牙周、矫齿和修复治疗。矫正黑三角的方法包括在间隙中添加复合树脂[4]使用牙齿贴片或移植牙龈。 [5]黑三角一般仅根据患者的美学要求进行治疗[6] ,不过严重的牙龈萎缩可能需要进行进一步的牙周治疗。

下颚中央门牙之间的黑三角
上颚中央门牙之间的黑三角

成因

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有几个风险因素会导致黑三角的形成。牙龈乳头尺寸可能由于以下任何原因而改变:

1.牙齿之间的邻间隙:当两只牙的临床牙冠之间的接触点位置过斜时,牙根角度不良会导致间隙的存在,牙根角度不良也可能是矫齿治疗的结果。 [7]

2.牙冠接触点与牙槽骨之间的距离增加:例如自然发生的牙间隙 [8]和牙槽骨流失。

3.牙龈厚度;厚牙龈和薄牙龈通常对炎症和创伤有不同的反应, [9] [10]薄牙龈在牙齿修复、牙冠修形、牙周手术及植齿后更容易萎缩。

4.年龄:牙龈随着年龄增长而萎缩。

5.牙周疾病,导致牙龈萎缩。

6.异常的牙冠和牙齿形态及牙齿修复形状;呈三角形的临床牙冠往往会导致间隙。 [11]

参考文献

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  1. ^ Burke, S; Burch, J; Tetz, J. Incidence and size of pretreatment overlap and posttreatment gingival embrasure space between maxillary central incisors. American Journal of Orthodontics and Dentofacial Orthopedics. 1994, 105 (5): 506–11. PMID 8166102. doi:10.1016/S0889-5406(94)70013-3. 
  2. ^ Ikeda, T; Yamaguchi, M; Meguro, D; Kasai, K. Prediction and causes of open gingival embrasure spaces between the mandibular central incisors following orthodontic treatment. Australian Orthodontic Journal. 2004, 20 (2): 87–92. PMID 16429878. 
  3. ^ Cunliffe, Joanne; Pretty, Iain. Patients' ranking of interdental "black triangles" against other common aesthetic problems. The European Journal of Prosthodontics and Restorative Dentistry. December 2009, 17 (4): 177–181. ISSN 0965-7452. PMID 20158060. 
  4. ^ Lenhard, M. Closing diastemas with resin composite restorations. The European Journal of Esthetic Dentistry. 2008, 3 (3): 258–68. PMID 19655542. 
  5. ^ De Castro Pinto, RC; Colombini, BL; Ishikiriama, SK; Chambrone, L; Pustiglioni, FE; Romito, GA. The subepithelial connective tissue pedicle graft combined with the coronally advanced flap for restoring missing papilla: A report of two cases. Quintessence International. 2010, 41 (3): 213–20. PMID 20213022. 
  6. ^ Clark, D. Restoratively driven papilla regeneration: Correcting the dreaded 'black triangle'. Texas Dental Journal. 2008, 125 (11): 1112–5. PMID 19180945. 
  7. ^ Cho, Hae-Sung; Jang, Hyun-Seon; Kim, Dong-Kie; Park, Joo-Cheol; Kim, Heung-Joong; Choi, Seong-Ho; Kim, Chong-Kwan; Kim, Byung-Ock. The Effects of Interproximal Distance Between Roots on the Existence of Interdental Papillae According to the Distance From the Contact Point to the Alveolar Crest. Journal of Periodontology. October 2006, 77 (10): 1651–1657. ISSN 0022-3492. PMID 17032106. doi:10.1902/jop.2006.060023. 
  8. ^ Portuguese Abstract Translations. Implant Dentistry. October 2014, 23 (5): e87–e93. ISSN 1056-6163. S2CID 220586634. doi:10.1097/id.0000000000000164. 
  9. ^ Houston, W. J. B. Textbook of clinical periodontology. Author: Jan Lindhe. Publisher: Munksgaard International Publishers Ltd., Price: D.kr. 460.00. The European Journal of Orthodontics. 1984-08-01, 6 (3): 234. ISSN 0141-5387. doi:10.1093/ejo/6.3.234. 
  10. ^ SANAVI, FARSHID; WEISGOLD, ARNOLD S.; ROSE, LOUIS F. Biologic Width and its Relation to Periodontal Biotypes. Journal of Esthetic and Restorative Dentistry. May 1998, 10 (3): 157–163. ISSN 1496-4155. PMID 9759032. doi:10.1111/j.1708-8240.1998.tb00351.x. 
  11. ^ Portuguese Abstract Translations. Implant Dentistry. October 2014, 23 (5): e87–e93. ISSN 1056-6163. S2CID 220586634. doi:10.1097/id.0000000000000164. 

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