黑三角 (牙科)
黑三角（英語：Black triangle，拉丁語：Angularis nigra），也称为开放性牙龈楔状隙、開放性牙間楔狀隙（英語：open gingival embrasures），是指位于齒頸鄰接面位、牙齿接触点下方的三角形間隙，當牙齦乳頭無法完全填充鄰牙間隙時，便會形成此種外觀可見的黑色三角區域。 [1]这种间隙有很多成因，包括牙龈萎缩和矯齒治疗后牙龈退缩等。 [2] 臨床研究顯示，黑三角被评为龋齿和牙冠高度後最影響美觀的口腔問題。 [3]現行治療方案涵蓋牙周治療、矯齒和修复治疗等多學科合作，具體措施包括复合树脂填補間隙、 [4]使用牙齒貼片或移植牙龈。 [5]黑三角一般仅根据患者的美學要求而治疗[6] ，不過严重的牙龈萎缩可能需要进行進一步的牙周治疗。
成因
[编辑]黑三角的發生與以下風險因素密切相關，其核心機制在於牙齦乳頭結構的改變：
1.牙齿之间接觸異常：臨床牙冠接觸點位置過高或傾斜和牙根角度異常（可能源於矯齒治療結果）会导致间隙的存在。 [7]
2.牙冠接触点與牙槽骨之间的距离增加：例如自然发生的牙間隙 [8]和牙槽骨流失。
3.牙龈厚度；厚牙齦和薄牙齦通常对炎症和创伤有不同的反应， [9] [10]薄牙龈在牙齒修复、牙冠修形、牙周手術及植齒后更容易萎缩。
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.异常的牙冠和牙齒形態及牙齒修复形状；呈三角形的临床牙冠往往会导致间隙。 [11]
参考文獻
[编辑]- ^ 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.
- ^ 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.
- ^ 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.
- ^ Lenhard, M. Closing diastemas with resin composite restorations. The European Journal of Esthetic Dentistry. 2008, 3 (3): 258–68. PMID 19655542.
- ^ 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.
- ^ Clark, D. Restoratively driven papilla regeneration: Correcting the dreaded 'black triangle'. Texas Dental Journal. 2008, 125 (11): 1112–5. PMID 19180945.
- ^ 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.
- ^ Portuguese Abstract Translations. Implant Dentistry. October 2014, 23 (5): e87–e93. ISSN 1056-6163. S2CID 220586634. doi:10.1097/id.0000000000000164.
- ^ 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.
- ^ 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.
- ^ Portuguese Abstract Translations. Implant Dentistry. October 2014, 23 (5): e87–e93. ISSN 1056-6163. S2CID 220586634. doi:10.1097/id.0000000000000164.
延伸阅读
[编辑]- Chow, Yiu Cheung; Wang, Hom-Lay. Factors and Techniques Influencing Peri-Implant Papillae. Implant Dentistry. 2010, 19 (3): 208–19. PMID 20523177. S2CID 13875737. doi:10.1097/ID.0b013e3181d43bd6.