锥形束CT在下颌阻生智齿拔除术前设计中的应用  

Application of cone beam CT in preoperative planning for extraction of mandibular impacted wisdom teeth

作　　者：周洁[1] 刘渊[1] 姜蕾[1] 李崴[1] 

机构地区：[1]第二军医大学长征医院口腔科,上海200003

出　　处：《第二军医大学学报》2012年第4期403-407,共5页Academic Journal of Second Military Medical University

摘　　要：目的比较锥形束CT(CBCT)与常规曲面断层片在下颌阻生智齿拔除术前设计中的应用价值。方法对97例135颗下颌阻生智齿行常规曲面断层片检查,其中41例共52颗进一步行CBCT检查并纳入本项研究。根据曲面断层片和CBCT所提供的影像资料,分别做出术前设计,判断能否根据影像资料决定术中去骨的部位、是否劈/截冠、分根以及确定脱位方向。采用SAS 9.3.1软件包对数据进行配对资料χ2检验。结果相对于曲面断层片,CBCT能在术前更准确、量化地判断去骨部位和数量、是否需要分根、决定脱位方向,差异有统计学意义(P<0.001);在术前决定是否需要劈/截冠上,两者差异无统计学意义。结论CBCT在下颌阻生智齿拔除术前设计中能够为术者提供充分的三维影像信息,便于术者选择合适便利的进路和采用正确的策略、方法,减少邻近组织结构的损伤,确保手术顺利完成,从而减少手术并发症的发生。Objective To compare the values of cone beam CT（CBCT） with panoramic radiograph in preoperative planning for extraction of mandibular impacted wisdom teeth.Methods Totally 97 patients with 135 wisdom teeth were assessed with panoramic radiograph,and 41 cases presenting 52 impacted wisdom teeth underwent additional CBCT scan were enrolled in this study.Preoperative planning was made for removal of bone,decapitating the crown,sectioning the root and direction of tooth luxation according to the information provided by panoramic radiograph and CBCT images.The results were processed statistically with SAS 9.3.1 software package for χ^2 test.Results Compared with the panoramic radiograph,CBCT provided a more precise and quantitative guide for bone removal,root sectioning and direction of tooth luxation（P〈0.001）.The two methods showed no significant difference in making decision of crown decapitating.Conclusion CBCT can provide comprehensive three-dimensional information during preoperative planning for the extraction of mandibular impacted wisdom teeth.An appropriate surgical approach,with correct tactics and methods may facilitate the operation,prevent impairment to adjacent structures and reduce surgical complications.

关 键 词：锥束计算机体层摄影术 曲面断层片 阻生牙 拔牙 

分 类 号：R782.11[医药卫生—口腔医学]