微种植钉植入上颌后牙区的安全区域分析  

Analysis on regional security for micro-implant placed in maxillary posterior area

作　　者：黄颖荷[1,2] 钟小龙[3] 李杏蕊[1,2] 彭伟[3] 姜瑞[3] 

机构地区：[1]台山市人民医院 [2]广东医学院附属台山医院口腔科,广东台山529200 [3]中山大学附属第一医院口腔科

出　　处：《中国美容医学》2013年第5期558-563,共6页Chinese Journal of Aesthetic Medicine

基　　金：广东省科技计划项目(编号:2011B080701086);广东省江门市科技计划项目(编号:〔2011〕95号-2)

摘　　要：目的:探讨上颌双尖牙与磨牙间不同水平断层和不同矢状层面的微种植钉植入安全区域,为临床植入微种植钉时提供参考。方法:利用CT轴层(横断面)图像,将上颌第一双尖牙和上颌第一磨牙区域的横断面划分为从牙槽嵴向根方的SL1到SL9共9层,每层间隔1.0mm。将每一横断面从颊侧向舌侧沿牙根间隙平分线Pb划分10层矢状面Pv,每层间隔1.0mm。分别测量每一横断面中不同矢状面Pb与双尖牙和磨牙牙根的距离;测量上颌第一双尖牙和上颌第一磨牙牙根表面到颊腭侧牙槽骨表面的距离;测量牙槽骨厚度。结果:牙根间隙最大为8.0mm,位于SL9的Pv第6层;最小为2.6mm,位于SL4的Pv第4层。Pb与上颌第一双尖牙牙根表面的距离:从横断面看,从SL1到SL9总体是从小到大;从矢状面看,Dp1到Dp10是两侧大、中间小,即牙根间隙从颊侧到中间和从舌侧到中间均是由大到小。Pb与上颌第一磨牙牙根表面的距离:从横断面看,从SL1到SL9总体变化不明显;从矢状面看,Dm1到Dm10在SL1到SL5是两侧大、中间小,即牙根间隙从颊侧到中间和从舌侧到中间都是由大到小;SL6到SL10,Dm从颊舌侧向中间过渡时,开始是由大变小,但在接近中间时再变大,体现双根牙的特征。牙根表面到牙槽骨表面的距离:上颌第一双尖牙牙根表面到腭侧牙槽骨表面的距离从SL1的1.39mm到SL9的5.05mm,由小到大变化明显,其余牙根表面到牙槽骨表面的距离从SL1到SL9无明显渐进性变化。牙槽骨厚度从SL1的13.89mm到SL9的16.25mm,呈现明显由小到大的变化。结论:在不同的区域牙根间隙及牙根周围骨质量存在差异,植入微种植钉时应根据具体情况选择不同的位置和路径。Objective To investigate regional security for micro-implant when planted maxillary posterior area horizontally and sagittallyt. Methods The maxillary first premolar and the maxillary first molar area of cross-section was divided into 9 layers （SL1 to SL9,1.0mm interval） from the alveolar ridge to the root with CT scanning technology.From the buccal toward the lingual side, each crosssection was divided into 10 sagittal sections Pv （1.0mm interval） along the root clearance bisector. Some distances were measured respectively. Results The maximum root clearance was 8.0mm, located in layer 6 of PV,SL9. And the minimum was 2.6mm,located in the layer 4 of PV,SL4.Distance of Pb and the maxillary 1st premolar root surface：it became generally larger from SL1 to SL9 on the cross-section. While on the sagittal-section, it got the maximum on the two sides and the minimum in the middle which means the root clearance became smaller from either the buccal or lingual side to the middle.Distance of Pb and the root surface of maxillary first premolar：little change was observed from SL1 to SL9 on the cross-section; as for the sagittal section, SL1 to SL5, Dm was larger on both sides and smaller in the middle, meant the root clearance got bigger on both sides and smaller in the middle;And for the SL6 to SL10,from sides to the middle,it decreased first and then increased when closed to the middle, reflecting the characteristics of the double root teeth.Distance of Root surfaces to the alveolar surface： maxillary first premolar root surface to the palatal alveolar surface from SL1 1.39mm to SL9 5.05, reflecting an obviously increasing trend. While other teeth root surface proved no significant change.Alveolar bone thickness from SL1 （13.89mm） to SL9 （16.25mm） showed obvious changes from small to large. Conclusion According to the specific root clearance and bone quality in different zones,the implantation of microimplant should be selented different location and path.

关 键 词：微种植钉 安全区域 CT 

分 类 号：R783[医药卫生—口腔医学]