上颌尖牙腭侧埋伏阻生的锥形束CT定位诊断  

Three-dimensional localization and assessment of maxillary palatal impacted canines with cone-beam computed tomography

作　　者：于剑南[1] 顾月光[2] 赵春洋[1] 刘可[3] 莫仕成 李琥[1] 潘成琼 王林[1] 

机构地区：[1]南京医科大学口腔医学研究所口腔正畸科,江苏南京210029 [2]连云港市第一人民医院,江苏连云港222002 [3]南京军区南京总医院口腔科,江苏南京210029

出　　处：《上海口腔医学》2015年第1期65-70,共6页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(81230022);教育部博士学位点基金(20113234110003);江苏省高校优势学科建设工程资助项目(201437)~~

摘　　要：目的 ：应用锥形束CT（CBCT）探讨上颌腭侧埋伏阻生尖牙的埋伏特征及邻牙牙根吸收情况。方法：选取南京医科大学附属口腔医院正畸科就诊的上颌尖牙腭侧埋伏阻生的青少年患者22例,获取CBCT三维数据,应用Dolphin imaging 11.0软件,分析腭侧埋伏尖牙的埋伏状况、与邻牙位置关系并分类,观察邻牙牙根的吸收情况。结果 ：上颌腭侧埋伏尖牙大多近中、腭向倾斜阻生,近中异位以Ⅰ类和Ⅳ类较为多见,分别占30.8%和38.5%;近中倾斜角度多在53.8°~68.5°,腭侧异位距正中矢状面多在5.4~8.4 mm。年龄越大,上颌腭侧埋伏尖牙近中腭向异位越远,近中倾斜角度越大。84.6%的相邻侧切牙及19.2%的中切牙牙根与埋伏尖牙接触;50%的相邻侧切牙及15.4%的邻中切牙牙根吸收,相邻侧切牙吸收多位于根尖1/3,而相邻中切牙吸收多位于根中1/3;相邻切牙牙根吸收概率与腭侧埋伏尖牙与切牙间的最小距离呈反比关系。结论：CBCT能在三维方向诊断上颌尖牙埋伏状况及与邻近组织的关系,准确判断邻牙根吸收情况,准确测量埋伏尖牙倾斜度及埋伏深度,为上颌腭侧埋伏尖牙的治疗提供指导。PURPOSE： To evaluate the location of maxillary palatal impacted canines and resorption of neighboring incisors with cone-beam computed tomography（CBCT）. METHODS： Twenty-two healthy adolescent patients who had received orthodontic treatments at Stomatological Hospital of Nanjing Medical University were selected and scanned by CBCT. Palatal impacted maxillary canines were reconstructed by Dolphin imaging 11.0 software. The impactions, spatial relationships and classification relative to adjacent structures and incisor resorption were assessed. RESULTS： Most of the maxillary palatal impacted canines inclinated mesially and palatally. Mesial malpositions were more significantly prevalent in Class Ⅰ and Ⅳ, and the prevalence rates were 30.8% and 38.5% respectively. Mesial inclinations of the impacted canines to occlusal plane were mostly between 53.8° and 68.5 °, and the distances from the impacted canines to median sagittal plane were between 5.4 and 8.4 mm. Older the patient was, further the impacted canines mesiopalatal displaced and mesial inclined. The roots of 84.6% of lateral incisors and 19.2% of central incisors contacted impacted canines; Root resorption occurred in 50% of lateral incisors and 15.4% of central incisors, which predominantly located in apical third of the lateral incisors and middle third of the central incisors. A inverse correlation was found between the resorption rates of adjacent incisors and minimum distances from impacted canines to adjacent incisors. CONCLUSIONS： CBCT allows three dimensional evaluation of impaction and spatial relationships relative to adjacent structures. In addition, 3 dimensional measurement contributes to more accurate exhibition of the adjacent root resorptions, inclinations and depths of the impacted canines, which leads to more efficient guidance of maxillary palatal impacted canines treatment.

关 键 词：上颌尖牙 腭侧埋伏阻生 锥形束CT 定位诊断 

分 类 号：R783.5[医药卫生—口腔医学] R816.98[医药卫生—临床医学]