上颌牙槽突颊舌向生理倾斜角的锥形束CT研究  

Buccolingual angulations of the maxillary alveolar process measured by CBCT

作　　者：郭小龙[1] 王照五[1] 吕岩[1] 刘一涵[1] 王一珠 梁乙然 许来青[1] 袁一方 郭斌[1] 

机构地区：[1]中国人民解放军总医院口腔医学中心,北京100853

出　　处：《中国实用口腔科杂志》2016年第3期171-177,共7页Chinese Journal of Practical Stomatology

基　　金：解放军总医院临床科研扶持基金(2012FC-TSYS-2003);军队保健专项科研课题(14BJZ10);四川省科技计划项目(2013SZ0008)

摘　　要：目的采用锥形束CT（CBCT）影像测量上颌牙槽突颊舌向生理倾斜角,为种植体植入位置和方向的确定提供参考。方法按照事先制定的纳入与排除标准,从中国人民解放军总医院口腔医学中心影像数据库中随机抽取2014年11月至2015年11月初次就诊患者拍摄的CBCT影像51份（均由New Tom 5G设备拍摄）。采用New Tom5G自带软件进行重建,重建区域上下边界与上颌牙平面平行,采用0.5 mm层厚、5 mm层间距,在牙列弧形线上对牙槽突进行垂直切割,获得上颌牙槽突的24个等间距的颊舌向断面。使用NNT 5.6软件测量每个颊舌向切面的牙槽突倾角。结果按从右上颌最后一个层面（第2层）到左上颌最后一个层面（第23层）的顺序,上颌各层面牙槽突倾角平均值或中位值分别为：0°、0°、0°、0°、10.2°、17.4°、23.9°、31.9°、40.7°、42.3°、31.8°、32.6°、41.7°、40.7°、31.8°、22.9°、16.1°、8.2°、0°、0°、0°、0°。左右对称层面牙槽突倾角差异无统计学意义（P〉0.05）。男女之间的牙槽突倾角差异无统计学意义（P〉0.05）。第2～5层和第20～23层（对应于磨牙区）中,牙槽突倾角为0°的牙槽突比例高于颊侧倾斜牙槽突（P〈0.05）。结论前牙区牙槽突倾角最大,前磨牙区倾角次之,磨牙区倾角逐渐递减为0。前牙区和前磨牙区牙槽突向唇、颊侧倾斜,磨牙区牙槽突在多数情况下呈垂直向,其次为向颊侧倾斜。了解牙槽突倾角有助于种植体植入位置和方向的确定,在不具备种植手术导板的情况下,其参考作用尤其明显。ObjectiveTo measure the anatomic buccolingual angulation values of the maxillary alveolar process based on CBCT images in order to form a basis for the implant treatment planning,including the design of implant position and angulation.MethodsA random sample of 51 CBCT images were selected and analyzed. The New Tom 5G CBCT data sets were reformatted at a 0.5-mm spacing,with the inferior border of the region of interest parallel to the occlusion plane of maxillary teeth. Twenty-four buccolingual cross-sectional images of the maxillary alveolar process were obtained for buccolingual angulation measurements.ResultsMean or median values of the buccolingual angulation of maxillary alveolar process ranged from about 0 degree to more than 40 degrees. Cross-sections distal to the premolar region showed a statistically higher proportion of vertical process（angulation equals to 0 degree）,compared to cross-sections corresponding to maxillary premolars and anterior teeth region（P〈0.05）. There were no statistical differences between the angulation of alveolar process both from the right side and left side and from males and females patients（P〉0.05）.Conclusion The buccolingual angulation of maxillary alveolar process decreases from anterior teeth region through the premolars region to the molars region,with the lateral incisor and canine region being the most inclined bucally and a high proportion of the molars region being nearly vertical. Knowing average values of buccolingual angulation of maxillary alveolar process before dental implantation may help the clinician plan the position and orientation of implants,especially when an implant surgical template is not available.

关 键 词：锥形束CT 上颌 牙槽突 颊舌向倾角 

分 类 号：R78[医药卫生—口腔医学]