上颌埋伏阻生前牙的CBCT诊断及治疗  

Diagnosis of maxillary impacted maxillary anterior teeth by CBCT and the treatment

作　　者：黄晓红[1] 许亮[1] 林珊[1] 

机构地区：[1]福建医科大学附属第一医院口腔科,福州350005

出　　处：《实用口腔医学杂志》2016年第6期839-843,共5页Journal of Practical Stomatology

摘　　要：目的：探讨CBCT在上颌埋伏阻生前牙诊断中的作用及采用不同牙槽外科开窗术牵引矫正埋伏牙的治疗效果。方法：比较30例34颗拟牵引矫正的埋伏牙的曲面断层片及CBCT在牙冠定位、牙根情况及萌出间隙等相关测量项目，进行统计学分析。20例患者选择闭合式牵引导萌术，10例选择牙龈环切术开放牵引导萌，比较治疗结果。结果：在牙根弯曲情况、根尖孔闭合情况及萌出间隙测量方面CBCT优于曲面断层片（P〈0．05）。治疗后7～9d，选择牙龈环切术的5例出现不同程度的临床冠伸长，牙龈外形欠美观，牙槽嵴高度降低等牙周附着不足等并发症。选择闭合式牵引导萌术，术后均取得了较满意的牙龈外形。34颗牵引矫正的埋伏牙中成功26颗（76．47％），一般8颗（23．53％），无失败病例。结论：CBCT能精确显示埋伏牙位置、形状、与邻牙关系等，采用外科手术闭合式牵引导萌术可达到更好的牵引效果。Objective： To investigate the efficiency of CBCT in the diagnosis of impacted maxillary anterior teeth and the treatment effect of different guided eruption methods. Methods： 34 impacted maxillary anterior teeth in 30 patients were examined by panoramic films and CBCT, the dental crowns, root, eruption space and other related items were measured and compared between 2 examinations. 20 cases were treated by closed guided eruption and traction（CGET） technique, 10 cases by circumferential supracrestal fibrotomy and exposed traction（ CSF-EE）, results were compared. Results： CBCT was more effective than panoramic films in the revelation of tooth root bending, apical pore closure and eruption measurements（P 〈 0.05）. 7 - 10 d after treatment 5 out off the 10 casses treated by CSF- EE showed different degrees of clinical crown elongation, poor gum appearance and low height of alveolar ridge as insufficient periodontal attachment. However, the treatment of CGET for 26 teeth （76.47% of all cases） was highly successful and received very satisfactory re- suits, the rest 8 teeth （23.53% of all cases） showed mediocre satisfaction. Conclusion： CBCT can accurately display the position, shape, relation with adjacent teeth of the impacted teeth. Closed guided eruption and traction is more effective for the treatment.

关 键 词：埋伏牙 锥形束CT(CBCT) 牙龈环切术(CSF) 封闭式牵引导萌术 矫正牵引 

分 类 号：R783[医药卫生—口腔医学]