基于锥形束CT的上颌前牙区微种植钉植入位点探讨  

Optimal implantation site of orthodontic microscrew in maxillary anterior region based on CBCT

作　　者：王彦男 徐娟[1] 时权[1] 刘波[1] 汪倩欣 张亮[1] 张红艳[1] WANG Yannan;XU Juan;SHI Quan;LIU Bo;WANG Qianxin;ZHANG Liang;ZHANG Hongyan(Department of Orthodontics,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心口腔正畸科

出　　处：《解放军医学院学报》2019年第6期557-560,579,共5页Academic Journal of Chinese PLA Medical School

摘　　要：目的利用锥形束CT(cone heam computed tomography,(CBCT)对上颌前牙区的解剖结构进行分析以确定微种植钉的最佳植入位点,为临床种植位点的选取、提高微种植钉植入后稳定性提供依据。方法选取2017年1月-2018年6月在本中心进行CBCT扫描的患者40例,男女比例1:1,年龄20~40岁。用CBCT测量其双侧上颌中切牙牙根之间(1-1)、中切牙牙根和侧切牙牙根之间(1-2)以及侧切牙牙根和尖牙牙根之间(2-3)距上颌牙槽嵴顶2 mm、4 mm、6 mm、8 mm处的近远中径、颊舌径、唇侧骨皮质厚度以及舌侧骨皮质厚度,对该区域内牙槽骨的厚度进行综合分析评估。结果在距上颌牙槽嵴顶8 mm以内,随着离牙槽嵴顶越远,1-1、1-2、2-3近远中径、颊舌径、唇侧骨皮质厚度总体不断增大。2-3距牙槽脊顶8 mm处近远中径、颊舌径、唇侧骨皮质厚度、舌侧骨皮质厚度皆较宽。结论从安全性角度考虑,2-3之间距牙槽脊顶8 mm处的区域可以为作为常规植入区域。虽然1-1之间的近远中径和颊舌径较厚,但唇侧骨皮质厚度与舌侧骨皮质厚度最薄,选择在该部位植入微种植钉时应设计合适的植入方法以提高其稳定性。Objective To determine the optimal implantation site of orthodontic microscrew by cone beam computed tomography(CBCT)analysis in anatomical structure of the maxillary anterior region,and provide a theoretical basis for orthodontic implant placement and improve post-implantation stability.Methods Forty patients who underwent CBCT scanning in our department from January 2017 to June 2018 were selected for this study,with male to female ratio of 1:1 and age ranging from 20 to 40 years.The CBCT scanning was applied to measure the interradicular distances between neighboring roots,buccolingual dimension,labial cortical bone thickness and lingual cortical bone thickness between maxillary anterior teeth at planes of 2 mm,4 mm,6 mm and8 mm above the alveolar ridge crest.Data were measured to comprehensively evaluate the certain site condition of the alveolar bone.Results The interradicular distance,buccolingual dimension and labial cortical bone thickness between maxillary anterior teeth were positively correlated with the distance above the alveolar ridge crest(within 8 mm).The interradicular distances,buccolingual dimension,labial cortical bone thickness and lingual cortical bone thickness between lateral incisor root and canine incisor root at8 mm above the alveolar ridge crest were all greater than those between other maxillary anterior teeth.Conclusion The area between lateral incisor root and canine incisor root at 8 mm plane from alveolar ridge crest,can be used as an optimal site for implanting orthodotic microscrew.Though the interradicular distance and buccolingual dimension between maxillary central incisor roots are highest,implantation at this site still needs stability enhancement strategy to overcome the weakest labial cortical bone thickness and lingual cortical bone thickness.

关 键 词：锥形束CT 上颌前牙区 微种植钉 

分 类 号：R783.6[医药卫生—口腔医学]