根管治疗后隐匿性牙根纵裂临床特征分析及CBCT影像学研究  

Clinic Features and CBCT Presentation of Subtle Vertical Root Fracture in Endodontically Treated Teeth

作　　者：曹丹彤 古丽比热·艾合买提 高安天 曹雅 谭葆春[2] 王从跃 林梓桐[1] CAO Dantong;Gvlbira·AHMAT;GAO Antian;CAO Ya;TAN Baochun;WANG Congyue;LIN Zitong(Department of Oral and Dentomaxillofacial Radiology,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,China;Department of Periodontal,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,China;Department of Oral Surgery,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院,南京市口腔医院口腔颌面医学影像科,江苏南京210008 [2]南京大学医学院附属口腔医院,南京市口腔医院牙周科,江苏南京210008 [3]南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,江苏南京210008

出　　处：《口腔医学研究》2020年第7期644-647,共4页Journal of Oral Science Research

基　　金：江苏省自然科学基金面上项目(编号:BK20150089);江苏省南京市医学科技发展项目(编号:YKK19090);南京市卫生青年人才培养工程(编号:QRX17079)。

摘　　要：目的:通过对临床上根管治疗后隐匿性牙根纵裂牙的临床特征进行分析并对其锥形束CT(cone beam computed tomography,CBCT)的影像学表现进行总结。方法:对临床上收集的92例患者的97颗隐匿性牙根纵裂(subtle vertical root fracture,SVRF)患牙的临床特征及CBCT影像学特征进行统计,临床资料包括患者的性别,年龄,牙位,同时对其CBCT上牙根折裂线情况,牙槽骨及根尖周骨质吸收情况进行评价和统计。结果:92名被诊断为SVRF患者中,男性占35.9%,女性占64.1%,年龄26~84岁,其中31~40岁,41~50岁,51~60岁,61~70岁4个年龄段间的发生率没有明显差异。下颌第一磨牙发生率最高(35颗,36.1%),其次为上颌第二前磨牙(18颗,18.6%)和上颌第一前磨牙(17颗,17.5%)。97颗SVRF患牙中,有28颗(28.9%)患牙在CBCT图像上能观察到细小折裂纹。97颗SVRF患牙均发生不同程度的骨吸收,其中68颗(70.1%)合并垂直型骨吸收及根尖周骨吸收,28颗(28.9%)表现为垂直型骨吸收,仅1颗(1.0%)表现为根尖周骨吸收。结论:SVRF多见于女性,年龄无明显差异,多见于下颌第一磨牙近中根及上颌前磨牙,考虑与牙根形态有关,VRF常伴有不同程度的垂直型牙周骨质吸收。Objective:To summarize the clinic features and radiographic manifestation on the CBCT images of subtle vertical root fracture(SVRF)in endodontically treated teeth.Methods:92 patients with 97 SVRF teeth in endodontically treated teeth were collected in this study.The gender,age,and tooth position were analyzed.Fracture line,apical bone,and periodontal bone resorption were evaluated on the CBCT images.Results:Of the 92 patients,64.1%were females and 35.9%were males.The age ranged from 26 to 84 years old,and the incidence rates among four age groups of 31-40,41-50,51-60,and 61-70 were not significantly different(all around 20%).The incidence of mandibular first molars was the highest(35,36.1%),followed by the maxillary second premolars(18,18.6%)and maxillary second premolars(17,17.5%).Among the 97 SVRF teeth,28 teeth presented with subtle fracture lines on the CBCT image.97 SVRF teeth suffered from different degrees of bone resorption.Among them,68 teeth(70.1%)presented with vertical bone resorption and periapical bone resorption,28 teeth(28.9%)presented with vertical bone resorption,and only 1 tooth(1.0%)presented with periapical bone resorption.Conclusion:The occurrence of SVRF in endodontically treated teeth was higher in female patients than in male patients,and there was no significant difference between different age groups.SVRFs occurred mainly in mesial root of mandibular first molar and maxillary premolar,which was considered to be related with the morphology of root of these teeth.SVRFs often presented with varying degrees of vertical bone resorption.

关 键 词：隐匿性牙根纵裂 锥形束CT 骨吸收 

分 类 号：R78[医药卫生—口腔医学]