正畸治疗中利用锥形束CT测量牙根位置方法的研究进展  

Research progress on root position measurement methods in orthodontic treatment using cone beam CT

作　　者：陈佳君 薛超然[1] 王沛棋 白丁[1] CHEN Jiajun;XUE Chaoran;WANG Peiqi;BAI Ding(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Department of Orthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院正畸科,四川成都610041

出　　处：《口腔疾病防治》2022年第10期740-745,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：四川省科技创新苗子工程(20-YCG045);中华口腔医学会口腔正畸专委会中青年临床-科研项目(COS-C2021-02);四川大学华西口腔医院交叉学科创新项目(RD-03-202108);四川大学华西-口腔医院探索与研发项目(LCYJ-2022-YY-3)。

摘　　要：牙根位置对于正畸治疗的健康、稳定、美观具有重要意义。过去应用二维放射影像评估牙根位置的准确性、精度不佳。近年来,利用锥形束CT(cone beam CT,CBCT)及其重建影像测量牙根三维空间位置及角度已经成为主流。牙根位置主要通过在颊舌向、垂直向、近远中向三个方向上测量牙根与邻近结构的关系及测量牙根角度来描述。牙根颊舌侧的牙槽骨厚度代表颊舌向位置,牙根在牙槽骨中的垂直高度及与上颌窦的距离关系代表垂直向位置,根间牙槽骨厚度代表牙根近远中向位置,牙根角度则多以传统的二维测量中的下颌中切牙-下颌平面角、轴倾角、转矩等角度表示。拟合CBCT和数字化模型数据能监测正畸治疗中的牙根与牙槽骨位置关系,但需要更为全面、规范的牙根位置三维测量方法,以充分利用CBCT提供的牙根数据研究相对于不同层次解剖结构的牙根最佳位置,从而与计算机技术结合优化正畸诊疗数字化设计。Root position plays an important role in healthy,stable,and aesthetic orthodontic treatment.In the past,two-dimensional radiographic images were used to assess the accuracy and precision of tooth root positions.In recent years,the use of cone beam CT(CBCT)and its reconstructed images to measure the three-dimensional spatial position and angle of root position has become mainstream.The root position is mainly described by measuring the relationship between the root and adjacent structures in the buccolingual,vertical,and mesiodistal directions as well as the root angle.The thickness of the alveolar bone on the buccolingual side of the root represents the buccolingual position,the vertical height in the alveolar bone and the relationship between apex and maxillary sinus represents the vertical position,the interroot alveolar bone thickness represents the mesiodistal position of the root,and the root angle is mostly based on incisal mandibular plane angle,angulation,torque,and other angles in the traditional two-dimensional measurement.Fitting CBCT and digital model data can be used to monitor the relationship between root and alveolar bone during orthodontic treatment,but a more comprehensive,standardized three-dimensional tooth root position measurement method is required to make full use of the root data provided by CBCT to study the relative optimal position of the tooth root at different anatomical levels,which combines with computer technology to optimize the digital design of orthodontic diagnosis and treatment.

关 键 词：牙根位置 锥形束CT 数字化模型 数字化设计 正畸 三维测量 牙长轴 牙槽骨厚度 牙槽骨高度 轴倾角 转矩 上颌窦 

分 类 号：R78[医药卫生—口腔医学]