CBCT结合Mimics软件重建体内上颌第三磨牙根管系统的准确性研究  

Accuracy of CBCT combined with Mimics software to reconstruct maxillary third molar root canal system in vivo

作　　者：张译 梁继超[1] 陈波 何浏 庞富升 周峰 王芬[4] ZHANG Yi;LIANG Ji-chao;CHEN Bo;HE Liu;PANG Fu-sheng;WANG Fen(Dept.of Cariology and Endodontics,The First People’s Hospital of Qujing,Yunnan Province,Qujing 655000,China)

机构地区：[1]云南省曲靖市第一人民医院口腔医院牙体牙髓科,曲靖655000 [2]云南省曲靖市第一人民医院口腔医院颌面外科,曲靖655000 [3]昆明医科大学基础医学院,昆明650500 [4]云南省曲靖市第一人民医院口腔医院正畸科,曲靖655000 [5]云南省曲靖市第一人民医院口腔医院放射科,曲靖655000

出　　处：《中华老年口腔医学杂志》2022年第6期334-339,343,共7页Chinese Journal of Geriatric Dentistry

基　　金：云南省教育厅科学研究基金项目(项目编号:2018JS265)。

摘　　要：目的:运用CBCT结合Mimics Medical软件三维重建提取体内上颌第三磨牙根管系统解剖形态,并评估CBCT数据三维重建根管系统的准确性。方法:选取在我院口外门诊就诊需拔除上颌第三磨牙的患者100例,拔牙前行CBCT扫描,导出数据后用Mimics Medical 21.0软件三维重建活体牙根管系统并测量重建牙体数据(共113颗);拔牙后离体牙进行编号并与CBCT扫描数据一一对应,测量离体牙数据后再制作透明牙观察根管类型,以离体牙、透明牙为标准,评估CBCT三维重建活体牙根管系统的准确性。结果:CBCT结合Mimics Medical软件三维重建体内上颌第三磨牙共发现Ⅰ、Ⅱ、Ⅲ、Ⅴ、Ⅵ型根管,三维重建牙体数据与离体牙实测相近(P>0.05);在主根管类型分型上与透明牙一致性较好(kappa=0.798>0.75,P<0.001);但对侧副根管检出率,一致性较差(Kappa=0.309<0.4,P<0.001),三维重建检出率(7.1%),明显低于透明牙检出率(22.1%)且差别具有统计学意义。结论:CBCT结合Mimics Medical三维重建技术能较好的显示主根管,可满足大部分临床需求,但对侧副根管的重建精度不足;上颌第三磨牙体外形差异大,根管系统复杂。Objective:CBCT combined with Mimics Medical software three-dimensional reconstruction to extract the anatomical morphology of the root canal system of the vivo maxillary third molar,and to evaluate the accuracy of the threedimensional reconstruction of the root canal system with CBCT data.Methods:A collection of 100 local patients(113 teeth in total)who needed to extract the maxillary third molar in the Department of Oral and Maxillofacial Surgery of our hospital.All patients underwent CBCT examination and used Mimics Medical 21.0 software to analyze the CBCT data Threedimensional reconstruction of the root canal system.Observe and measure the data after extraction,and then make transparent teeth to observe the root canal type.Use the measured and transparent teeth as the standard to evaluate the accuracy of CBCT three-dimensional reconstruction of the root canal.Results:CBCT combined with Mimics Medical 21.0 software for three-dimensional reconstruction of maxillary third molars found a total of type Ⅰ,Ⅱ,Ⅲ,Ⅴ,Ⅵ root canal types.The measured tooth data is similar to the actual measurement of isolated teeth(P>0.05);in the main root canal type The classification is consistent with transparent teeth(kappa=0.798>0.75,P<0.001);but the detection rate of contralateral accessory root canals is poor(Kappa=0.309<0.4,P<0.001),and the detection rate of three-dimensional reconstruction(7.1%),Which was significantly lower than the detection rate of transparent teeth(22.1%)and the difference was statistically significant(P=0.004).Conclusion:CBCT combined with Mimics Medical three-dimensional reconstruction technology can better display the main root canal,but the reconstruction accuracy of the root canal communication branches is insufficient.The shape of the maxillary third molar is very different,and the root canal system is complex.

关 键 词：CBCT 上颌第三磨牙 三维重建 根管系统 透明牙 

分 类 号：R781.33[医药卫生—口腔医学]