基于CBCT的上颌第一磨牙区上颌窦动脉骨孔的影像学研究  

Imaging study on the alveolar antral artery canal of maxillary first molar based on CBCT

作　　者：王晓东[1] 孟令娇 孙辉[1] 陈志方[1] WANG Xiaodong;MENG Lingjiao;SUN Hui;CHEN Zhifang(Department of Oral and Maxillofacial Surgery,Clinical School of Anhui Medical University/West Branch of Hefei Stomatological Hospital,Hefei,Anhui 230001,China;Department of Endodontics,Clinical School of Anhui Medical University/West Branch of Hefei Stomatological Hospital,Hefei,Anhui 230001,China)

机构地区：[1]安徽医科大学合肥口腔临床学院/合肥市口腔医院西区口腔颌面外科,合肥230001 [2]安徽医科大学合肥口腔临床学院/合肥市口腔医院西区牙体牙髓科,合肥230001

出　　处：《重庆医学》2023年第6期849-854,共6页Chongqing medicine

基　　金：安徽省合肥市口腔医院院级科研项目(202003);陈志方牙槽外科名医工作室项目(201916701)。

摘　　要：目的运用锥形束CT(CBCT)分析上颌窦动脉(AAA)骨孔的解剖特点。方法回顾性分析2020年1月至2022年4月于该院行CBCT检查的456例患者912例上颌窦影像资料,统计分析AAA检出率、骨孔下界至窦底的垂直距离(Df)、骨孔下界至牙槽嵴顶的垂直距离(Dc)、骨孔直径(Da)、上颌窦外侧壁厚度(LWT)、剩余牙槽嵴高度(RBH)。结果AAA检出率为70.7%(645/912)。Df分布为0~23.36 mm,平均(6.95±3.67)mm。Df在不同性别、年龄、牙齿状况之间比较,差异无统计学意义(P>0.05)。Dc分布为4.51~33.34 mm,平均(15.08±3.87)mm。18~<36岁、M1存在、RBH>5 mm的患者Dc更大,差异有统计学意义(P<0.05)。Da分布为0.48~2.90 mm,平均(1.22±0.48)mm。男性、56~87岁、M1缺失、LWT>2 mm的患者Da更大,差异有统计学意义(P<0.05)。在M1缺失患者AAA检出的牙位中,RBH≤5 mm占43.5%(124/285),Dc≤15 mm占64.2%(183/285),Da≥2 mm占14.4%(41/285),三者交集高风险牙位占5.3%(15/285)。结论术前运用CBCT有助于完善手术设计、降低术中损伤AAA的风险。Objective To observe and analyze the anatomic characteristics of the alveolar antral artery(AAA)by cone beam CT(CBCT).Methods A retrospective analysis was performed on the maxillary sinus imaging data of 456 patients with 912 cases who underwent CBCT examination in this hospital from January 2020 to April 2022.The detection rate of AAA bone foramen,the distance between the inferior border of the vessel and the sinus floor(Df),the distance between the inferior border of the vessel and the alveolar crest(Dc),the diameter of alveolar antral artery(Da),the maxillary sinus lateral wall thickness(LWT),and the residual alveolar bone height(RBH)were statistically analyzed.Results The detection rate of AAA was 70.7%(645/912).Df distribution was 0-23.36 mm with an average of(6.95±3.67)mm.There was no significant difference in Df among different gender,age and dental status(P>0.05).Dc distribution was 4.51-33.34 mm with an average of(15.08±3.87)mm.Patients aged 18-<36,with M1 present and RBH>5 mm had greater Dc,the difference was statistically significant(P<0.05).Da distribution was 0.48-2.90 mm with an average of(1.22±0.48)mm.The Da of male,56-87 years old,M1 deletion,LWT>2 mm patients was greater,the difference was statistically significant(P<0.05).In the patients with M1 absence,RBH≤5 mm accounted for 43.5%(124/285),Dc≤15 mm accounted for 64.2%(183/285),Da≥2 mm accounted for 14.4%(41/285),and the high-risk dental sites with the three components accounted for 5.3%(15/285).Conclusion Detection of the characteristics of the AAA by using CBCT is crucial to adjust the surgical treatment plan and reduce the risk of tearing the vessel in operation.

关 键 词：锥形线束CT 上颌窦外侧壁厚度 上颌窦动脉 出血 侧壁开窗 

分 类 号：R78[医药卫生—口腔医学]