种植牙手术前后CBCT参数预测种植体早期稳定性的效能分析  

Efficacy Analysis of CBCT Parameters in Predicting the Early Stability of Implants before and after Dental Implant Surgery

作　　者：蒋冰坤 宁慧影 JIANG Bingkun;NING Huiying(Department of Periodontics,Shanghai Songjiang Central Hospital,Shanghai 201613,China;Periodontal Department,Shanghai Stomatological Hospital,Shanghai 201613,China)

机构地区：[1]上海市松江区中心医院口腔科,上海201613 [2]上海市口腔医院牙周科,上海201613

出　　处：《临床误诊误治》2024年第5期73-78,共6页Clinical Misdiagnosis & Mistherapy

基　　金：上海市松江区科学技术攻关项目(16SJGG41)。

摘　　要：目的探讨种植牙手术前后锥形束计算机体层摄影术(CBCT)参数预测种植体早期稳定性的效能。方法选取2020年6月—2022年6月收治的单颗牙缺损126例,均拟行种植牙手术,术前采用CBCT测量缺损区域骨密度、骨皮质厚度,术后即刻采用CBCT测量牙槽骨宽度,术后即刻、术后12周采用Ostell ISQ测量仪测量种植体稳定系数(ISQ值)。根据术后12周ISQ值分为稳定组(ISQ值≥70)102例与不稳定组(ISQ值<70)24例。比较2组基本资料、CBCT参数,术后即刻、术后12周ISQ值,采用Pearson相关系数分析CBCT参数与ISQ相关性,采用受试者工作特征(ROC)曲线分析CBCT参数对种植体稳定性预测价值。结果稳定组与不稳定组缺损区域位置、种植体直径差异有统计学意义(P<0.05)。不稳定组缺损区域术前骨密度、术前骨皮质厚度及术后即刻、术后12周ISQ值低于稳定组(P<0.05)。下颌前牙缺损患者缺损区域术前骨密度、术前骨皮质厚度>下颌后牙缺损患者>上颌前牙缺损患者>上颌后牙缺损患者(P<0.05);种植体直径4.8、4.1 mm患者缺损区域术前骨密度、术前骨皮质厚度高于种植体直径3.3 mm患者(P<0.05)。下颌后牙缺损患者术后即刻、术后12周ISQ值下颌后牙缺损患者>下颌前牙缺损患者>上颌后牙缺损患者>上颌前牙缺损患者(P<0.05);种植体直径4.8、4.1 mm患者缺损区域术后即刻、术后12周ISQ值高于种植体直径3.3 mm患者(P<0.05)。缺损区域术前骨密度、术前骨皮质厚度与术后即刻、术后12周ISQ值呈正相关(P<0.01),术后即刻牙槽骨宽度与术后即刻、术后12周ISQ值无明显相关性(P>0.05)。ROC曲线分析,缺损区域术前骨密度、术前骨皮质厚度预测术后12周种植体稳定性的曲线下面积分别为0.711(95%CI:0.624,0.788)、0.759(95%CI:0.674,0.830),敏感度分别为53.92%、74.51%,特异度分别为87.75%、70.83%。结论CBCT测量缺损区域术前骨密度、术前骨皮质厚度与种植体早期�Objective To investigate the efficacy of conical beam computerized tomography(CBCT)parameters in predicting the early stability of implants before and after dental implant surgery.Methods A total of 126 patients with single tooth defect treated from June 2020 to June 2022 were selected,all of which were intended to undergo dental implant surgery.CBCT was used to measure the bone mineral density(BMD)and cortical thickness of the defect area before surgery,and the alveolar bone width was measured by CBCT immediately after surgery.Implant stability quotient(ISQ)value was measured by Ostell ISQ measuring instrument immediately and at 12 weeks after surgery.According to the ISQ value at 12 weeks after surgery,they were divided into stable group(ISQ value≥70,n=102)and unstable group(ISQ value<70,n=24).Basic data and CBCT parameters as well as ISQ values immediately after surgery and at 12 weeks after surgery were compared between the two groups.Pearson correlation coefficient was used to analyze the correlation between CBCT parameters and ISQ,and receiver operating characteristics(ROC)curve was used to analyze the predictive value of CBCT parameters for stability.Results The location and implant diameter of the defect area were significantly different between the stable group and the unstable group(P<0.05).BMD,cortical thickness,ISQ immediately after surgery and at 12 weeks after surgery in the defect area in the unstable group were lower than those in the stable group(P<0.05).Preoperative BMD and bone cortical thickness in patients with mandibular anterior tooth defect were the largest,followed by patients with mandibular posterior tooth defect patients,patients with maxillary anterior tooth defect and patients with maxillary posterior tooth defect(P<0.05).The preoperative BMD and cortical thickness of defect area in patients with implant diameter of 4.8 and 4.1 mm were higher than those in patients with implant diameter of 3.3 mm(P<0.05).The ISQ value in patients with mandibular posterior teeth was the largest,foll

关 键 词：牙缺损 锥形束计算机体层摄影术 牙种植体 单牙 稳定性 骨密度 骨皮质厚度 ROC曲线 曲线下面积 

分 类 号：R783.3[医药卫生—口腔医学]