锥形线束CT三维重建与X射线摄影在口腔正畸患者埋伏牙诊断中的应用研究  

Application of CBCT 3D Reconstruction and X-Ray Photography in the Diagnosis of Ambush Teeth in Orthodontic Patients

作　　者：李雪娇 LI Xue-jiao(Department of Stomatology,the First Hospital of Dandong,Liaoning Dandong 118000)

机构地区：[1]丹东市第一医院口腔科,辽宁丹东118000

出　　处：《中国医疗器械信息》2024年第9期77-79,共3页China Medical Device Information

摘　　要：目的:探讨口腔正畸患者埋伏牙采用锥形线束CT三维重建与X射线摄影诊断的价值。方法:选择2021年10月~2023年5月本院接受影像学诊断的口腔正畸埋伏牙患者,合计80例(110颗牙),其经过口腔正畸手术治疗前后接受锥形线束CT三维重建及X射线摄影检查,将手术结果作为金标准,分析埋伏牙分布情况,并对2种不同检查方式判断埋伏牙牙弓唇腭侧位置的诊断效能与金标准的一致性进行判断。结果:经正畸手术治疗后,证实110颗埋伏牙分布如下:上颌前牙区埋伏牙最多,共46颗,占比41.82%,其次为下颌前牙区,共20颗,占比18.18%;多生牙主要分布于上颌,共18颗,占比16.36%;X射线摄影诊断埋伏牙位置的总准确度81.82%(90/110),与正畸手术结果比较无显著差异,两者一致性中等(Kappa=0.612);锥形线束CT三维重诊断埋伏牙位置的总准确度92.73%(102/110),与正畸手术结果比较无显著差异,两者一致性较好(Kappa=0.812),可见,锥形线束CT三维重建诊断埋伏牙位置的总准确度显著高于X射线摄影(χ^(2)=5.893,P<0.05);锥形线束CT三维重建诊断不同位置埋伏牙的灵敏度、特异度及准确率均高于X射线摄影,但组间对比无统计学差异(P>0.05)。结论:口腔正畸患者埋伏牙的诊断无论采用锥形线束CT三维重建还是X射线摄影检查均有显著价值,然而锥形线束CT三维重建技术的总准确性更高,具有更高的临床诊断价值,帮助医生诊断埋伏牙的位置、生长方向和周围结构情况,从而制定更精准的治疗方案。Objective:To explore the value of CBCT reconstruction and X-ray diagnosis.Methods:A total of 80 patients(110 teeth)with buried teeth in orthodontic treatment who underwent imaging diagnosis in our hospital from October 2021 to May 2023 were selected,the CBCT 3D reconstruction and X-ray examination before and after orthodontic surgery treatment,the surgical results as the gold standard to analyze the distribution of ambush teeth,and two different examination methods of the position and the consistency of the gold standard.Results:After orthodontic treatment,the distribution of 110 ambush teeth was confirmed as follows:in the maxillary anterior tooth area,46,accounting for 41.82%,followed by the mandibular anterior area,20,accounting for 18.18%;The multiple teeth were mainly distributed in the maxilla,18,or 16.36%;The total accuracy of X-ray photography 81.82%(90/110),no significant difference from the orthodontic surgery results,the consistency was moderate(Kappa=0.612);The total accuracy of 92.73%(102/110),there was no significant difference with the orthodontic surgery results,and the consistency was good(Kappa=0.812),so the total accuracy of cone beam CT 3D reconstruction was significantly higher than that of X-radiography(χ^(2)=5.893,P<0.05);The sensitivity,specificity and accuracy of different locations were higher than that of X-ray photography,but there was no statistical difference between groups(P>0.05).Conclusion:Oral orthodontic patients of the tooth diagnosis whether using CBCT 3D reconstruction or X-ray photography are of significant value,however CBCT 3D reconstruction technology total accuracy is higher,has higher clinical diagnosis value,help doctors diagnose the tooth position,growth direction and the surrounding structure,so as to develop more accurate treatment plan.

关 键 词：口腔正畸 埋伏牙 锥形线束CT三维重建 X射线摄影 

分 类 号：R783.5[医药卫生—口腔医学]