牙根纵裂的CBCT影像学特征  

The radiographic features of vertical root fracture by cone-beam computed tomography

作　　者：孙鑫鸣 闫世杰 杨连丰 吴国荣[3] SUN Xinming;YAN Shijie;YANG Lianfeng;WU Guorong(Department of Third Clinic,Affiliated Stomatological Hospital of Nanjing Medical University,,Nanjing 210029,CHINA)

机构地区：[1]南京医科大学附属口腔医院第三门诊部,江苏210029 [2]南京医科大学附属口腔医院放射科,江苏210029 [3]南京中医药大学附属医院口腔科

出　　处：《江苏医药》2024年第10期1056-1060,共5页Jiangsu Medical Journal

摘　　要：目的采用锥形束CT(CBCT)分析牙根纵裂(VRF)的影像学特征。方法收集336例患者的CBCT数据,包括362颗VRF病原牙和377个牙根。从矢状位、冠状位和轴位观察VRF病原牙的影像学特征,包括牙位、牙根、纵裂线方向和长度、患牙根尖周组织情况及伴发疾病。结果发生VRF的磨牙占比高于前磨牙和前牙(83.98%vs.12.43%和3.59%)(P<0.05)。VRF好发牙根是下颌第一磨牙的近中根(20.95%),其次是上颌第一磨牙的腭根(13.26%)和近颊根(10.08%)。男性和女性患者的上颌第二磨牙、上颌第一磨牙腭根均以近远中向纵裂为主,上颌第一磨牙近颊根均以颊腭向纵裂为主,下颌第一磨牙近中根和远中根、下颌第二磨牙近中根均以颊舌向纵裂为主。VRF的纵裂线累及牙根全长最多见(P<0.05)。227颗(62.71%)VRF病原牙伴有根尖周病合并牙周病,62颗(17.13%)有牙源性上颌窦炎。结论VRF的发生有一定规律,CBCT能准确判断VRF,尤其是二维影像难以诊断的VRF及伴发疾病。Objective To analyze the radiographic features of vertical root fracture(VRF)by cone-beam computed tomography(CBCT).Methods The CBCT data of 336 patients were collected,including 362 VRF teeth and 377 roots.The radiographic features of VRF teeth from sagittal,coronal and axial planes were observed,including tooth position,roots,length and direction of fracture lines,periapical tissues and associated diseases.Results The ratio of molars with VRF was higher than that of anterior teeth and premolars(83.98%vs.12.43%and 3.59%)(P<0.05).The proximal roots of VRF were the mesial roots of mandibular first molars(20.95%),which was followed by the palatal roots(13.26%)and mesiobuccal roots(10.08%)of maxillary first molars.The fracture lines of palatal roots of maxillary second molars and maxillary first molars were mainly mesiodistal direction,the fracture line of mesial roots of maxillary first molars primarily was buccopalatine direction,while the fracture lines of mesial and distal roots of mandibular first molars,and mesial roots of mandibular second molar were mainly buccolingual direction.The fracture lines of VRF involved the total length of roots most frequently(P<0.05).A total of 227 VRF teeth(62.71%)had both periapical and periodontal disease,and 62 teeth(17.13%)had odontogenic maxillary sinusitis.Conclusion The occurrence of VRF has certain rules.CBCT can accurately judge VRF,especially the VRF and accompanying diseases difficult to be diagnosed by two-dimensional imaging.

关 键 词：锥形束计算机断层成像 牙根纵裂 影像学特征 

分 类 号：R781[医药卫生—口腔医学]