基于CBCT分析下颌阻生第三磨牙对第二磨牙牙槽骨的影响  

Effect of impacted mandibular third molar on alveolar bone of second molar by CBCT

作　　者：李曼 段春红 杨敏[3] LI Man;DUAN Chunhong;YANG Min(School of Stomatology,Shanxi Medical University,Taiyuan 030000,China;Depart-ment of Stomatology,Shanxi Provincial People's Hospital;Department of Oral Surgery,Shanxi Provincial People's Hospital)

机构地区：[1]山西医科大学口腔医学院,太原030000 [2]山西省人民医院口腔内科 [3]山西省人民医院口腔外科

出　　处：《山西医科大学学报》2024年第12期1584-1590,共7页Journal of Shanxi Medical University

基　　金：山西省科技合作交流专项项目(202204041101041)。

摘　　要：目的 利用锥形束CT(cone beam computed technology,CBCT)分析下颌阻生第三磨牙(mandibular third molar,MTM)对第二磨牙(mandibular second molar,MSM)不同部位牙槽骨的影响,为临床MTM的拔除指征及MSM的诊断、治疗及预后提供理论依据。方法 收集山西省人民医院口腔中心CBCT数据库中随机抽取18岁以上500例阻生MTM的CBCT图像,根据阻生深度及阻生角度分别确定PG及Winter分类,测量MTM与MSM釉牙骨质界之间(CEJ)的距离及第二磨牙颊侧、舌侧、近中、远中牙槽骨吸收的距离。采用Friedman秩和检验比较颊、舌、近中、远中牙槽骨吸收;采用非参数Kruskal Wallis检验、Mann-Whitney U检验分析不同阻生类型间牙槽骨吸收的差异;采用Spearman秩相关及多元线性回归分析各因素与牙槽骨吸收最大侧的关系。结果 远中牙槽骨吸收距离(distal alveolar bone loss of mandibular second molar,MSM-DBL)高于颊侧、舌侧及近中。在Winter分类中,牙槽骨吸收距离水平组最大,近中组次之,垂直组和远中组最小;在PG分类中,从低位、中位到高位牙槽骨吸收距离逐渐降低(P<0.001)。CEJ距离、阻生角度(11°~100°)以及阻生深度均为MSM-DBL的独立危险因素,前二者与MSM-DBL呈正相关(P<0.05)。本研究人群中,MSM-DBL男性高于女性(P<0.05),年龄与MSM-DBL不存在相关性(P>0.05)。结论 阻生MTM对MSM-DBL影响最大;CEJ距离、阻生角度、阻生深度、性别为MSM-DBL的影响因素。Objective To analyze the effects of impacted mandibular third molar(MTM)on the dental alveolar bone in different parts of the mandibular second molar(MSM)using cone beam computed tomography(CBCT),and provide theoretical basis for the extrac‐tion indications,diagnosis,treatment and prognosis of impacted MTM in clinical practice.Methods A total of 500 CBCT images from patients aged 18 years and above with impacted MTM were randomly selected from the CBCT database of the Oral Center of Shanxi Provincial People′s Hospital.The images were classified by PG and Winter categories according to the depth of impaction and the angle of impaction.The distances between enamel‐dentine junction(CEJ)of MTM and MSM and the distances of the alveolar bone absorption of four sides of MSM were measured.Friedman rank sum test was used to compare the difference of alveolar bone resorption of buccal,lingual,mesial and distal teeth.Non‐parametric Kruskal Wallis test and Mann‐Whitney U test were used to compare the al‐veolar bone resorption in different impacted types.Spearman rank correlation and Multiple linear regression were used to analyze the relationship between the factors and the maximum side of alveolar bone absorption.Results Distal alveolar bone loss of mandibular second molar(MSM‐DBL)was higher than that of buccal,lingual and mesial MSM.In Winter category,the alveolar bone loss of MSM was the highest in horizonral group,followed by mesial group,and the least in distal group and vertical group.In PG classification,the alveolar bone loss of MSM was gradually decreased from Position A,B to C(P<0.001).CEJ distance,impaction angle(11°-100°)and impaction depth were independent risk factors for MSM‐DBL,and the former two were positively correlated with MSM‐DBL(P<0.05).MSM‐DBL was higher in males than in females(P<0.05),and there was no correlation between age and MSM‐DBL(P>0.05).Conclusion Impacted MTM has the greatest impact on MSM‐DBL.CEJ distance,impacted angle,impacted depth,and sex are the influencing f

关 键 词：磨牙阻生 CBCT 智齿拔除 下颌第三磨牙 下颌第二磨牙 牙槽骨吸收 

分 类 号：R782.1[医药卫生—口腔医学]