繁茂型牙骨质-骨结构不良患者锥形束CT影像学特点分析  

Analysis of Cone-beam Computed Tomography Features of Florid Cemento-osseous Dysplasias

作　　者：赵培 郝晓琪 梅双 刘伟胜 于美清[1] ZHAO Pei;HAO Xiaoqi;MEI Shuang;LIU Weisheng;YU Meiqing(Department of Medical Imaging,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,School and Hospital of Stomatology,Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]河北医科大学口腔医学院·口腔医院医学影像科,河北省口腔医学重点实验室,河北省口腔疾病临床医学研究中心,河北石家庄050017

出　　处：《口腔医学研究》2025年第3期207-211,共5页Journal of Oral Science Research

基　　金：河北省卫健委课题(编号:20221458)。

摘　　要：目的:探讨繁茂型牙骨质-骨结构不良(florid cemento-osseous dysplasias,FLCOD)患者的锥形束CT(cone-beam computed tomography,CBCT)影像学特点。方法:收集诊断为FLCOD患者的临床资料及CBCT资料,对患者的影像学特征进行分析。结果:37例FLCOD患者中,30岁以上女性发病率高,约占94.6%。37例FLCOD,累及125个象限,受累区域包含牙齿394颗,牙缺失25颗。病变好发于下颌后牙区,约占44.2%;病变在颌骨内的密度以高密度与混合密度为主;FLCOD病变周围存在低密度影,上颌后牙区的病变周围低密度影36例(31.9%)部分存在,病变区对应皮质骨可变薄、穿孔以及颌骨膨隆,其中下前牙病变区皮质骨变薄的概率最高,约60例(76.9%)。上颌窦及下颌神经管作为颌骨内的重要解剖结构,在该疾病中也会受累及。受累牙齿可存在牙根吸收、牙骨质增生、牙周膜影像模糊不清等影像学表现。结论:FLCOD是一种罕见的,发生在颌骨内的范围广泛的骨代谢异常疾病,中年女性发病率高,好发于下颌后牙区,CBCT可以更精确地反映病变区域的密度以及微小的结构变化,能够提高口腔医师对FLCOD的认识,降低误诊率。Objective:To explore the cone-beam computed tomography(CBCT)imaging characteristics of florid cemento-osseous dysplasias(FLCOD).Methods:Clinical and CBCT data from patients diagnosed with FLCOD were collected,and the imaging characteristics of the patients were analyzed.Results:Among the 37 patients with FLCOD,the incidence rate was high in women over 30 years old,accounting for approximately 94.6%.In the 37 cases of FLCOD,125 quadrants were involved,including 394 teeth with 25 missing teeth.The lesions predominantly occurred in the mandibular posterior region,accounting for about 44.2%.The density of the lesions within the jawbone was mainly high density and mixed density.There was a low-density shadows around the FLCOD lesions.In the maxillary posterior tooth area,low-density shadows were partially present in 36 cases(31.9%)of the lesions.The cortical bone in the lesion area may become thin,perforated,and the jaw bone may become swollen,with the highest probability of thinning in the anterior mandibular lesion area,about 60 cases(76.9%).Important anatomical structures within the jawbone,such as the maxillary sinus and the mandibular nerve canal,may also be involved in this disease.The affected teeth may exhibit imaging manifestations such as root resorption,cementum hyperplasia,and blurred periodontal membrane images.Conclusion:FLCOD is a rare,extensive bone metabolism abnormality occurring within the jawbone,with a high incidence rate in middle-aged women,predominantly in the mandibular posterior region.CBCT can accurately reflect the density of the lesion area and minute structural changes,which can enhance the oral physician's understanding of FLCOD and reduce the misdiagnosis rate.

关 键 词：牙骨质-骨结构不良 繁茂型牙骨质-骨结构不良 锥形束CT 影像学特点 

分 类 号：R78[医药卫生—口腔医学] R816.98[医药卫生—临床医学]