中国实用口腔科杂志

中国实用口腔科杂志

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下颌牙槽突颊舌向生理倾斜角锥形束CT影像研究

郭小龙，王照五，吕    岩，刘一涵，王一珠，梁乙然，许来青，袁一方，郭    斌   

  1. 中国人民解放军总医院口腔医学中心，北京100853
  • 出版日期:2016-05-15 发布日期:2016-06-14
  • 基金资助:

    解放军总医院临床科研扶持基金（2012FC-TSYS-2003）；军队保健专项科研课题（14BJZ10）；四川省科技计划项目（2013SZ0008）

  • Online:2016-05-15 Published:2016-06-14

摘要：

目的    采用锥形束CT（CBCT）影像测量整个下颌骨牙槽突颊舌向生理倾斜角，为种植手术提供参考。方法      按照事先制定的纳入与排除标准，从中国人民解放军总医院口腔医学中心影像数据库中随机抽取2014年11月至2015年11月初次就诊患者拍摄的CBCT影像51例。采用NewTom 5G自带软件进行重建，重建区域上下边界与下颌骨下缘平行，采用0.5 mm层厚、5 mm层间距，在牙列弧形线上对牙槽突进行垂直切割，获得下颌牙槽突的24个等间距的颊舌向切面。使用NNT 5.6软件测量每个颊舌向切面的牙槽突倾角。结果    从右下颌磨牙区（第2层）到左下颌磨牙区（第23层），牙槽突倾角均值或中位值分别为-27.6°、-28.5°、-26.2°、-21.7°、-17.7°、-12.9°、-7.4°、-2.8°、2.2°、3.7°、4.8°、5.8°、3.5°、1.8°、-2.5°、-6.9°、-12.0°、-15.7°、-20.0°、-24.9°、-27.0°和-28.2°，负值表示向舌侧倾斜。左右对称层面间和男女之间的牙槽突倾角差异均无统计学意义（均P＞0.05）。第2 ~ 7层、第17 ~ 23层绝大多数牙槽突向舌侧倾斜（P＜0.05）；第8 ~ 11层偏向颊侧牙槽突逐渐增多，第14 ~ 17层偏向颊侧牙槽突逐渐减少（P＜0.05）；第10 ~ 15层偏向颊侧牙槽突数目多于偏向舌侧牙槽突数目，偏向舌侧牙槽突比例为7.8%（4/51） ~ 37.3%（19/51）。结论    下前牙区牙槽突倾角值最小，从前磨牙区至第二磨牙区牙槽突倾角值逐渐增大。前牙区主要向颊侧倾斜，前磨牙区主要向舌侧倾斜，磨牙区均向舌侧倾斜。了解牙槽突倾斜方向和倾角大小有助于种植体植入方向的确定，可为种植手术提供参考作用。

关键词: 锥形束CT, 下颌, 牙槽突, 颊舌向倾角

Abstract:

Objective    To measure the anatomic buccolingual angulation values of the mandibular alveolar process based on CBCT images in order to help determine the implant angulation at the implant treatment-planning phase. Methods    A random sample of 51 CBCT images were selected and analyzed. The NewTom 5G CBCT data sets were reformatted at a 5-mm spacing，with the inferior border of the region of interest parallel to the base of the mandible. Twenty-four buccolingual cross-sectional images of the mandibular alveolar process of each CBCT scan were obtained for angulation measurements by NNT5.6 software. Results    The mean or median values of the buccolingual angulation of the mandibular alveolar process，ranging from 1.8 degrees to 28.5 degrees，were obtained. There were no statistically significant differences on the angulation values of the alveolar process between the right side and left side or between male and female patients（P＞0.05）. The number of buccally-inclined alveolar process cross-sections increased from cross-section NO.8 to NO.11，and decreased from cross-section NO.14 to NO.17，which were statistically significant（P＜0.05）. Conclusion    The mean or median values of the buccolingual angulation of mandibular alveolar process increase gradually from the anterior tooth region via the premolar region to the second molar region. Most of the mandibular alveolar process cross-sections at the anterior teeth region incline buccally，while most of those at the premolar region and all of those at the molar region incline lingually. Knowing buccolingual angulation values of the mandibular alveolar process before dental implantation may help the clinician plan the orientation of implants.

Key words: cone beam computed tomography, CBCT；mandible；alveolar process； buccolingual angulation