应用锥形束CT分析侵袭性牙周炎患者牙槽骨缺损程度及方式

Evaluation of the degree and pattern of alveolar bone defect inaggressive periodontitis using cone-beam CT

目的 应用锥形束CT分析侵袭性牙周炎（aggressive periodontitis,AgP）患者牙槽骨缺损程度和方式,探讨AgP患者牙槽骨缺损的分布规律.方法 采用简单化随机法选取中国医科大学口腔医学院牙周科门诊广泛型AgP患者40例,年龄14～ 36岁,男性15例,女性25例,采用锥形束CT对入选对象进行扫描,并应用其自带的NNT软件测量分析切牙区、尖牙区、前磨牙区及磨牙区牙齿的牙槽骨缺损程度及缺损方式.结果 40例广泛型AgP患者中,中、重度牙槽骨缺损的位点数占总位点数的86.6％（3 769/4 352）.上颌磨牙区牙槽骨缺损最严重[（6.3±0.7）mm],尖牙区最轻[（4.8±0.8）mm];下颌切牙区牙槽骨缺损最严重[（5.9±0.9）mm],尖牙区最轻[（5.1±0.7）mm].上颌尖牙区、磨牙区和下颌前磨牙区同区不同位点间牙槽骨缺损程度差异有统计学意义（P＜0.05）,下颌尖牙区和磨牙区同区不同位点间牙槽骨缺损程度差异有统计学意义（P＜0.01）.上颌磨牙近中[（6.9±0.7）mm]和下颌切牙近中[（6.5±1.1） mm]牙槽骨缺损最严重.下颌第一磨牙近中[13.6％ （42/308）]、上颌第一磨牙近中[12.0％（39/316）]及上颌第一前磨牙近中[10.8％（34/316）]易出现斜形骨缺损.结论 广泛型AgP患者大多数位点牙槽骨缺损较严重,其中缺损最严重的部位为上颌磨牙近中和下颌切牙近中;下颌第一磨牙、上颌第一磨牙和上颌第一前磨牙近中最易出现斜形骨缺损.

Objective To evaluate the degree and pattern of alveolar bone defect in aggressive periodontitis（AgP） using cone-beam CT（CBCT）,and to investigate the distribution of alveolar bone defects in aggressive periodontitis.Methods Forty AgP patients（age：14-36 years,male：15 cases,female：25 cases） were selected by simple random method and scanned by CBCT.NNT software was applied to measure the average degree of alveolar bone defects and bone loss types in different regions.Results In forty AgP patients,86.6%（3 769/4 352） sites presented moderate and severe alveolar bone defects.In the maxilla,the molar areas presented the heaviest alveolar bone defect[（6.3±0.7） mm],the canine areas showed the lightest bone loss[（4.8±0.8） mm].In the mandible,the incisal areas presented the heaviest alveolar bone defect[（5.9±0.9） mm],the canine areas showed the lightest bone loss[（5.1±0.7） mm].The degree of alveolar bone defect in the areas of maxillary canine,maxillary molars,mandibular premolar was significantly different（P〈0.05）.The degree of alveolar bone defect in mandibular canine and mandibular molars was significantly differenct （P〈0.01）.The most serious alveolar bone defect was in the mesial side of maxillary molar[（6.9±0.7） mm] and the mesial side of mandibular incisor[（6.5± 1.1） mm].The oblique bone defects were found in the mesial part of the first molars in mandibula[13.6% （42/308）],the first molars in maxilla[12.0%（39/316）] and the first premolar in maxilla[10.8%（34/316）].Conclusions The alveolar bone defects of generalized AgP patients were serious.The most serious areas were located in the mesial side of maxillary molars and the mesial side of mandibular incisor.