国人正常上颌骨骨壁CBCT测量及其临床意义

Measurement of the maxilla using CBCT and its clinical significance

目的 利用CBCT在传统Le Fort Ⅰ截骨区域对发育正常成人上颌各骨壁测量,为临床Le Fort Ⅰ截骨提供理论依据.方法 对60例正常颌中国成人上颌骨进行CBCT扫描并重建,选定传统Le Fort Ⅰ截骨断面,对截骨区域重要解剖结构位置进行测量.结果 正常成人测量数据左右间差异无统计学意义;男女间测量数据差异,部分具有统计学意义.梨状孔缘至翼腭管的距离男性为（35.18±2.56）mm,女性为（32.90±1.40）mm,颧牙槽嵴至翼上颌联合的距离男性为（32.02±2.91）mm,女性为（31.73±2.60）mm,前鼻棘到后鼻棘的距离男性为（49.13±2.79）mm,女性为（47.41±3.70）mm,上颌窦内壁与鼻中隔夹角度男、女分别为10.30°±1.36°与9.52°±1.97°.翼上颌连接下缘点至腭平面的距离男性为（4.36±0.68）mm,女性为（4.27±0.57）mm.翼上颌连接上缘点至腭平面的距离男性为（10.46±1.10）mm,女性为（10.48±0.86）mm.翼腭管与腭平面的角度男性为62.24°±4.07°,女性为62.24°±4.56°.结论 本研究可为上颌Le Fort Ⅰ截骨提供参考,对避免上颌意外骨折、腭降动脉的损伤等具有指导意义.

Objective To measure the maxilla pertaining to bone cut design of Le Fort I osteotomy using CBCT to offer the basis for clinical application of Le Fort I osteotomy. Methods Sixty Chinese adults were ex- amined with CBCT, and three-dimensional images were produced. The maxilla pertaining to Le Fort I osteotomy were measured. The data were analyzed statistically. Results All measurement data between left and right had no statistically significant difference in normal adult group. There were some statistical differences between male and female groups. The mean length of the medial sinus wall measuring from the pirform rim to the descending palatine canal at the Le Fort I level was （35.18 ±2.56） mm in males and （32.90±1.40） mm in females. The mean length from the zygo-alveolar ridge to the pterygomaxillary junction was （ 32.02 ± 2.91 ）mm in males and （31.73 ±2.60） mm in females. The average distance from the anterior nasal spine to the posterior nasal spine was （49.13±2.79） mm in males and （47.41 ±3.70） mm in females. The angle between the medial maxillary sinus wall and nasal septum was 10.3°± 1.36° in males and 9.52°±1.97° in females. The mean height from the inferior edge of the pterygomaxillary junction to palate plane was （4.36 ± 0.68 ） mm in males and （4.27± 0.57 ） mm in females. The mean height from the superior edge of the pterygomaxillary junction to palate plane was （ 10.46 ±1.10） mm in males and （ 10.48 ± 0.86） mm in females. The angle between desending palatine canal and the palate plane was 62.24°±4.07° in males and 62.24° ±4.56° in females. Conclusion This study could provide better understanding of the maxillary anatomy that is important for the bone-cut design of Le Fort I osteotomy to avoid the injury of the descending palatine artery and unfavorable fractures.