基于CT数据的影像学方法在口腔正畸的临床应用

Orthodontic treatment outcome assessment basing on the CT images

近年来,随着成像设备的发展,医学影像已成为医学技术中发展最快的领域之一。目前影像技术发展的一个重点方向就是三维立体化,其可为临床提供准确的诊断及治疗计划依据。针对正畸所面临的扩弓及内收引起的骨吸收、功能矫治对下颌生长长期客观认识、正畸及正颌治疗对关节及上气道的影响等重大问题,有必要对正畸疗效做出更加客观的评价,以指导临床实践。本文介绍了CT的发展趋势及分类,基于CT数据举例说明在口腔正畸力环境下发生的牙槽骨、牙周膜、牙齿、面部软组织及关节等形态学三维改变。三维CT影像可实现口腔颌面骨骼、牙齿、面部软组织及气道等三维可视化。三维图像配准和距离测量是用来分析正畸力环境下各部分形态变化,评价口腔颌面生物系统形态及功能的可靠工具。CT技术是评价矫治器矫正机制、疗效以及稳定性的可靠技术。随着包括CT技术及生物信息数据处理等系统生物学研究方法的发展,CT技术将会对错牙合畸形的预防、诊断、治疗及预后产生重要影响。

In the last 20 years, three-dimensional image have developed progressively in the orthodontic practice with the rapid development of CT, MRI and laser scanning technol- ogy. The 3D visualization, the key technology of 3D image methodology, Plays an important role in the diagnosis and treatment planning in dentistry. In orthodontics, there exist several problems such as alveolar bone dehiscence and fenes- tration after retraction and arch expansion, growth modifica- tion of functional appliance, the effect of orthodontics and or- thopedics to temporomandibular joint （TMJ） morphology and airway analysis. In this study, we assessed the treatment out- come and risk of orthodontics by mean of three-dimensional image as well as the development and the classification. The application of CT data for studying the reaction characteristic of alveolar bone, PDL, teeth, TMJ, and facial soft tissue to the orthodontic force was illustrated in this article. The visualiza- tion of 3D model superimposition and the surface distance cal- culations were used to identify treatment outcomes and stabili- ty after treatment. The 3D CT images can provide clear infor-mations of craniofacial skeletal and teeth, facial soft tissue and airway. The visualization of 3D model superimposition and the surface distance calculations are available tools for as- sessing growth, treatment changes, and stability. The 3D tech- nology is an available tool for studying the mechanism and treatment changes, and stability of orthodontic appliance. With the development of CT technology and systemic biologi- cal methodology, the 3D images technology will play an impor- tant role in the diagnosis, treatment planning and prognosis of orthodontic treatment.