CBCT和数字曲面体层片在颌骨后牙区牙种植术中应用研究

Application research of dental implant in posterior area of maxillary and mandible using CBCT and digital orthopantomography

目的探讨CBCT与数字曲面体层片在牙种植术中的应用价值。方法 50例(58颗)牙种植治疗患者同时采用CBCT和数字曲面体层检查方法,将得到的术前颌骨牙槽骨量和术后骨结合的影像结果对照,分析差异性。结果下颌后牙区牙槽骨量不足CBCT检出阳性率为28.57%;数字曲面体层影像检查检出阳性率为7.14%。经过χ2检验,P<0.05,差异有统计学意义。上颌后牙区牙槽骨量不足CBCT和数字曲面体层影像检查检出阳性率分别为36.36%、9.09%。经过χ2检验,P<0.05,差异有统计学意义。种植牙术后3个月种植体未发生骨结合的阳性率,CBCT检出阳性率为3.45%(2/58);数字曲面体层片检出阳性率为8.62%(5/58),两者无统计学差异(P>0.05),实际临床检测发现仅1例未发生骨结合,阳性率为1.72%(1/58)。结论 CBCT是种植牙术前目前颌骨骨量测量较为可靠方法。CBCT与数字曲面体层片相比,数字曲面体层片存在变形,牙槽骨高度数据测量值普遍偏大。在术后检查中CBCT能更清晰地反映种植体周围骨质,评估种植手术的成功与否及对上部结构的修复有重要的指导意义。

Objective To explore the application value of CBCT and digital orthopantomography in dental implant in the posterior area of maxillary and mandible. Methods 50 patients received 58 implants,adopting CBCT and digital orthopantomography method at the same time. The pre-operative radiographic results and the post-operative images of the osseointegrated implants were compared and the differences were analyzed. Results The detected positive rate of bone deficiency in the mandible posterior area was 28.57% by CBCT and 7.14% by digital pantomogram,showing statistical significance by Chi-square test（ P 〈 0.05）. The detected positive rate of bone deficiency in the maxillary posterior area was 36.36% by CBCT and 9.09% by digital pantomogram, also showing statistical sig-nificance by Chi-square test （P 〈 0.05）. The detected positive rate of osseointegration failure after 3 months was 3.45% （2/58） by CBCT and 8.62% （5/58） by digital pantomogram, showing no statistical significance by Chi-square test （P 〉0. 05 ）. In clinic test, there was just 1 （ 1.72% ） case of osseointegration failure. Conclusions CBCT is considered as the relatively reliable method for meas-urement of jaw bone volume nowadays. Digital pantomograms,however, display distortion and have greater measurements of the alveolar bone when compared with CBCT. In post-operative examination, CBCT images can more clearly exhibit the peri-implant sclerotin, so that CBCT plays an important role in evaluating the success of the planting operation and in restoration of upper structure.