三维头影测量技术在口腔正畸学中的临床应用评价

Preliminary clinical application of three-dimensional cephalometric in orthodontics

目的探讨三维头影测量技术在正畸学中的初步应用并评价其与传统测量方法的差异。方法 2012年5—12月就诊于徐州市中心医院的13例正畸患者,其中严重骨性错颌畸形5例,骨埋伏牙8例。所有患者在术前通过常规全景片、头颅定位侧位片检查,患者决定治疗后签署拍摄锥形束CT同意书。摄取相关影像后,导入专业软件进行三维头影测量,测量结果与传统测量法的比较采用配对t检验。结果三维重建后的锥形束CT(CBCT)影像可以更清楚地显示头影测量所需的标志点,与传统方法相比,ANB角[(0.78±2.64)°,(1.51±1.92)°,t=2.63]、MP-FH角[(32.14±4.25)°,(32.96±2.84)°,t=2.59)]、L1-NB角[(28.27±3.72)°,(29.02±2.81)°,t=2.68]、SNA角[(80.15±3.39)°,(81.47±1.85)°,t=3.08]、U1-NA角[(26.85±4.35)°,(28.36±3.46)°,t=3.21]差异有统计学意义(P<0.05);其余的测量项目则差异无统计学意义。结论三维头影测量技术在某些方面比传统的定点描记具有更大的优势,三维头影测量技术可以取代传统的头影测量法,可对正畸术前矫治方案设计提供相关依据。

Objective To evaluate the clinical application of 3D cephalometric in orthodontics and compare conventional cephalometric with 3D cephalometric,which reconstructed by cone beam computed tomography （CBCT）images.Methods From May 2012 to December 2012,there were 13 patients going with orthodontic therapy,among which 5 patients with severe dental maxillofacial malocclusion and 8 patients with impacted tooth.All patients were detected by regular pantomography and lateral cephalogram,then CBCT scans with consent.All patients were detected by 3D cephalometric analytics with professional software compared with conventional cephalometric.Results 3D constructed CBCT form showed more accurate images.Compared with 2D,3D cephalometric measurements showed differences in ANB,MP-FH, L1-NB,SNA,U1-NA parameters（t =2.63,2.59,2.68,3.08,3.21;P＆lt;0.05 ）,there was no significant difference between other parameters.（t =1.32,1.17,1.46,1.37,1.62,1.03;P〈0.05）.Conclusions CBCT combined with 3D cephalometric takes great advantage to conventional cephalometric.It has important clinical guidance to establish treatment scheme for patients with dental maxillofacial deformity.