锥形束CT在定位和拔除上颌埋伏阻生牙中应用的临床研究

Application of cone-beam computed tomography in location and extraction of unerupted impacted maxillary teeth

目的探讨锥形束CT在上颌埋伏阻生牙定位和拔除中应用的价值。方法对在我院就诊经传统X线片确定有拟拔除的上颌埋伏阻生牙但不能具体定位的29例患者,术前采用锥形束CT扫描获得高分辨率影像,并对扫描信息进行三维重建和任意曲面观察来准确定位埋伏牙,指导选择合适的手术入路以拔除埋伏阻生牙。结果经锥形束CT扫描、三维重建后,所有共36颗埋伏牙被准确定位,根据CS 3D imaging software软件任意曲面观察埋伏牙后分析得出最佳手术入路,使得埋伏牙均顺利拔除,创口均Ⅰ期愈合,无感染及邻牙损伤等并发症发生。结论与传统的根尖片、咬合片、曲面断层全景片相比,锥形束CT能精确定位上颌埋伏阻生牙,在上颌埋伏阻生牙拔除方案的制订和拔牙操作中具有重要的指导意义。

ObjectiveTo study the application value of cone-beam computed tomography （CBCT） in location and extraction of unerupted impacted maxillary teeth.Methods36 enrupted impacted teeth in the maxilla of 29 patients were included, which were detected by the traditional X-ray, but difficult to locate accurately. Preoperative CBCT were used for accurate positioning of enrupted impacted teeth, and guiding of appropriate operation approaches.ResultsAccording to CBCT scanning, three-dimensional （3D） reconstruction, and analysis, the number, shape, surrounding anatomical structures, and three-dimensional location of all of 36 enrupted impacted teeth were demonstrated accurately. The optimum operation approach was obtained, and the teeth were extracted successfully. No serious complications such as infection and damage to adjacent teeth happened.ConclusionCompared with traditional 2-dimensional （2D） images including periapical, occlusal, and panoramic radiographs, CBCT can diagnose and localize enrupted impacted teeth in the maxilla, which is helpful for treatment planning.