成人不同牙弓形态腭侧微种植支抗位点皮质骨厚度的CBCT研究

The cortical bone thickness analysis of different arch form in adult palatal microscrew anchorage point with cone-beam computed tomography

目的研究性别、种植部位及牙弓型对腭侧微螺钉种植支抗位点处骨皮质厚度的影响。方法选取方圆型、卵圆型、尖圆型牙弓患者各40例,每组男性20例,女性20例,共120例。利用Kavo锥形束计算机断层扫描(cone beam computed tomography,CBCT)对其口腔颌面部进行扫描,在所得的CBCT图像中定位9个腭侧微螺钉种植支抗位点,并测量该处的皮质骨厚度。结果不同性别患者的相同种植位点处的骨皮质厚度比较,差异无统计学意义;腭中缝及腭中旁3 mm处皮质骨厚度差异无统计学意义;腭中缝自切牙孔向后3 nm、6 mm、9 mi以及腭中缝旁3 mm处,自切牙孔向后3 mm、6 mm、9 mm皮质骨厚度依次减少;第一前磨牙与第二前磨牙根间中点处对应的腭侧皮质骨厚度较第二前磨牙与第一磨牙根间中点处者小,但比第一磨牙与第二磨牙根间中点处者大;不同牙弓型在第一前磨牙至第二磨牙根间中点处的3个微种植位点处皮质骨厚度差异有统计学意义,方圆型、卵圆型、尖圆型在相同位点处皮质骨厚度依次减小,在不同牙弓形的其他6个种植支抗位点皮质骨厚度无统计学差异。结论临床手术操作植入种植支抗时,应考虑不同种植位点及牙弓型态皮质骨厚度对手术操作和支抗稳定性的影响。

Objective To investigate palatal bone factors associated with different arch form in adult patients.Methods A cone beam computed tomography was obtained from 120 patients,age for 18 to 40 year old.Based on arch forms,the patient’s tomography were equally divided into three basic categories：square,tapered,and ovoid,each consisting 40 patients which consist of equal gender.Cortical bone thicknesses of different implant sites in palatal bone were measured.Results There is no statistically difference between different gender.There is no statistically difference of the cortical bone thickness between the midpalatal and 3 mm from the midpalatal.Both of the midpalatal and parapalatal cortical bone thickness is decrease progressively form the foramen.The sequence of the alveolar cortical bone thickness is56,45,67.There are statistically difference between different arch form.Conclusion It is important for orthodontist to consider the cortical bone thickness in different type of arch form and palatal implant sites which will influence the stability of the microscrews.