锥形束CT在慢性牙周炎患者牙周基础治疗后评估牙槽骨变化中的应用

Role of cone beam CT scan in evaluating of alveolar bone changes in chronic periodontitis patients after periodontal therapy

目的通过锥形束CT(cone beam CT,CBCT)测量牙周基础治疗前后慢性牙周炎患者牙槽骨高度和密度的变化情况,探讨牙周基础治疗前后牙槽骨骨量的变化。方法选择丽水市第二人民医院口腔科2013年1月—2015年12月牙周基础治疗慢性牙周炎患者100例作为研究对象,100例患者均给予牙周基础治疗,采用CBCT测量牙周基础治疗前后牙槽骨高度和密度的变化情况。结果轻度牙周炎治疗前和治疗后牙槽骨密度高于中度牙周炎和重度牙周炎(P<0.05),中度牙周炎牙槽骨密度高于重度牙周炎(P<0.05)。轻度、中度、重度牙周炎治疗后牙槽骨密度均高于治疗前(P<0.05)。轻度牙周炎治疗前和治疗后牙槽骨吸收低于中度和重度牙周炎(P<0.05),中度牙周炎牙槽骨吸收低于重度牙周炎(P<0.05)。轻度、中度、重度牙周炎治疗后牙槽骨吸收均低于治疗前,但差异无统计学意义(P>0.05)。前牙治疗后牙槽骨密度和治疗前比较差异无统计学意义(P>0.05),前磨牙和磨牙治疗后牙槽骨密度均高于治疗前(P<0.05)。前牙、前磨牙、磨牙治疗后牙槽骨吸收和治疗前比较差异均无统计学意义(P>0.05)。结论牙周基础治疗可以改善慢性牙周炎的牙槽骨密度,CBCT可以用于牙周基础治疗前后牙槽骨骨量变化的评估。

Objective To study the alveolar bone changes before and after periodontal treatment via measuring the chan- ges in alveolar bone height and density by cone beam CT（CBCT） in patients with chronic periodontitis. Methods We selected 100 cases of chronic periodontitis patients in Lishui city second people＇s hospital from January,2013 to Decem- ber,2015 for the study. All patients were given periodontal treatment. The changes in alveolar bone height and density were measured by using CBCT. Results The alveolar bone density of mild periodontitis patients were higher than those of moderate periodontitis and severe periodontitis patients both before and after the treatment（ P 〈0.05）. The alveolar bone density all increased after the treatment in mild, moderate, and severe periodontitis patients （ P 〈 0. 05 ）. Both before and after treatment, the alveolar bone loss of mild periodontitis patients was less than that of moderate periodontitis （ P 〈 0.05） ,and moderate periodontitis less than severe periodontitis（P 〈 0.05 ）. The alveolar bone loss after the treatment in mild periodontitis,moderate periodontitis and severe periodontitis patients were marginally higher than those before the treatment, but the difference was not statistically significant（P 〉 0.05）. The anterior alveolar bone density after the treat- ment was not improved significantly,the difference was not statistically significant（P 〉 0.05）. The premolars and molars alveolar bone density after the treatment were improved significantly（P 〈0.05）. The alveolar bone loss of anterior teeth, premolars and molars after the treatment were not improved significantly（P 〉 0. 05）. Conclusion The periodontal treat- ment can improve alveolar bone density in patients with chronic periodontitis. CBCT scan can be used to assessing alveolar bone mass before and after the periodontal treatment.