不同骨龄青少年上颌后牙颊侧微螺钉种植体支抗植入区骨质密度的口腔锥形束CT测量

Measurement of bone density with buccal alveolar ridge at maxillary molar areas for implant anchorage insertion by cone beam computed tomography in adolescent patients with different bone ages

目的:通过对不同骨龄青少年上颌后牙区微螺钉种植体支抗植入部位骨质密度进行测量分析,为其基础研究及临床应用提供参考。方法:对青少年患者颅面部进行口腔锥形束CT(CBCT)扫描,测量双侧上颌第2前磨牙与第1磨牙区的骨质密度,依据改良颈椎分析法(Cvs)将研究对象分为4组(Cvs3、Cvs4、Cvs5、Cvs6组),分析并比较不同骨龄青少年上颌后牙区微螺钉种植体支抗植入部位骨质密度的差异。结果:密质骨及松质骨骨密度不同骨龄相同测量平面(距离牙槽嵴4mm处及6mm处平面即P4平面与P6平面)间LSD两两比较结果,Cvs3组与Cvs4组、Cvs4组与Cvs5组、Cvs5组与Cvs6组比较,差异均具有统计学意义,随骨龄增长P4及P6平面上青少年上颌后牙颊侧微螺钉种植体支抗植入区密质骨及松质骨骨密度呈逐渐增大趋势;相同骨龄患者在P6平面中上颌后牙颊侧微螺钉种植体支抗植入区密质骨(4组)和松质骨(Cvs3组、Cvs5组及Cvs6组)骨密度均显著高于P4平面。结论:随骨龄增长,青少年上颌后牙颊侧微螺钉种植体支抗植入区骨密度逐渐增大,距离牙槽嵴6mm处骨密度显著高于4mm处,这提示以一定角度倾斜植入微螺钉种植体支抗,尽量由P4向P6平面去植入,增加植入位置骨密度,还可以有效避免上颌窦穿通的风险。

Objective:To analyze the bone mineral density of implanted anchorage sites in the maxillary posterior region of adolescents with different bone ages and to provide reference for the basic research and clinical application of microscrew implant anchorage.Methods:Adolescent patients underwent CBCT scans to measure the bone density of the bilateral maxillary region between second premolar and the first molar region.According to the modified cervical vertebra sort(Cvs),the subjects were divided into Cvs3 group,Cvs4 group,Cvs5 group,and Cvs6 group.The differences in bone mineral density of the implanted anchorage sites in the maxillary posterior region of different bone ages were analyzed and compared.Results:Comparison of bone density for compact bone and cancellous bone between planes(distance from the alveolar ridge 4 mm and 6 mm plane,ie,P4 plane and P6 plane)with the same measurement of different bone ages showed the results of the LSD between the groups showed that the significant differences between Cvs3 group and Cvs4 group,Cvs4 group and Cvs5 group,Cvs5 group and Cvs6 group.With the increase of bone age,the cortical bone mineral density and cancellous bone mineral density of the maxillary posterior buccal side on P4 and P6 planes of the adolescent were gradually increased.Bone mineral density in the patients with the same bone age of the four groups in the P6 plane of the maxillary posterior teeth of the buccal side was significantly higher than that of the P4 plane.In the Cvs3 group,Cvs5 group and Cvs6 group,the cancellous bone density of the maxillary posterior buccal side of the P6 plane was significantly higher than that of the P4 plane.Conclusion:With the increase of bone age,the bone density of the implanted area of the maxillary posterior teeth of the adolescent is gradually increased.The bone density at 6 mm from the alveolar ridge is significantly higher than 4 mm.This suggests that the micro-screw implant should be implanted at an angle.Implantation from the P4 to the P6 plane as much as possible not only increases the bone density at the implantation site,but also effectively avoids the risk of maxillary sinus penetration.