上前牙矢状面牙根位置分类及唇侧骨板厚度的CBCT研究

The CBCT study on classification of sagittal roots position and the thickness of the labial bone wall of maxillary anterior teeth

目的应用锥形束CT(CBCT)对上颌前牙矢状面牙根在牙槽骨中的解剖位置进行分类,并测量其唇侧骨板厚度,为上颌前牙即刻种植修复治疗提供影像学研究数据。方法回顾性筛选出200名患者的CBCT影像,其中男性80名,女性120名。CBCT矢状面影像中,上前牙牙根在牙槽骨中的位置分为4类,并且测量其唇侧牙槽嵴顶下1.5 mm处唇侧骨板的厚度。结果中切牙4种分类的发生率分别为Ⅰ类80.5%、Ⅱ类7.5%、Ⅲ类1%以及Ⅳ类11%,侧切牙的发生率分别为Ⅰ类72%、Ⅱ类11.5%、Ⅲ类1%以及Ⅳ类15.5%,尖牙的发生率分别为Ⅰ类82%、Ⅱ类9.5%、Ⅲ类0%以及Ⅳ类8.5%。中切牙唇侧骨板平均厚度男性为(1.10±0.26)mm、女性为(0.98±0.19)mm,侧切牙唇侧骨板平均厚度男性为(0.87±0.20)mm、女性为(0.83±0.20)mm,尖牙唇侧骨板平均厚度男性为(1.18±0.35)mm、女性为(1.04±0.25)mm。除侧切牙外,中切牙和尖牙唇侧骨板厚度男性均大于女性,且差异具有统计学意义。结论上前牙矢状面牙根位置的影像学分类研究对该区域患牙即刻种植修复治疗手术有导向性意义,并且上前牙牙槽嵴顶下1.5 mm处唇侧骨板菲薄,即刻种植修复前应结合以上两点进行详细评估。

Objective To supply image research data for immediate implant placement and proviosionalization,the relationship of the sagittal roots position of the maxillary anterior teeth in the alveolar bone was classified and the thickness of the labial bone plate of the maxillary anterior zone was measured by cone beam computed tomography(CBCT).Methods The CBCT images of 200 patients were retrospectively selected,including 80 male patients and 120 female patients.In these CBCT image,the sagittal position of the anterior teeth roots in the alveolar bone was classified into four categories,and the thickness of the bone plate at 1.5 mm below the labial margin of the alveolar crest was measured.Results The incidences of the four types of incisors were 80.5%for ClassⅠ,7.5%for ClassⅡ,1%for ClassⅢ,and 11%for ClassⅣ.The incidence of lateral incisors was 72%for ClassⅠ,11.5%for ClassⅡ,1%for ClassⅢand 15.5%for ClassⅣ,the incidence of canines were 82%for ClassⅠ,9.5%for ClassⅡ,0%for ClassⅢ,and 8.5%for ClassⅣ.The average thickness of the labial plate of the central incisor was 1.10±0.26 mm for men and 0.98±0.19 mm for women.The average thickness of the lateral plate of the lateral incisors was 0.87±0.20 mm for men and 0.83±0.20 mm for women.The average thickness of the bone plate was 1.18±0.35 mm for men and 1.04±0.25 mm for women.Except for lateral incisors,the thickness of the central incisors and the labial thickness of the canines in the male patient group were thicker than those in the female patient group,and there were significant differences.Conclusion The classification of the sagittal position of the anterior maxillary teeth is a pilot for the immediate implant placementand provisionalization,and the labial bone plate at 1.5 mm below the anterior alveolar ridge is thin.Before surgical operation,the aforementioned two points should be considered thoroughly.