口腔颌面锥形束CT在种植牙术前诊断、术后效果评估中的应用

Application of Oral and Maxillofacial Cone Beam CT on the Evaluation of Preoperative Diagnosis and Postoperative Effect of Dental Implants

目的探究口腔颌面锥形束CT在种植牙术前诊断、术后效果评估中的应用价值。方法回顾性分析我院2015年8月至2017年8月期间收治的93例接受种植牙手术患者的口腔影像学资料,所有患者均接受口腔颌面锥形束CT和曲面断层检查。两种方式影像学分析,比较两种方式检测患者颏孔解剖检出情况,下颌区垂直距离测量以及种植术术后检查情况。结果锥形束CT可以更加清晰地显示颌骨解剖结构和术后骨结合。锥形束CT在颏孔、颏棘上孔、切牙管、副颏孔以及颏神经环等解剖结构中的检出率均显著高于曲面断层(P<0.05)。锥形束CT前牙区下颌骨根尖处根尖骨宽度显著长于曲面断层(P<0.05),磨牙区下颌骨根尖处根尖骨宽度显著短于曲面断层(P<0.05);锥形束CT前牙区和磨牙区可用骨高度,前牙区骨类牙根长度和前磨牙区下颌骨牙槽嵴顶跟间骨宽度均显著低于曲面断层(P<0.05)。锥形束CT对种植牙术后未发生骨结合的检出率(3.85%)显著低于曲面断层的检出率(11.54%)(P<0.05);而锥形束CT对种植牙术后骨量不足的检出率(25.00%)显著高于曲面断层的检出率(12.50%)。结论锥形束CT对种植牙术前颌骨解剖结构显示及诊断、术后种植体情况检测均要优于曲面断层,临床应用价值高。

Objective To explore the application value of oral and maxillofacial cone-beam CT on evaluating the preoperative diagnosis and postoperative effect of dental implants.Methods A retrospective analysis was performed on the oral imaging data of 93 patients undergoing dental implant surgery in the hospital from August 2015 to August 2017.All patients underwent oral and maxillofacial cone-beam CT and panoramic radiograph examination.The imaging with the two methods was analyzed.The detection of mental foramen dissection,measu rement of vertical distance in the mandible area,and postoperative examination after dental implants surgery by the two methods were compared.Results Cone-beam CT could more clearly show the dissection structure of jaw bone and postoperative osseointegration.The detection rates of dissection structures in the mental foramen,an upper hole of mental spine,incisive canal,deputy mental foramen,and chin nerve ring by the cone-beam CT were significantly higher than those by panoramic radiograph(P<0.05).The apical bone width at the root place of the lower jawbone in the anterior area by the cone-beam CT was significantly longer than that by panoramic radiograph(P<0.05),while the width in the molar area was substantially shorter than that by panora mic radiograph(P<0.05).The height of available bone in the anterior and the molar regions,the length of tooth root of the bone in the anterior area and the width of alveolar ridge crest of lower jawbone,intermedium bone in the anterior molar area by cone-beam CT were significantly lower than those by panora mic radiograph(P<0.05).The detection rate for no occurre n ce of osseointegration after dental impla nts surgery by cone-beam CT was significantly lower than that by panoramic radiograph(3.85% vs.11.54%)(P<0.05),while the detection rate for shortage of bone was significantly higher than that by panora mic radiograph(25.00% vs 12.50%).Conclusion Cone beam CT is superior to the panoramic radiograph in displaying and diagnosing dissection structure of jaw bone before dental implant surgery and in detecting of postoperative implant.The clinical application value is high.