基于锥形束CT对邻面接触区釉质厚度的测量与分析

Measurement and analysis of adjacent tooth enamel thickness by cone beam computed tomography

目的应用锥形束CT(cone beam computed tomography,CBCT)测量上下颌牙列邻面接触区釉质厚度及邻接点距离[牙合]面和釉牙骨质界的垂直高度,为临床邻面去釉提供参考数据。方法选取2019年6—10月于吉林大学口腔医院医学影像科行CBCT检查患者50例,根据纳入标准选取符合测量条件的牙齿145颗,运用Invivo软件测量每颗牙齿邻面接触区的釉质厚度及邻接点距离[牙合]面和釉牙骨质界的垂直高度。结果从切牙至第一磨牙邻面接触区釉质厚度有逐渐增大的趋势;大多数牙位的远中邻面接触区釉质厚度大于近中(P<0.05),仅有上颌第一前磨牙和下颌第一磨牙的近远中邻面接触区釉质厚度差异无统计学意义(P>0.05);上下颌左右侧同名牙邻面接触区釉质厚度差异无统计学意义(P>0.05);除上颌中切牙-侧切牙、上下颌侧切牙-尖牙邻面接触区外,其余相邻牙齿近远中邻面接触区釉质厚度相似,差异均无统计学意义(均P>0.05);上颌邻面接触区平均釉质厚度大于下颌,差异有统计学意义(P<0.05);上下颌近远中邻接点到[牙合]面的垂直距离均小于到釉牙骨质界的垂直距离(均P<0.05)。结论不同牙位近远中邻面接触区釉质厚度不同,邻接点距离[牙合]面和釉牙骨质界的垂直高度也不同,临床邻面去釉时不同牙位去釉量不能按照同一标准进行,应结合CBCT影像资料制定个体化治疗方案。

Objective To provide reference for clinical enamel removal in adjacent areas by measuring the proximal enamel thickness of the maxillary and mandibular and the vertical distance of each contact area by cone beam computed tomography(CBCT).Methods A total of 145 teeth were selected from all the patients who underwent CBCT examination in the Department of Imaging of Jilin University Stomatological Hospital from June 2019 to October 2019.The enamel thickness in the proximal and distal adjacent areas of each permanent tooth and the vertical distance of each contact area were respectively measured by the measurement software Invivo for statistical analysis.Results The enamel thickness of adjacent teeth increased from incisor to first molar.The enamel thickness in the distal adjacent area of most teeth was greater than that in the proximal adjacent area(P<0.05),and there was no statistical difference in the proximal and distal enamel thickness in the maxillary first premolars and the mandibular first molars(P>0.05).There was no significant difference in the thickness of distal and proximal enamel in the upper/lower jaw(P>0.05).Except for the adjacent areas of maxillary central incisors-lateral incisors and upper and lower mandibular lateral incisors-canine teeth,the enamel thickness in the contact area between the proximal and distal sides of the other adjacent teeth was similar,and the difference was not statistically significant(P>0.05).The average enamel thickness in the contact area of the upperjaw was greater than that of the lower jaw,which had statistical significance(P<0.05).The mesial and distal adjacent point of upper and lower jaws was closer to the maxillofacial than the enamel cemen-tum boundary(P<0.05).Conclusion Different permanent teeth have different enamel thicknesses and vertical distance in the mesial and distant regions of adjacent areas.The scheme of interproximal reduction should be set according to the specific situation of different patients.CBCT imaging data should be considered in making individualized treatment plans.