锥形束CT对埋伏阻生尖牙在正畸牵引助萌中的临床应用研究

Clinical Application of Cone Beam CT in Orthodontic Traction and Eruption Assistance of Impacted Canines

目的:对锥形束CT应用于口腔正畸矫治埋伏阻生尖牙的临床效果进行分析。方法:选择2017年1月~2020年1月本院正畸科收治的92例的埋伏阻生尖牙患者,均在口腔正畸治疗前应用普通X射线片确定埋伏尖牙存在及锥形束CT检查其位置,并比较两种检查方法与实际情况的符合率。观察立体方位牵引牙齿与邻牙的间距、矫治疗效及安全性。结果:经过临床观察对比,锥形束CT的诊断符合率明显高于普通X射线片,差异有统计学意义(P<0.05)。CBCT结果显示,92例患者中,埋伏阻生尖牙颗数共计145颗,均为上颌前牙埋伏阻生,牙齿与邻牙最近间距平均值为2.05mm。根据锥形束CT定位,埋伏阻生尖牙手术入路精准,创面较小,正畸牵引萌出顺利,未造成牙根吸收及明显的牙龈萎缩等不良反应。结论:锥形束CT应用于正畸牵引助萌埋伏阻生尖牙效果显著,可以精准的三维定位患牙方位、形态,实际符合率较高,对患牙定位及矫正治疗、手术入路有较高的指导意义,避免牵引过程中造成邻牙牙根的吸收,减少患者的口腔创伤面积。

Objective:To analyze the clinical effect of cone beam CT in orthodontic treatment of impacted canine.Methods:92 patients with impacted canines were selected from the Department of Orthodontics in our hospital from January 2017 to January 2020.Before orthodontic treatment,the presence of impacted canines was determined by ordinary X-ray film and the location were examined by cone beam CT.The coincidence rate among X-ray,cone beam CT and the actual situation of the impacted canines was compared.To observe the distance between three-dimensional traction teeth and adjacent teeth,the curative effect and safety of orthodontic treatment.Results:Through clinical observation and comparison,the diagnostic coincidence rate of cone beam CT was significantly higher than that of ordinary X-ray film,the difference was statistically significant(P<0.05).CBCT showed that there were 145 impacted canines in 92 patients,all of which were impacted maxillary anterior teeth,and the average distance between teeth and adjacent teeth was 2.05mm.According to the cone-beam CT location,the surgical approach of impacted canines is accurate,the wound is small,the orthodontic traction eruption is smooth,and no adverse reactions such as root absorption and obvious gingival atrophy are caused.Conclusion:The application of cone beam CT in assisting the eruption of impacted canines has significant effect.It can accurately locate the position and shape of the impacted teeth in three dimensions,with a high actual coincidence rate.It has a high guiding significance for the positioning of the affected teeth and the surgical approach,also it can help to avoid the absorption of the adjacent teeth in the process of traction,and to reduce the oral trauma in patients,which is suitable for clinical application.