利用CBCT对上颌前牙区牙龈及骨组织的测量分析

Measurement and analysis of the anatomical structure of the gingival and bone tissue of maxillary anterior teeth using cone-beam CT

目的探讨不同性别健康成人上颌前牙区牙龈厚度情况、上颌前牙各牙位的基骨条件、上颌前牙与牙槽骨的唇腭向倾斜度以及各测量结果之间的相关性,为上颌前牙区的美学种植修复提供一定的参考依据。方法95例体检者行锥形束CT(CBCT)扫描。分别测量上颌前牙唇侧牙龈厚度、唇腭侧骨壁厚度、牙槽骨厚度、牙槽骨高度以及前牙唇腭向倾斜度,进行相关统计分析。结果80%以上的牙齿唇侧牙龈厚度小于1 mm,平均厚度在(0.85±0.10)mm~(0.91±0.12)mm,属于薄龈生物型。上颌中切牙、侧切牙和尖牙的唇侧骨壁厚度小于1 mm的比例分别为40.02%、77.95%和70.58%。70%以上的牙齿腭侧骨壁厚度大于2 mm。牙槽骨的平均厚度在(7.49±0.82)mm~(10.23±1.04)mm,平均高度在(19.90±2.97)mm~(22.31±2.51)mm。牙齿倾斜度在(13.90±5.70)°~(18.58±5.12)°。腭侧骨壁厚度与牙槽骨厚度及唇腭向倾斜度呈正相关。结论该组健康成人普遍存在上颌前牙唇侧牙龈和唇侧骨壁较薄的情况,对种植体美学效果有重要影响,在拔牙和种植过程中应予以关注。

Objective To determine the dimensions of and the correlation between the gingival tissue and alveolar bone in the maxillary anterior esthetic zone.This study provides a reference for esthetic implant restoration of maxillary anterior teeth.Methods Ninety-five patients underwent CBCT scans.The thickness of the labial gingival tissue and labial and palatal bone,the thickness and height of the alveolar bone,and the inclination of maxillary anterior teeth were measured and analyzed.Results 80%of all teeth regions were classified as the thin gingival biotype(GB)(<1 mm).For maxillary central incisors,lateral incisors and canines,labial bone thickness greater than 1 mm was noted in 40.02%,77.95%and 70.58%of teeth,respectively.The thickness of the palatal bone was greater than 2 mm in greater than 70%of all teeth regions.The thickness and height of the alveolar bone were between(7.49±0.82)and(10.23±1.04)mm and between(19.90±2.97)and(22.31±2.51)mm,respectively.The inclination of teeth was between(13.90±5.70)°and(18.58±5.12)°.The palatal bone thickness was positively correlated with the alveolar bone thickness and the inclination.Conclusion This study demonstrates the prevalence of thin labial gingiva and labial alveolar bone of maxillary anterior teeth in this group of the healthy adults,which have an important influence on implant esthetics,and special attention and care should be taken during extraction and implantation.