CBCT在替牙期儿童颌骨骨髓炎中的诊断价值

The use of cone beam-CT in the diagnosis of osteomyelitis of jaws during mixed dentition

目的 探讨口腔锥形束CT(CBCT)在诊断替牙期儿童颌骨骨髓炎中的价值。方法 回顾21例儿童颌骨骨髓炎的CBCT影像学表现,分析其CBCT征象,明确诊断。结果 21例患儿男13例,女8例,病变均发生在下颌第一恒磨牙根尖区或下颌乳磨牙区。CBCT影像学征象,21例颌骨均出现骨质破坏,密质骨板外均见骨膜反应,9例下颌肿大,见骨膜新生骨。其中14例见病源牙,4例未见明确病源牙,3例乳磨牙缺失。影像学诊断,14例中央性颌骨骨髓炎,4例边缘性颌骨骨髓炎,3例Garré骨髓炎。12例追踪复查,病变颌骨重新塑形。结论 儿童颌骨骨髓炎具有多样性,CBCT能早期准确诊断儿童颌骨骨髓炎,有助于选择合适的临床治疗方式。

Objective To investigate the value of cone-beam CT(CBCT)in the diagnosis of jaw osteomyelitis during mixed dentition.Methods The CBCT images of 21 children with osteomyelitis of jaws were retrospectively reviewed to analyze the characteristics of the images.Results Among the 21 cases in this study,there were 13 males and 8 females.The lesions all appeared in the mandibular primary molar region and the first permanent molar.The CBCT images demonstrated that all the 21 cases had bone destruction of the jaws and periosteal reactions.Nine cases had jaw swelling and new bone formation in the periosteum.In addition,the pathogenic tooth could be seen in 14 cases,but not in 4 cases.The other 3 cases showed missing deciduous molars.Forteen cases of central jaw osteomyelitis,4 cases of marginal jaw osteomyelitis,3 cases of Garréosteomyelitis were confirmed by CBCT.Twelve cases were followed up and re-examined,and the diseased jaw was reshaped.Conclusions Osteomyelitis of the jaws in children is diversified and CBCT is useful in early diagnosis of osteomyelitis.