基于锥形束计算机断层扫描研究牙根吸收的临床特征

Clinical Characteristics of Root Resorption were Studied by Cone-beam Computed Tomography

目的:确定因不同指征接受锥形束计算机断层扫描(CBCT)成像的患者中牙根吸收的发生率和特征。方法:收集厦门医学院附属口腔医院866次连续CBCT扫描数据,并计算总样本和特定指征的吸收率。结果:137例患者共199颗牙齿存在吸收,在特定指征中患病率为3.1%~29.2%。17.5%(24例)的患者有2个吸收点,7.3%(10例)的患者有3个或更多的吸收点;以前牙为主[43.7%(87/199)],其次为磨牙[40.7%(81/199)]和前磨牙[15.6%(31/199)]。最常见的吸收类型为外吸收[41.2%(82/199)]、颈部吸收[19.6%(39/199)]、感染诱发的根尖吸收[17.6%(35/199)]、阻生齿吸收[9.5%(19/199)]、内吸收[7.5%(15/199)]和替代吸收[4.5%(9/199)]。大多数吸收的牙齿未接受过牙髓治疗[80.9%(161/199)],影像学上尖周正常[64.8%(129/199)]。137例存在吸收的患者中,45例(32.8%)为偶然发现。结论:CBCT检测到高比例的偶然发现的吸收表明,常规放射线成像不能精准检测到吸收的存在,因此牙根吸收未得到充分诊断。

Objective The purpose of this study was to determine the incidence and characteristics of root resorption in patients undergoing conical beam computed tomography(CBCT)imaging for different indications.Method The study was based on scan data from 866 consecutive patients.Data were extracted from imaging reports and absorption rates for total samples and specific indications were calculated.Results Absorption was found in 137 patients and 199 teeth,with prevalence ranging from 3.1%~29.2%in the specific indication.17.5%(24 cases)of patients had 2 absorption points and 7.3%(10 cases)had 3 or more absorption points.The anterior teeth were mainly composed of 43.7%(87/199),followed by Molars[40.7%(81/199)]and Premolars[15.6%(31/199)].The most common types of absorption were external[41.2%(82/199)],cervical[19.6%(39/199)],infection-induced apical[17.6%(35/199)],impacted tooth[9.5%(19/199)],internal[7.5%(15/199)]and replacement[4.5%(9/199)].Most of the absorbed teeth had not received endodontic treatment[80.9%(161/199)]and were radiologically normal periapical[64.8%(129/199)].Absorption was found in 137 patients,45 cases(32.8%)were discovered by chance.Conclusion The high proportion of incidental absorption detected by CBCT indicates that the presence of absorption cannot be accurately detected by conventional radiography,so the root resorption is underdiagnosed.