上颌切牙区美学种植相关影像学测量及分析研究

Radiological measurement and analysis of aesthetic implantation in maxillary incisor positions

目的基于锥形束CT影像数据研究上颌切牙唇侧牙槽骨厚度以及上颌同侧双颗切牙间的近远中空间,为上颌切牙连续缺失的美学种植提供参考依据。方法本研究采集并选取619例患者的CBCT影像数据,测量上颌切牙在釉牙骨质界根方3 mm处的唇侧牙槽骨厚度以及上颌同侧双颗切牙间的近远中空间,并进行统计分析。结果上颌中切牙及侧切牙处唇侧牙槽骨厚度分别为(1.03±0.32)mm、(0.96±0.36)mm,中切牙处厚度大于侧切牙。上颌同侧双颗切牙间近远中空间为(15.94±1.18)mm,其中男性近远中空间(16.31±1.13)mm稍大于女性(15.59±1.12)mm,未见左右侧位置差异,其中近远中空间在14 mm以下即不满足植入2枚种植体的空间要求者占5.01%。结论上颌切牙唇侧骨壁厚度绝大多数难以满足理想种植要求,需进行骨增量手术。对于上颌相邻中切牙及侧切牙,整体近远中空间有5.01%无法满足植入两枚种植体的水平间距,在缺失后建议植入1枚种植体通过单端悬臂桥的方式进行修复以获得长期美学效果。

Objective To investigate the labial alveolar bone thickness of maxillary incisors and mesiodistal space in the maxillary adjacent central and lateral incisors based on cone beam computed tomography(CBCT)image data,and provide reference for aesthetic implantation in cases of consecutive missing maxillary incisors.Methods CBCT image data of 619 patients were selected in this study.The labial alveolar bone thickness of maxillary incisors as well as the mesiodistal space in the maxillary adjacent central and lateral incisors were measured at three millimeters apical to the cementoenamel junctio,followed by statistical analysis.Results The labial alveolar bone thickness at the maxillary central incisor and lateral incisor locations was(1.03±0.32)mm and(0.96±0.36)mm,respectively,with central incisors having greater thickness than lateral incisors.The mesiodistal space in the maxillary adjacent central and lateral incisors was(15.94±1.18)mm,with males(16.31±1.13)mm exhibiting slightly greater space than females(15.59±1.12)mm,showing no left-right positional differences.Among these,5.01%failed to satisfy a space of 14 mm.Conclusion The majority of maxillary incisors fail to meet the ideal thickness requirements of labial alveolar bone for implantation,necessitating bone augmentation surgery.For the maxillary adjacent central and lateral incisors,approximately 5.01%of the mesiodistal spaces fail to meet the essential horizontal distance for the placement of two implants.In such situations after tooth loss,it is recommended to place only one implant in the region of the central incisor and aprosthetic restoration consisting of an implant crown on this implant connected with a cantilever at the position of the lateral incisor for long-term aesthetic results.