基于锥形线束CT的上颌后牙区牙槽骨增龄性变化研究

Age-related changes of alveolar bone in maxillary posterior based on cone-beam CT

目的·测量分析上颌骨后牙区皮质骨厚度,以及牙槽骨高度和宽度的增龄性变化。方法·收集2019年1月—2022年12月于上海交通大学医学院附属瑞金医院口腔科就诊的种植患者锥形线束CT(cone-beam CT,CBCT)资料,其中青年组(18~30岁)40例、老年组(≥60岁)40例,男女比例为1∶1。应用i-Dixel软件分别对牙列整齐的一侧上颌后牙牙间3个区域(区域Ⅰ为上颌第一前磨牙和第二前磨牙间,区域Ⅱ为上颌第二前磨牙和第一磨牙间,区域Ⅲ为上颌第一磨牙和第二磨牙间)的牙槽骨颊、腭侧皮质骨厚度,以及牙槽骨宽度和高度进行测量,比较不同组间的差异。结果·在区域Ⅲ,老年男性颊侧皮质骨厚度[(1.49±0.29)mm]显著大于青年男性[(1.11±0.34)mm](P<0.001);在区域Ⅰ、Ⅱ,老年女性腭侧皮质骨厚度[区域Ⅰ:(1.27±0.30)mm;区域Ⅱ:(1.28±0.27)mm]均显著小于青年女性[区域Ⅰ:(1.70±0.32)mm;区域Ⅱ:(1.58±0.61)mm](均P<0.05)。牙槽骨宽度在3个区域均呈现老年组小于青年组的趋势,但仅在区域Ⅱ、Ⅲ,老年男性[区域Ⅱ:(8.61±1.15)mm;区域Ⅲ:(11.06±2.40)mm]与青年男性[区域Ⅱ:(10.29±1.69)mm;区域Ⅲ:(13.39±1.59)mm]之间差异有统计学意义(均P<0.05)。牙槽骨高度在区域Ⅰ、Ⅱ,老年男性和老年女性分别显著大于青年男性和青年女性(均P<0.05)。老年组中,男性颊侧皮质骨厚度在区域Ⅰ、Ⅲ均显著大于女性(均P<0.05)。结论·女性上颌后牙区腭侧皮质骨厚度随着年龄增加显著变薄;上颌后牙区牙槽骨宽度随着年龄增长都呈现缩窄趋势,老年男性变化尤为显著;老年人上颌后牙区牙槽骨的高度显著增加。

Objective·To measure and analyze age-related changes in cortical bone thickness and alveolar bone height and width in the posterior teeth of the maxilla.Methods·Cone-beam CT(CBCT)data of the implant patients in the Department of Stomatology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were collected from January 2019 to December 2022.There were 40 cases in the youth group(18‒30 years)and 40 cases in the elderly group(≥60 years),with a male-to-female ratio of 1∶1.The i-Dixel software was used to measure the thickness of buccal and palatal cortical bone,and the width and height of alveolar bone in three regions of the posterior teeth of the maxilla on the side with regular dentition(partⅠ:between the first and the second premolar of maxillary;partⅡ:between the second premolar and the first molar of maxillary;partⅢ:between the first and the second molar of maxillary),and the differences between different groups were compared.Results·In partⅢ,the buccal cortical bone thickness of the elderly men[(1.49±0.29)mm]was significantly greater than that of the young men[(1.11±0.34)mm](P<0.001).In partⅠandⅡ,the thickness of palatal cortical bone in the elderly women[partⅠ:(1.27±0.30)mm;partⅡ:(1.28±0.27)mm]was significantly smaller than that in the young women[partⅠ:(1.70±0.32)mm;partⅡ:(1.58±0.61)mm](P<0.05).The width of alveolar bone showed a trend of being smaller in the elderly group than in the young group in all three regions,but there were significant differences only between the elderly males[partⅡ:(8.61±1.15)mm;partⅢ:(11.06±2.40)mm]and the young males[partⅡ:(10.29±1.69)mm;partⅢ:(13.39±1.59)mm]in the partⅡandⅢ(P<0.05).The alveolar bone height in partⅠandⅡwas significantly greater in elderly men and women than that in the young men and women,respectively(P<0.05).In the elderly group,the thickness of buccal cortical bone in men was significantly greater than that in women in partⅠandⅢ(P<0.05).Conclusion·The thickness of palatal cortical bone in female maxillary posterior teeth significantly decreases with age;the width of alveolar bone in maxillary posterior region shows a narrowing trend with age,especially in elderly men;the height of alveolar bone in the maxillary posterior region of the elderly increases significantly.