螺旋CT三维重建定位埋伏牙的应用研究
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摘要
目的探讨螺旋CT三维重建在口腔埋伏牙中的应用研究。方法将口腔正畸科进行检查的110例患者行普通X线片及螺旋CT扫描,比较X线与螺旋CT对埋伏牙的检出率。以确诊的80例患者为研究对象,通过CT三维重建应用表面遮盖法(SSD)以及高分辨率最大密度投影法(MIP)等对确诊患者进行埋伏牙的准确定位,分析患者埋伏牙的牙数、形态、位置及其与周围组织的关系。并应用多平面重建、多方位断层等观察患者牙根吸收情况。结果螺旋CT对埋伏牙的检出率为72.73%,X线片对埋伏牙的检出率为50.91%,差异有统计学意义(P<0.05)。三维重建可以清晰显示埋伏牙的位置、数量、形态及邻近牙根吸收情况。80例患者,单颗埋伏牙患者占总数的87.5%,所占比例最高;牙位以上颌尖牙为主,发生率为31.87%,其次为上颌中切牙,占16.48%;埋伏牙多位于舌腭侧,占79.12%;邻牙中有78颗无牙根吸收,占42.86%,67颗轻微的牙根吸收,占36.81%。结论螺旋CT三维重建对埋伏牙的检出率明显高于X线,应用CT三维重建技术可以显著提高埋伏牙的检出率。埋伏牙以单颗埋伏为主,上颌尖牙患病率最高,埋伏牙主要位于腭侧,临近牙根多无根吸收或轻微根吸收。螺旋CT三维重建对埋伏牙的精确诊断及定位,为临床治疗以及矫治方案的制定提供了准确且科学的参考依据。
Objective To investigate the application of spiral computed tomography( CT) with three-dimensional( 3-D) reconstruction in the embedded teeth. To investigatethe application of three-dimensional reconstruction of spiral CT in the impacted teeth. Methods A total of 110 patients were examined by conventional X-ray and spiral CT scan examination in Department of Orthodontics of our hospital to compare the detection rate of embedded teeth between the two mothods,among 11 patients,80 patients who were diagnosed definitely were enrolled as research objects. The accurate localization of embedded teeth in these patients was performed by spiral CT with 3-D reconstruction using shaded surface display( SSD) and high-resolution maximum-intensity projection( MIP),and the number,morphology and location of embedded teeth of the patients as well as its relationship with the surrounding tissues were recorded. Multi-planar reconstruction and multi-directional CT were performed to observe the root resorption of patients. Results The detection rate of embedded teeth by spiral CT and X-ray was 72. 73% and 50. 91%,respectively,there was a significant difference btween the two methods( P < 0. 05). The CT with 3-D reconstruction could clearly reveal the position,number,morphology,and absorption of adjacent tooth roots. Of 80 patients,those with single embedded teeth had the largest proportion,accounting for 87. 5%. For tooth position,there were predominantly the maxillary cuspids,with an incidence of 31. 87%,followed by the maxillary central incisor,accounting for16. 48%. Most of embedded tooth were located at lingual and palatal side,accounting for 79. 12%. Of the adjacent teeth,78 had no root absorption,accounting for 42. 86%,and 67 had slight root absorption,accounting for 36. 81%. Conclusion The detection rate of spiral CT with 3-D reconstruction for embedded teeth is significantly higher than that of X-ray. CT with 3-D reconstruction technique can significantly improve the detection rate of embedded teeth, which includes mainly single embedded teeth. In addition,the maxillary cuspids has the highest prevalence. The embedded teeth are mainly located at the palatal side,and there is no root absorption or slight root absorption near the roots. Spiral CT with 3-D reconstruction ensures the accurate diagnosis and localization of embedded teeth,which provides an accurate and scientific reference for clinical management and treatment plan.
Objective To investigate the application of spiral computed tomography( CT) with three-dimensional( 3-D) reconstruction in the embedded teeth. To investigatethe application of three-dimensional reconstruction of spiral CT in the impacted teeth. Methods A total of 110 patients were examined by conventional X-ray and spiral CT scan examination in Department of Orthodontics of our hospital to compare the detection rate of embedded teeth between the two mothods,among 11 patients,80 patients who were diagnosed definitely were enrolled as research objects. The accurate localization of embedded teeth in these patients was performed by spiral CT with 3-D reconstruction using shaded surface display( SSD) and high-resolution maximum-intensity projection( MIP),and the number,morphology and location of embedded teeth of the patients as well as its relationship with the surrounding tissues were recorded. Multi-planar reconstruction and multi-directional CT were performed to observe the root resorption of patients. Results The detection rate of embedded teeth by spiral CT and X-ray was 72. 73% and 50. 91%,respectively,there was a significant difference btween the two methods( P < 0. 05). The CT with 3-D reconstruction could clearly reveal the position,number,morphology,and absorption of adjacent tooth roots. Of 80 patients,those with single embedded teeth had the largest proportion,accounting for 87. 5%. For tooth position,there were predominantly the maxillary cuspids,with an incidence of 31. 87%,followed by the maxillary central incisor,accounting for16. 48%. Most of embedded tooth were located at lingual and palatal side,accounting for 79. 12%. Of the adjacent teeth,78 had no root absorption,accounting for 42. 86%,and 67 had slight root absorption,accounting for 36. 81%. Conclusion The detection rate of spiral CT with 3-D reconstruction for embedded teeth is significantly higher than that of X-ray. CT with 3-D reconstruction technique can significantly improve the detection rate of embedded teeth, which includes mainly single embedded teeth. In addition,the maxillary cuspids has the highest prevalence. The embedded teeth are mainly located at the palatal side,and there is no root absorption or slight root absorption near the roots. Spiral CT with 3-D reconstruction ensures the accurate diagnosis and localization of embedded teeth,which provides an accurate and scientific reference for clinical management and treatment plan.
引文
1徐刚,胡海箐,徐新超,等.多排螺旋CT全景齿科成像技术的临床价值探讨.中国CT与MRI杂志,2011,9:26-27.
2 孙田力,吴白龙,方梅.CT三维重建在上颌埋伏牙微创拔除术的临床应用.蚌埠医学院学报2014,39:897-899.
3 张雅萍,赵振华,王伯胤,等.多层螺旋CT不同重建技术在口腔颌面正畸中的对比研究.中国临床医学影像杂志,2010,21:669-671.
4 闻越,程宪国,王军,等.螺旋CT三维重建技术在闭合式外科导萌加正畸牵引治疗埋伏牙中的临床应用.口腔医学,2011,31:55-56.
5 刘文,王燕,宋玲,等.螺旋CT三维重建方法在埋伏阻生上颌中切牙正畸治疗中的应用研究.中国美容医学,2013,22:1541-1543.
6 周燕玲,李娜,米长江,等.螺旋CT对埋伏牙定位的应用价值.国际口腔医学杂志,2011,38:24-26.
7 梁颂,李静远,时清,等.纵向断层摄影术在儿童前牙区埋伏多生牙拔除中的应用.北京口腔医学,2008,16:226-227.
8 64排螺旋CT三维重建对复杂多生埋伏牙的诊断价值.实用医学影像杂志,2013,14:419-421.
9 闻越,程宪国,王军,等.螺旋CT三维重建技术在闭合式外科导萌加正畸牵引治疗埋伏牙中的临床应用.口腔医学,2011,31:55-56.
10 许来青,姜曚,丁虹,等.埋伏阻生牙诊断及治疗-埋伏阻生牙的定位及诊断.中国实用口腔科杂志,2012,9:641-645.
11 熊焱,张慧娟.螺旋CT三维重建技术在正畸埋伏阻生牙助萌中的应用.农垦医学,2014,36:230-231.
12 Cotton TP,Geisler TM,Holden ML,et al.Endodontic applicati ons of cone-beam volumetric tomography.J Endod,2007,33:1121-1132.
13 邵玶,闫伟军,宋冰,等.基于CT扫描图像的上颌牙列的三维重建及有限元模型建模研究.中国美容医学,2012,21:773-1775.
14 何爱娥,梁爽,肖云鹤,等.64排螺旋CT后处理技术在正畸埋伏牙诊疗中的价值.临床口腔医学杂志,2013,29:609-612.
15 高保军,于雪萍,王秀云,等.MSCT后处理技术在埋伏牙正畸中的应用价值.中国中西医结合影像学杂志,2015,13:653-655.
2 孙田力,吴白龙,方梅.CT三维重建在上颌埋伏牙微创拔除术的临床应用.蚌埠医学院学报2014,39:897-899.
3 张雅萍,赵振华,王伯胤,等.多层螺旋CT不同重建技术在口腔颌面正畸中的对比研究.中国临床医学影像杂志,2010,21:669-671.
4 闻越,程宪国,王军,等.螺旋CT三维重建技术在闭合式外科导萌加正畸牵引治疗埋伏牙中的临床应用.口腔医学,2011,31:55-56.
5 刘文,王燕,宋玲,等.螺旋CT三维重建方法在埋伏阻生上颌中切牙正畸治疗中的应用研究.中国美容医学,2013,22:1541-1543.
6 周燕玲,李娜,米长江,等.螺旋CT对埋伏牙定位的应用价值.国际口腔医学杂志,2011,38:24-26.
7 梁颂,李静远,时清,等.纵向断层摄影术在儿童前牙区埋伏多生牙拔除中的应用.北京口腔医学,2008,16:226-227.
8 64排螺旋CT三维重建对复杂多生埋伏牙的诊断价值.实用医学影像杂志,2013,14:419-421.
9 闻越,程宪国,王军,等.螺旋CT三维重建技术在闭合式外科导萌加正畸牵引治疗埋伏牙中的临床应用.口腔医学,2011,31:55-56.
10 许来青,姜曚,丁虹,等.埋伏阻生牙诊断及治疗-埋伏阻生牙的定位及诊断.中国实用口腔科杂志,2012,9:641-645.
11 熊焱,张慧娟.螺旋CT三维重建技术在正畸埋伏阻生牙助萌中的应用.农垦医学,2014,36:230-231.
12 Cotton TP,Geisler TM,Holden ML,et al.Endodontic applicati ons of cone-beam volumetric tomography.J Endod,2007,33:1121-1132.
13 邵玶,闫伟军,宋冰,等.基于CT扫描图像的上颌牙列的三维重建及有限元模型建模研究.中国美容医学,2012,21:773-1775.
14 何爱娥,梁爽,肖云鹤,等.64排螺旋CT后处理技术在正畸埋伏牙诊疗中的价值.临床口腔医学杂志,2013,29:609-612.
15 高保军,于雪萍,王秀云,等.MSCT后处理技术在埋伏牙正畸中的应用价值.中国中西医结合影像学杂志,2015,13:653-655.