颧牙槽嵴区骨宽度及皮质骨厚度的CBCT测量分析
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摘要
目的:应用锥形束CT(CBCT)测量成年人与青少年的颧牙槽嵴区域的骨宽度、皮质骨厚度及窦底高度,并评价2组的差异,为临床中颧牙槽嵴区微种植体的植入提供参考。方法:选取成年人个别正常志愿者和安氏Ⅰ类青少年患者各30例,获取其口腔颌面部CBCT扫描影像。测量颧牙槽嵴区域的骨宽度、皮质骨厚度及上颌窦底高度,并对测量数据进行统计学分析。结果:两实验组颧牙槽嵴区域均为第二前磨牙和第一磨牙之间的骨宽度最大,且每层的5个测量值均表现为随测量点向颅方移动骨宽度值逐渐减小。两实验组各层颧牙槽嵴区骨宽度与窦底高度成正相关关系。结论:成年人组各位置骨宽度平均值及皮质骨厚度平均值均较青少年组相应位置大。颧牙槽嵴区骨宽度随窦底高度增大而增大。2组样本上颌窦个体差异均非常大,植入微种植体前需拍摄CBCT以确定是否满足植入条件。
Objective:To measure the bone width,the cortical bone thickness,and the height of maxillary sinus floor of infrazygomatic crest in adults and adolescents,and to compare the specific differences between two groups by cone beam computed tomography(CBCT).Methods:CBCT scans were taken in 30 individual normal occlusion adult volunteers and 30 adolescent ClassⅠ patients.Multiple measurements were performed at infrazygomatic crest.The data were analyzed statistically.Results:The maximum width of infrazygomatic crest in adults and adolescents all located at the interradicular space of the maxillary second premolar and first molar.Thereafter,the values decreased gradually from root tips to basis cranii in every slice.The height of the maxillary sinus floor and infrazygomatic crest width in every slice showed a positive correlation.Conclusion:The bone width and cortical bone thickness of infrazygomatic crest in adults are thicker than those in adolescents.The infrazygomatic crest width becomes thicker as the height of maxillary sinus floor increases.Individual differences exist in the height of maxillary sinus floor.CBCT is needed in this region before inserting micro-implant anchorage.
Objective:To measure the bone width,the cortical bone thickness,and the height of maxillary sinus floor of infrazygomatic crest in adults and adolescents,and to compare the specific differences between two groups by cone beam computed tomography(CBCT).Methods:CBCT scans were taken in 30 individual normal occlusion adult volunteers and 30 adolescent ClassⅠ patients.Multiple measurements were performed at infrazygomatic crest.The data were analyzed statistically.Results:The maximum width of infrazygomatic crest in adults and adolescents all located at the interradicular space of the maxillary second premolar and first molar.Thereafter,the values decreased gradually from root tips to basis cranii in every slice.The height of the maxillary sinus floor and infrazygomatic crest width in every slice showed a positive correlation.Conclusion:The bone width and cortical bone thickness of infrazygomatic crest in adults are thicker than those in adolescents.The infrazygomatic crest width becomes thicker as the height of maxillary sinus floor increases.Individual differences exist in the height of maxillary sinus floor.CBCT is needed in this region before inserting micro-implant anchorage.
引文
[1]谢雨菲,沈刚.微种植支抗钉在颧牙槽嵴的应用进展[J].口腔医学研究,2013,29(4)∶381-382
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[3]蒋佳秀,陆珮珺.CBCT在微种植体支抗中的应用进展[J].口腔材料器械杂志,2014,23(4)∶210-212
[4]Holm M,Brinkmann PG,Mah J,et al.Bone thickness of the anterior palate for orthodontic miniscrews[J].Angle Orthodontist,2016,86(5)∶826-831
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[6]胡露露,宋锦璘,邓峰,等.锥形束CT对微螺钉植入后牙安全区域的分析[J].华西口腔医学杂志,2012,30(2)∶156-160
[7]Cassetta M,Sofan AA,Altieri F,et al.Evaluation of alveolar cortical bone thickness and density for orthodontic mini-implant placement[J].J Clin Exp Dent,2013,5(5)∶245-252
[8]Nienkemper M,Wilmes B,Renger S,et al.Improvement of miniimplant stability in orthodontics[J].Orthod Fr,2012,83(3)∶201-207
[9]Uemura M,Motoyoshi M,Yano S,et al.Orthodontic miniimplant stability and the ratio of pilot hole implant diameter[J].Eur JOrthod,2012,34(1)∶52-56
[10]李文艳,彭嘉琪,林巍,等.微种植体颌骨植入区的CBCT测量分析[J].口腔医学,2015,35(1)∶29-33
[11]Motoyoshi M,Inaba M,Ono A,et al.The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone[J].Int J Oral Maxillofac Surg,2009,38(1)∶13-18
[12]Baumgaertel S,Hans MG.Assessment of infrazygomatic bone depth for mini-screw insertion[J].Clin Oral Implants Res,2009,20(6)∶638-642
[13]赵岩,屈振宇,韩文利,等.应用锥形束CT探查颧牙槽嵴处微种植钉植入的安全范围[J].口腔医学研究,2013,29(2)∶145-147
[14]吴军,陈振琦.上颌第一恒磨牙根方颧牙槽嵴宽度的解剖分析[J].中国口腔颌面外科杂志,2014,12(6)∶521-524
[15]Kim SH,Kang SM,Choi YS,et al.Cone-beam computed tomography evaluation of mini-implants after placement:is root proximity a major risk factor for failure[J].Am J Orthod Dentofacial Orthop,2010,138(3)∶264-276
[16]Park J,Cho HJ.Three-dimensional evaluation of inerradicular spaces and cortical bone thickness for the placement and initial stability of microimplants in adults[J].Am J Orthod Dentofacial Orthop,2009,136(3)∶314.e1-314.e12
[2]Lee HS,Choi HM,Choi DS,et al.Bone thickness of the infrazygomatic crest area in skeletal Class III growing patients:A computed tomographic study[J].Imaging Science in Dentistry,2013,43(4)∶261-266
[3]蒋佳秀,陆珮珺.CBCT在微种植体支抗中的应用进展[J].口腔材料器械杂志,2014,23(4)∶210-212
[4]Holm M,Brinkmann PG,Mah J,et al.Bone thickness of the anterior palate for orthodontic miniscrews[J].Angle Orthodontist,2016,86(5)∶826-831
[5]孔娜娜,苗芬,袁华,等.基于CBCT的下颌前牙区颌骨形态学研究[J].口腔生物医学,2013,4(4)∶181-185
[6]胡露露,宋锦璘,邓峰,等.锥形束CT对微螺钉植入后牙安全区域的分析[J].华西口腔医学杂志,2012,30(2)∶156-160
[7]Cassetta M,Sofan AA,Altieri F,et al.Evaluation of alveolar cortical bone thickness and density for orthodontic mini-implant placement[J].J Clin Exp Dent,2013,5(5)∶245-252
[8]Nienkemper M,Wilmes B,Renger S,et al.Improvement of miniimplant stability in orthodontics[J].Orthod Fr,2012,83(3)∶201-207
[9]Uemura M,Motoyoshi M,Yano S,et al.Orthodontic miniimplant stability and the ratio of pilot hole implant diameter[J].Eur JOrthod,2012,34(1)∶52-56
[10]李文艳,彭嘉琪,林巍,等.微种植体颌骨植入区的CBCT测量分析[J].口腔医学,2015,35(1)∶29-33
[11]Motoyoshi M,Inaba M,Ono A,et al.The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone[J].Int J Oral Maxillofac Surg,2009,38(1)∶13-18
[12]Baumgaertel S,Hans MG.Assessment of infrazygomatic bone depth for mini-screw insertion[J].Clin Oral Implants Res,2009,20(6)∶638-642
[13]赵岩,屈振宇,韩文利,等.应用锥形束CT探查颧牙槽嵴处微种植钉植入的安全范围[J].口腔医学研究,2013,29(2)∶145-147
[14]吴军,陈振琦.上颌第一恒磨牙根方颧牙槽嵴宽度的解剖分析[J].中国口腔颌面外科杂志,2014,12(6)∶521-524
[15]Kim SH,Kang SM,Choi YS,et al.Cone-beam computed tomography evaluation of mini-implants after placement:is root proximity a major risk factor for failure[J].Am J Orthod Dentofacial Orthop,2010,138(3)∶264-276
[16]Park J,Cho HJ.Three-dimensional evaluation of inerradicular spaces and cortical bone thickness for the placement and initial stability of microimplants in adults[J].Am J Orthod Dentofacial Orthop,2009,136(3)∶314.e1-314.e12