锥形束CT测量分析预种植区颌骨质量
摘要
目的:应用锥形束CT对预种植区牙槽骨相对骨密度及骨量进行测量分析,为临床安全、稳定地植入种植体提供参考依据。方法:对56例拟种植患者利用日本公司3D,multi-Image Morita Micro CT,对患者缺牙区进行扫描,扫描图像运用Iviewer专业软件进行重建,对100个预种植位点骨密度及骨量进行测量。利用SPSS11.0软件对数据进行统计分析,Mann-Whitney U检验比较不同区域骨密度的差异,并分析骨密度、骨量与种植区域及年龄的关系。结果:1.下前牙区平均相对骨密度值最大,为(132.68±15.87),其次为下后牙区(120.43±13.76),上前牙区(107.67±14.34),骨密度值最小为后上牙区(90.55±14.55),缺牙区域的骨密度比较,差异有统计学意义(P<0.05)。2.随年龄增长,骨密度值逐渐下降。3.前牙缺失后多表现为牙槽骨宽度不足,后牙多为牙槽骨高度不足。结论:所有预种植区域中,前下牙区平均骨密度值最大,后上牙区平均骨密度值最小,随年龄增长,颌骨密度逐渐下降。锥形束CT可以提供种植区骨密度、骨量的信息,对种植的术前设计和术后评估有重要意义。
Objective:To investigate the bone deficiency of oral pre-implant sites using cone beam CT and Iviewer software to provide references to the safe and stable placement of oral implants Methods:56 patients’alveolar bone were scanned by cone beam CT,scanned images were reconstructed by Iviewer software.The height、width and density of 100 designed pre-implant sites were measured.The data was analyzed by SPSS11.0 software and Mann-Whitney U test.We analysed the relationship between bone quality and age. Results:1.The anterior mandible mean bone density was132.68±15.87>posterior mandible120.43±13.76> anterior maxilla107.67±14.34>posterior maxilla90.55±14.55. 2.The alveolar bone density was decreased according to age increasing 3. The lack of bone width in ineisor region increase the failure rate of dental implantation . The lack of bone height in posterior region increase the failure rate of dental implantation. Conclusion:Anterior mandible has the highest mean bone density and posterior maxilla has the lowest mean bone density. The alveolar bone density is decreased according to age increasing. Cone beam CT is a useful tool for determining the bone density,it is important for preoperative design and postoperative assessment.
Objective:To investigate the bone deficiency of oral pre-implant sites using cone beam CT and Iviewer software to provide references to the safe and stable placement of oral implants Methods:56 patients’alveolar bone were scanned by cone beam CT,scanned images were reconstructed by Iviewer software.The height、width and density of 100 designed pre-implant sites were measured.The data was analyzed by SPSS11.0 software and Mann-Whitney U test.We analysed the relationship between bone quality and age. Results:1.The anterior mandible mean bone density was132.68±15.87>posterior mandible120.43±13.76> anterior maxilla107.67±14.34>posterior maxilla90.55±14.55. 2.The alveolar bone density was decreased according to age increasing 3. The lack of bone width in ineisor region increase the failure rate of dental implantation . The lack of bone height in posterior region increase the failure rate of dental implantation. Conclusion:Anterior mandible has the highest mean bone density and posterior maxilla has the lowest mean bone density. The alveolar bone density is decreased according to age increasing. Cone beam CT is a useful tool for determining the bone density,it is important for preoperative design and postoperative assessment.
引文
[1] Moberg LE, Kondell PA, Kullman L, et al. Evaluation of single-tooth restoration on ITI dental Implants:A prospective study of 29 patients[J].Clinical oral Implant Research,1999, 10(l):45-53.
[2] Blanes RJ, Bemard JP, Blanes ZM, et al. A 10-year prospective study of ITI dental Implants placed in the posterior region. I:Clinical and radiographic results[J]. Clin Oral Implants Res,2007,18(6):699-706.
[3]林野,李健慧,马力,等.口腔种植修复临床效果十年回顾研究[J].中华口腔医学杂志,2006,14(3):131-135.
[4]汤春波,马建民,童昕,等.种植义齿修复10年临床效果评价[J].上海口腔医学, 2007,16(5):470-474.
[5] T insley D, Watson CJ, Ogdena AR. Survey of U. K. centres on implant failures[J]. Oral rehabiliation. 1999, 26: 14-18.
[6] Wilson TG Jr, Nunn M .The relationship between the interleukin-1 Periodontal genotype and implant loss. initial data[J]. periodontal, 1999 Jul, 70 (7) : 724-729.
[7]邱蔚六.口腔颌面外科学[M].第6版.北京:人民卫生出版社, 2008: 105-116, 130-131, 564-571.
[8] Barbier L, SehePers E. Adaptive bone remodeling around oral implants under axial and nonaxial loading conditions in the dog mandible [J]. Int J Oral Maxillofac implants, 1997, Mar-Apr, 12 (2) : 215-223.
[9] del Valle V, Faulk G, Wolfaardt J Craniofacial osseointegrated implant-induced strain distribution: a numerical study[J]. Int J Oral Maxillofac implants, 1997, 12 (2) : 200-210
[10] Becker W, Hujoel PP, Becker BE, et al. Osteopemsis and implant failure: an exploratory case-control study[J]. periodontol, 2000, 71 (4) : 625-631.
[11] Corten FGA. Measurement of mandibular bone density exvivo and invivo by dual-energy X-ray absorptimetry [J]. A rch Oral Biology, 1993, 38: 215.
[12] Arai Y, Tammisalo E, Iwai K, et al. Development of ortho cubic super high resolution CT.Assisted Radiology and Surgery [M]. Amsterdam Dlserier. 1998,780-785. .
[13] Arai Y, Hashimotn K, Iwai K, et al. Fundamental efficiency of limited cone-beam x-ray CT for practical use [J] . Dent Radiol. 2000, 40: 145-154
[14] Honda K, Arai Y, Iwai K, et al. Fundamental efficiency of new-style limited- cone-beam GT-comparison with helical CT[J]. Japan J Tomogr, 2000, 27: 193-198
[15] Naitoh M, Katsumata A, Mitsuya S, et al. Measurement of mandibles with micro focus x-ray computerized tomography and compact computerized tomography for dental use [J]. J Oral Maxillofac Implants , 2004; 19: 239-46.
[16] Van Daatselaar AN, Dunn SM, Spoelder HJ, et al. Feasibility of local CT of dental tissues [J]. Dentomaxillofac Radio, 2003,32: 173-180.
[17] Ohnesorge B, Flohr T, Schwarz K, et al. Efficient correction for CT image artifacts caused by objects extending outside the scan field of view [J]. Med Phys 2000, 27: 39-46
[18] Martinez L A,Gioso M A,Lobos CM, et al. Localization of the mandibular canal in brachycephalic dogs using computed tomography [J].J Vet Dent,2009, 26:156-163.
[19] Buser D.Long-termevaluation of non-submerged ITI implants.Partl:8-year life table analysis of a prospective multi-center study with 2359 implants[J].Clin Oral Impl Res, 1997, 8:161-172
[20] Honda K. Arai Y. Iwai K. et al. Fundamental efficiency of new-style limited- cone-beam GT-comparison with helical CT[J]. Japan J Tomogr,2000. 27: 193-198
[21] Naitoh M, Katsumata A, Mitsuya S, Kamemoto H, Ariji E. Measurement of mandibles with microfocus x-ray computerized tomography and compact computerized tomography for dental use [J]. J Oral Maxillofac Implants ,2004; 19: 239-46.
[22] van Daatselaar AN, Dunn SM, Spoelder HJ, Germans DM, Renambot L, Bal HE, van der Stelt PF. Feasibility of local CT of dental tissues [J]. Dentomaxillofac Radio2003,32: 173-80.
[23] Ohnesorge B, Flohr T, Schwarz K, Heiken JP, Bae KT. Efficient correction for CT image artifacts caused by objects extending outside the scan field of view[J]. Med Phys 2000,27: 39-46.
[24] Katsumata A, Hirukawa A, Noujeim M, Okumura S, Naitoh M, Fujishita M, et al. Image artifact in dental cone-beam CT[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 652-701.
[25] Cehreli M C,Sahin S.Fabrication of a dual-purpose surgical template for correct labiopalatal positioning of dental implants[J].Int J Oral Maxillofac Implants,2000,15:278-282.
[26] Hyo Sang Park, Lee Youn ju.Density of the alveolar and basal bones of the maxillaand the mandible American[J].Orthodonties and Dentofacial Orthopedies.2008,133(l):31-37.
[27] Tinsley D, Watson CJ, Ogdena AR.Survey of U.K. centres on implant failures[J].Oral Rehabiliation.1999,26:14-18.
[28] Shen Ningjiang, LI Yibo, Chen Wen qing, et al.Diagnosis of osteoporosis by vertebral bone mineral density measurement with quantitative computed tomography [J].Ortho Pedie Joumal of China.2008, 16(11):826-828.
[29]孟海,葛宝丰,白洁,等.兰州地区正常人群骨密度及骨质疏松检出率结果分析[J].中国骨疏松杂志.2008, 14(10):736-738.
[1] Carlson SK,Johnson E. Bracket positioning and resets: Five steps to align crowns and roots consistently[J]. Am J Orthod Dentofacial Orthop, 2001, 119 (1) : 76-80.
[2] Taylor NG, Cook PA. The reliability of positioning pre-adjusted brackets: An in vitro study. Br J Orthod[J], 1992, 19 (1) : 25-34.
[3] LIN Xin-ping,NI Zhen-yu, ZHANG Xiu-hua, et al. Tooth position of Chinese post-treatment casts with Roth straight wire appliance[J]. Chin J Orthodont, 2000, 7 (4) : 155-158.
[4] BAI Ding, LUO Song -jiao, CHEN Yang -xi, et al. The clinic skill in fixed appliance based on characteristics of Chinese normal occlusion[J]. West China J Stomatol, 2005, 23 (1) : 32-34.
[5] Sangcharearn Y, Ho C. Maxillary incisor angulation and its effect on molar relationships[J]. Angle Orthod, 2007, 77 (2) : 221-225.
[6] Gaunt WA. The vascular supply in relation to the formation of roots on the cheek teeth of the mouse [J]. Acta Anat (Basel) , 1960, 43 (2) : 116-136.
[7] Germane N, Bentley B, Isaacson RJ, et al. The morphology of canines in relation to preadjusted appliances [J]. Angle Orthod, 1990, 60 (1) : 49-54.
[8] Hashimoto K, Arai Y, Iwai K, et al. A comparison of a new limited cone beam computed tomography machine for dental use with a multidetector row helical CT machine[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 95 (3) : 371-377.
[9] YANG Xin-hai, ZENG Xiang-long. The effect of bracket heights of straight wire arch on torque[J]. Chin J Orthodont, 1999, 6 (2) : 54-56.
[10]Bryant RM, Sadowsky PL, Hazelrig JB. Variability in three morphologic features of the permanent maxillary central incisor. [J] Am J Orthod, 1984, 86 (1) : 25-32.
[11]Satio S, Sugimoto N, Morohashi T, et al. Endosseous titatium imp lants as anchors formesiodistal tooth in beagle dog [J]. Am J Orthod, 2000, 118 (6) : 601 - 607.
[12]Turkyilmaz I, Tumer C, Ozbek EN, et al. Relations between the bone density values from computerized tomography, and imp lant stability parameters: a clinical study of 230 regular p latform imp lants[J]. J Clin Periodontol, 2007, 34 (8) : 716 - 722.
[13]Dequchi T, NasuM, Murakami K, et al. Quantitative evaluation of cortical bone thickness with computed tomographic scanning for orthodontic imp lants[J]. Am J Orthod Dentofacial Orthop, 2006, 129 (6) : 721. 7 - 12.
[14]Park HS,Lee YJ, Jeong SH, et al. Density of the alveolar and basal bones of the maxilla and the mandible[J]. Am J Orthod Dentofacial Orthop, 2008, 133 (1)30 - 37.
[15]张扬,张丹,冯翠娟.微小种植体支抗生物力学的三维有限元分析[J].上海口腔医学, 2005, 6 (14) : 281 - 283.
[16]黄魁东,张定华,毛海鹏.锥束CT混合检测样本建模与投影仿真.计算机应用研究[J], 2007, 24 (12) : 366 - 369.
[17]朴孝尚.口腔微种植支抗(MIA)技术-技术原理与临床应用.第一版.北京:中国医药科技出版社[M], 2006, 7 - 33.
[18]Meyers KE, Thomson PD, Weiland H (1996) Noncompliance in children and adolescents after renal transplantation. [J] Transplantation 62: 186-189
[19]Bunchman TE (2000) Compliance in pediatric transplant[J]. Pediatr Transplan t 4: 165-169
[20]Foulkes LM, Boggs SR, Fennell RS, Skibinski K (1993) Social support, family variables, and compliance in renal transplant children[J]. Pediatr Nephrol 7: 185-188
[2] Blanes RJ, Bemard JP, Blanes ZM, et al. A 10-year prospective study of ITI dental Implants placed in the posterior region. I:Clinical and radiographic results[J]. Clin Oral Implants Res,2007,18(6):699-706.
[3]林野,李健慧,马力,等.口腔种植修复临床效果十年回顾研究[J].中华口腔医学杂志,2006,14(3):131-135.
[4]汤春波,马建民,童昕,等.种植义齿修复10年临床效果评价[J].上海口腔医学, 2007,16(5):470-474.
[5] T insley D, Watson CJ, Ogdena AR. Survey of U. K. centres on implant failures[J]. Oral rehabiliation. 1999, 26: 14-18.
[6] Wilson TG Jr, Nunn M .The relationship between the interleukin-1 Periodontal genotype and implant loss. initial data[J]. periodontal, 1999 Jul, 70 (7) : 724-729.
[7]邱蔚六.口腔颌面外科学[M].第6版.北京:人民卫生出版社, 2008: 105-116, 130-131, 564-571.
[8] Barbier L, SehePers E. Adaptive bone remodeling around oral implants under axial and nonaxial loading conditions in the dog mandible [J]. Int J Oral Maxillofac implants, 1997, Mar-Apr, 12 (2) : 215-223.
[9] del Valle V, Faulk G, Wolfaardt J Craniofacial osseointegrated implant-induced strain distribution: a numerical study[J]. Int J Oral Maxillofac implants, 1997, 12 (2) : 200-210
[10] Becker W, Hujoel PP, Becker BE, et al. Osteopemsis and implant failure: an exploratory case-control study[J]. periodontol, 2000, 71 (4) : 625-631.
[11] Corten FGA. Measurement of mandibular bone density exvivo and invivo by dual-energy X-ray absorptimetry [J]. A rch Oral Biology, 1993, 38: 215.
[12] Arai Y, Tammisalo E, Iwai K, et al. Development of ortho cubic super high resolution CT.Assisted Radiology and Surgery [M]. Amsterdam Dlserier. 1998,780-785. .
[13] Arai Y, Hashimotn K, Iwai K, et al. Fundamental efficiency of limited cone-beam x-ray CT for practical use [J] . Dent Radiol. 2000, 40: 145-154
[14] Honda K, Arai Y, Iwai K, et al. Fundamental efficiency of new-style limited- cone-beam GT-comparison with helical CT[J]. Japan J Tomogr, 2000, 27: 193-198
[15] Naitoh M, Katsumata A, Mitsuya S, et al. Measurement of mandibles with micro focus x-ray computerized tomography and compact computerized tomography for dental use [J]. J Oral Maxillofac Implants , 2004; 19: 239-46.
[16] Van Daatselaar AN, Dunn SM, Spoelder HJ, et al. Feasibility of local CT of dental tissues [J]. Dentomaxillofac Radio, 2003,32: 173-180.
[17] Ohnesorge B, Flohr T, Schwarz K, et al. Efficient correction for CT image artifacts caused by objects extending outside the scan field of view [J]. Med Phys 2000, 27: 39-46
[18] Martinez L A,Gioso M A,Lobos CM, et al. Localization of the mandibular canal in brachycephalic dogs using computed tomography [J].J Vet Dent,2009, 26:156-163.
[19] Buser D.Long-termevaluation of non-submerged ITI implants.Partl:8-year life table analysis of a prospective multi-center study with 2359 implants[J].Clin Oral Impl Res, 1997, 8:161-172
[20] Honda K. Arai Y. Iwai K. et al. Fundamental efficiency of new-style limited- cone-beam GT-comparison with helical CT[J]. Japan J Tomogr,2000. 27: 193-198
[21] Naitoh M, Katsumata A, Mitsuya S, Kamemoto H, Ariji E. Measurement of mandibles with microfocus x-ray computerized tomography and compact computerized tomography for dental use [J]. J Oral Maxillofac Implants ,2004; 19: 239-46.
[22] van Daatselaar AN, Dunn SM, Spoelder HJ, Germans DM, Renambot L, Bal HE, van der Stelt PF. Feasibility of local CT of dental tissues [J]. Dentomaxillofac Radio2003,32: 173-80.
[23] Ohnesorge B, Flohr T, Schwarz K, Heiken JP, Bae KT. Efficient correction for CT image artifacts caused by objects extending outside the scan field of view[J]. Med Phys 2000,27: 39-46.
[24] Katsumata A, Hirukawa A, Noujeim M, Okumura S, Naitoh M, Fujishita M, et al. Image artifact in dental cone-beam CT[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 652-701.
[25] Cehreli M C,Sahin S.Fabrication of a dual-purpose surgical template for correct labiopalatal positioning of dental implants[J].Int J Oral Maxillofac Implants,2000,15:278-282.
[26] Hyo Sang Park, Lee Youn ju.Density of the alveolar and basal bones of the maxillaand the mandible American[J].Orthodonties and Dentofacial Orthopedies.2008,133(l):31-37.
[27] Tinsley D, Watson CJ, Ogdena AR.Survey of U.K. centres on implant failures[J].Oral Rehabiliation.1999,26:14-18.
[28] Shen Ningjiang, LI Yibo, Chen Wen qing, et al.Diagnosis of osteoporosis by vertebral bone mineral density measurement with quantitative computed tomography [J].Ortho Pedie Joumal of China.2008, 16(11):826-828.
[29]孟海,葛宝丰,白洁,等.兰州地区正常人群骨密度及骨质疏松检出率结果分析[J].中国骨疏松杂志.2008, 14(10):736-738.
[1] Carlson SK,Johnson E. Bracket positioning and resets: Five steps to align crowns and roots consistently[J]. Am J Orthod Dentofacial Orthop, 2001, 119 (1) : 76-80.
[2] Taylor NG, Cook PA. The reliability of positioning pre-adjusted brackets: An in vitro study. Br J Orthod[J], 1992, 19 (1) : 25-34.
[3] LIN Xin-ping,NI Zhen-yu, ZHANG Xiu-hua, et al. Tooth position of Chinese post-treatment casts with Roth straight wire appliance[J]. Chin J Orthodont, 2000, 7 (4) : 155-158.
[4] BAI Ding, LUO Song -jiao, CHEN Yang -xi, et al. The clinic skill in fixed appliance based on characteristics of Chinese normal occlusion[J]. West China J Stomatol, 2005, 23 (1) : 32-34.
[5] Sangcharearn Y, Ho C. Maxillary incisor angulation and its effect on molar relationships[J]. Angle Orthod, 2007, 77 (2) : 221-225.
[6] Gaunt WA. The vascular supply in relation to the formation of roots on the cheek teeth of the mouse [J]. Acta Anat (Basel) , 1960, 43 (2) : 116-136.
[7] Germane N, Bentley B, Isaacson RJ, et al. The morphology of canines in relation to preadjusted appliances [J]. Angle Orthod, 1990, 60 (1) : 49-54.
[8] Hashimoto K, Arai Y, Iwai K, et al. A comparison of a new limited cone beam computed tomography machine for dental use with a multidetector row helical CT machine[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 95 (3) : 371-377.
[9] YANG Xin-hai, ZENG Xiang-long. The effect of bracket heights of straight wire arch on torque[J]. Chin J Orthodont, 1999, 6 (2) : 54-56.
[10]Bryant RM, Sadowsky PL, Hazelrig JB. Variability in three morphologic features of the permanent maxillary central incisor. [J] Am J Orthod, 1984, 86 (1) : 25-32.
[11]Satio S, Sugimoto N, Morohashi T, et al. Endosseous titatium imp lants as anchors formesiodistal tooth in beagle dog [J]. Am J Orthod, 2000, 118 (6) : 601 - 607.
[12]Turkyilmaz I, Tumer C, Ozbek EN, et al. Relations between the bone density values from computerized tomography, and imp lant stability parameters: a clinical study of 230 regular p latform imp lants[J]. J Clin Periodontol, 2007, 34 (8) : 716 - 722.
[13]Dequchi T, NasuM, Murakami K, et al. Quantitative evaluation of cortical bone thickness with computed tomographic scanning for orthodontic imp lants[J]. Am J Orthod Dentofacial Orthop, 2006, 129 (6) : 721. 7 - 12.
[14]Park HS,Lee YJ, Jeong SH, et al. Density of the alveolar and basal bones of the maxilla and the mandible[J]. Am J Orthod Dentofacial Orthop, 2008, 133 (1)30 - 37.
[15]张扬,张丹,冯翠娟.微小种植体支抗生物力学的三维有限元分析[J].上海口腔医学, 2005, 6 (14) : 281 - 283.
[16]黄魁东,张定华,毛海鹏.锥束CT混合检测样本建模与投影仿真.计算机应用研究[J], 2007, 24 (12) : 366 - 369.
[17]朴孝尚.口腔微种植支抗(MIA)技术-技术原理与临床应用.第一版.北京:中国医药科技出版社[M], 2006, 7 - 33.
[18]Meyers KE, Thomson PD, Weiland H (1996) Noncompliance in children and adolescents after renal transplantation. [J] Transplantation 62: 186-189
[19]Bunchman TE (2000) Compliance in pediatric transplant[J]. Pediatr Transplan t 4: 165-169
[20]Foulkes LM, Boggs SR, Fennell RS, Skibinski K (1993) Social support, family variables, and compliance in renal transplant children[J]. Pediatr Nephrol 7: 185-188