摘要
目的：研究下颌偏斜患者的全颌曲面断层片和头颅后前位定位片的相关性,探讨全颌曲面断层片定量分析评价下颌偏斜的应用价值。方法：本研究选取2008-2009年就诊于新疆医科大学第一附属医院口腔正畸科的50例下颌偏斜患者治疗前同期拍摄的全颌曲面断层片和头颅后前位定位片,分别应用下颌骨线距测量及Vig三角形测量法对全颌曲面断层片和头颅后前位定位片进行测量分析。方法一,下颌骨线距测量：分别定点左右两侧髁顶点、下颌角点及颏下点,并测量左右两侧下颌骨升支高度、下颌体长度、下颌综合长度,对测量结果进行相关性检验,并建立回归方程；方法二,Vig三角形测量法：定点与方法一相同,分别测量由这三点所围成的三角形面积大小,并对测量结果进行相关性检验,建立回归方程。结果：下颌骨线距测量结果：下颌骨升支高度及下颌综合长度在全颌曲面断层片和头颅后前位定位片上的测量值之间均有明显相关性,而下颌体长度在两测量值之间相关性较前两者为低；Vig三角形测量法：左右两侧下颌骨三角形面积大小在全颌曲面断层片和头颅后前位定位片上的测量值之间均有明显相关性。结论：在严格遵守拍摄要求的情况下,全颌曲面断层片作为一种辅助诊断方法,是可以进行下颌骨定量指标的测量来评价下颌偏斜的。
Objective:To study the relationship with two sides of mandibular between the panoramic and posterior-anterior radiographs of the patients with mandibular asymmetry, and discuss the value of quantitative analysis of panoramic radiographs for mandibular asymmetry.
Methods:Panoramic and posterior-anterior radiographs were taken in 50 patients with mandibular asymmetry before treatment, who have came to the Orthodontic Department of the First Affiliated Hospital of Xinjiang Medical University during 2008-2009. the mandibular linear dimensions and Vig's triangulation was introduced.method 1, Mandibular linear dimension measurement:Both sides of the mandibular ramus height, mandibular corpus lengh and mandibular total length were measured on these radiographs. The data were statistically analyzed. Method 2, Vig's triangulation:take the same samples, and both sides of the triangle acreage were measured on these radiographs. The data were statistically analyzed.
Results:result of mandibular linear dimension measurement:significant correlations of mandibular ramus height and mandibular total length between panoramic and posterior-anterior radiographs were found while lower significant correlation of mandibualr corpus lengh was noted. Result of Vig's triangulation:significant correlations of both sides of the triangle acreage between panoramic and posterior-anterior radiographs were noted.
Conclusion:when observe rigidly the screen demand, to be a method of assistant diagnosis, it can be used for quantitative analysis to evaluate the mandibular asymmetry.
引文
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[8]周冬青,吕婴.X线全颌曲面断层片与X线头颅侧位片相关性的研究[J].北京口腔医学,2003,11(3)：142-143.
[9]王云霞,彭友俭,王世平.66例Angle'sⅡ类错合患者下颌骨及左右侧髁突对称性临床分析[J].临床口腔医学杂志,2001,17(1)：47-48.
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[11]Habet LL, Bezuur JN, Naeiji M, et al. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems Ⅱ. The vertical symmetry[J]. J Oral Rehabil,1988, 15(5):465-471.
[12]Stramotas S, Geenty JP, Petocz P, et al. Accuracy of linear and angular measurements on panoramic radiographs take at various positions in vitro[J]. Eur J Orthod, 2002,24(1):43-52.
[13]Kambylafkas P, Murdock E, Gilda E, et al. Validity of panoramic radiographs for measuring mandibular asymmetry[J]. Angle Orthod,2006,76(3):388-393.
[14]Kiki A, Kilic N, Oktay H. Condylar asymmetry in bilateral posterior crossbite patients[J]. Angle Orthod,2007,77(1):77-81.
[15]Sezgin OS, Celenk P, Arici S. Mandibular asymmtry in different occlusion patterns[J]. Angle Orthod,2007,77(5):803-807.
[16]马文利,彭静,邓辉,等.曲面断层片中下颌角测量的准确性研究[J].现代口腔医学杂志,2003,17(5)：427-428.
[17]Catic A, Celebic A,Valentic-Peruzovic M, et al. Evaluation of the precision of dimensional measurements of the mandible on panoramic radiographs[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,1998,86(2):242-248.
[18]Larheim TA, Svanaes DB. Reproducibility of rotational panoramic radiography:mandibular linear dimensions and angle[J]. Am J Orthod Dentofacial Orthop,1986,90(1):45-51.
[19]Habets LL, Bezuur JN, van Ooij CP, et al. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. Ⅰ. The factor of vertical magnification[J]. J Oral Rehabil,1987,14(5):475-480.
[20]Kjellberg H, Ekestubbe A, Kiliaridis S, et al. Condylar height on panoramic radiographs-a methodologic study with a clinical appllication[J]. Acta Odontol Scand, 1994,52(1):43-50.
[21]谢旻,胡敏,刘洪臣,等.下颌后牙区颌骨高度的曲面体层片测量研究[J].口腔颌面修复学杂志,2002,3(1)：3-5.
[22]Cisneros GJ, Kaban LB. Computerized skeletal scintigraphy for assessment of mandibular asymmetry[J]. J Oral Maxillofac Surg,1984,42(2):513-520.
[23]高益鸣,田伟家,邱蔚六,等.发育性不对称畸形下领骨生长活性的核素显像研究[J].口腔颌面外科杂志,2006,16(3)：222-225.
[24]刘红,米丛波,居曼江·买买提.锥形束CT在口腔医学中的应用[J].牙体牙髓牙周病学杂志,2009,19(7)：416-426.
[25]Huntjens E, Kiss G, Wouters C, et al. Condylar asymmetry in children with juvenile idiopathic arthritis assessed by cone-beam computed tomography[J]. Eur J Orthod, 2008,30(6):545-551.
[26]Gribel BF, Gribel MN, Frazao DC, et al. Accuracy and reliability of craniometric measurements on lateral cephalometry and 3D measurements on CBCT scans[J]. Angle Orthod,2011,81 (1):28-37.
[27]吴莹莹,李东,丁寅,等.成人下颌偏斜患者下颌髁突三维CT形态对称性研究[J].实用口腔医学杂志,2008,24(3)：386-388.
[28]Hartmann J, Meyer-Marcotty P, Benz M, et al. Reliability of a method for computing facial symmetry plane and degree of asymmetry based on 3D-data[J]. J Orofac Orthop, 2007,68(6):477-490.
[29]Palomo JM, Hunt DW Jr, Hans MG, et al. A longitudinal 3-dimensional size and shape comparison of untreated Class I and Class Ⅱ subjects[J]. Am J Orthod Dentofacial Orthop,2005,127(5):584-591.
[30]Tolleson SR, Kau CH, Lee RP, et al.3-D analysis of facial asymmetry in children with hip dysplasia[J]. Angle Orthod,2010,80(4):707-712.
[31]Aksu M, Kaya D, Kocadereli L. Reliability of reference distances used in photogrammetry[J]. Angle Orthod,2010,80(4):670-677.