【摘要】：目的：隨著口腔醫(yī)學的發(fā)展與進步,牙種植術由于其獨特的優(yōu)勢,日益普及并逐漸成為牙缺失患者首選修復方式。牙種植的全過程離不開影像技術的支持。應用于牙種植中的傳統(tǒng)的影像學設備包括根尖片、曲面體層片以及多排螺旋CT等,這些影像學設備由于各種不足無法滿足牙種植臨床診療對影像學的需求。20世紀90年代出現(xiàn)的口腔錐形束CT(CBCT)為口腔種植提供了新的影像學診查手段。作為一種新興的影像學設備,CBCT也被廣泛地應用于口腔臨床診療的各個領域,大量學者對CBCT的優(yōu)劣勢進行了相關的研究與探討。然而,CBCT對牙齒種植位點線距測量的精確性仍然存在一定的爭議。本研究將通過模擬CBCT在牙種植術前評估中對下頜牙齒種植位點線距測量的精確性做一驗證,探討CBCT在牙種植中的應用價值,為CBCT在口腔種植中的臨床應用提供指導與參考。方法：選取10例無牙頜下頜骨病例,制作實驗模型。在下頜骨樹脂模型中混入10%硫酸鋇,使模型CT值(HU)與天然骨接近。首先在模型骨段上標記測量點,然后用蠟片包繞擬測量位點模型骨段,用牙膠尖在實驗模型上標記標志點作為放射標記,確定測量線距以及測量截面。將標記后的模型拍攝CBCT,影像數(shù)據(jù)導入設備自帶的DCTViewer軟件測量所標記線距。去除包繞的蠟片及放射標記,根據(jù)標記點截開模型骨段,采用游標卡尺直接測量標記線距。數(shù)據(jù)分為前牙垂直線距、后牙垂直線距、前牙水平線距,后牙水平線距4組。將各組數(shù)據(jù)的CBCT及游標卡尺對應測量值進行配對樣本t檢驗,P0.05表示差異有統(tǒng)計學意義。結果：CBCT測量前牙垂直線距、后牙垂直線距、前牙水平線距、后牙水平線距均值分別為(21.62±1.87)、(10.66±0.95)、(7.08±0.69)、(10.10±1.80)；游標卡尺測量的相應結果分別為(21.71±1.96)、(10.75±0.90)(7.13±0.65)、 (10.19±1.86)；二者之間差值分別為(-0.0895±0.2200)、(-0.0830±0.1900)、(-0.0520±0.1400)、(-0.0847±0.3200)mm。無論在前牙區(qū)或后牙區(qū),水平線距或垂直線距,CBCT測量結果與游標卡尺直接測量結果之間差異無統(tǒng)計學意義(t值分別為-1.784、-1.981、-1.621、-1.684,P值均0.05)。CBCT測量結果與游標卡尺直接測量結果之間無顯著差異。結論：在對牙齒種植位點線距的測量方面,CBCT具有較高的可靠性。CBCT能夠對下頜任意牙位的骨量高度與厚度數(shù)據(jù)做出準確評估。CBCT在牙齒種植術前骨量評估中具有很高的應用價值。
[Abstract]:Objective: with the development and progress of stomatology, dental implant is becoming more and more popular and gradually become the first choice for dental defect patients because of its unique advantages. The whole process of dental implant can not be separated from the support of image technology. Traditional imaging devices used in dental implants include apical, curved and multi-slice spiral CT. These imaging equipment can not meet the need of imaging for clinical diagnosis and treatment of dental implants due to various deficiencies. The appearance of oral conical bundle CT (CBCT) in 1990s provides a new method for imaging diagnosis and examination of dental implants. As a new imaging equipment, CBCT is also widely used in various fields of oral clinical diagnosis and treatment. A large number of scholars have studied and discussed the merits and demerits of CBCT. However, the accuracy of CBCT in measuring the distance between implant sites is still controversial. In this study, the accuracy of line distance measurement of mandibular implant sites was verified by simulating CBCT before dental implants, and the application value of CBCT in dental implants was discussed, which provided guidance and reference for clinical application of CBCT in dental implants. Methods: 10 cases of edentulous mandible were selected to make experimental model. 10% barium sulfate was added into the mandibular resin model, which made the CT value of the model close to that of the natural bone. First, the measuring points were labeled on the model bone segment, then the bony segment of the model was wrapped around the wax sheet, and the measuring line distance and the measuring cross section were determined by labeling the mark point on the experimental model with the dental glue tip as the radiolabelling mark. The tagged model was photographed and the image data was imported into the DCTViewer software of the equipment to measure the marked line distance. After removing the wrapped wax and radiating marks, the model bone segment was cut off according to the labeling points, and the marking line distance was measured directly by Vernier caliper. The data were divided into 4 groups: vertical distance of anterior teeth, vertical distance of posterior teeth, horizontal distance of anterior teeth and horizontal distance of posterior teeth. The corresponding values of CBCT and Vernier caliper for each group of data were matched by t-test (P0.05) and the difference was statistically significant. 緇撴灉錛欳BCT嫻嬮噺鍓嶇墮鍨傜洿綰胯窛,鍚庣墮鍨傜洿綰胯窛,鍓嶇墮姘村鉤綰胯窛,鍚庣墮姘村鉤綰胯窛鍧囧，

本文編號：2141997