【摘要】：目的：隨著口腔醫(yī)學(xué)的發(fā)展與進步,牙種植術(shù)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(fù)方式。牙種植的全過程離不開影像技術(shù)的支持。應(yīng)用于牙種植中的傳統(tǒng)的影像學(xué)設(shè)備包括根尖片、曲面體層片以及多排螺旋CT等,這些影像學(xué)設(shè)備由于各種不足無法滿足牙種植臨床診療對影像學(xué)的需求。20世紀(jì)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(xué)診查手段。作為一種新興的影像學(xué)設(shè)備,CBCT也被廣泛地應(yīng)用于口腔臨床診療的各個領(lǐng)域,大量學(xué)者對CBCT的優(yōu)劣勢進行了相關(guān)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(shù)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(yīng)用價值,為CBCT在口腔種植中的臨床應(yīng)用提供指導(dǎo)與參考。方法：選取10例無牙頜下頜骨病例,制作實驗?zāi)Ｐ�。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(biāo)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?zāi)Ｐ蜕蠘?biāo)記標(biāo)志點作為放射標(biāo)記,確定測量線距以及測量截面。將標(biāo)記后的模型拍攝CBCT,影像數(shù)據(jù)導(dǎo)入設(shè)備自帶的DCTViewer軟件測量所標(biāo)記線距。去除包繞的蠟片及放射標(biāo)記,根據(jù)標(biāo)記點截開模型骨段,采用游標(biāo)卡尺直接測量標(biāo)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(biāo)卡尺對應(yīng)測量值進行配對樣本t檢驗,P0.05表示差異有統(tǒng)計學(xué)意義。結(jié)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(biāo)卡尺測量的相應(yīng)結(jié)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(jié)果與游標(biāo)卡尺直接測量結(jié)果之間差異無統(tǒng)計學(xué)意義(t值分別為-1.784、-1.981、-1.621、-1.684,P值均0.05)。CBCT測量結(jié)果與游標(biāo)卡尺直接測量結(jié)果之間無顯著差異。結(jié)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?qū)ο骂M任意牙位的骨量高度與厚度數(shù)據(jù)做出準(zhǔn)確評估。CBCT在牙齒種植術(shù)前骨量評估中具有很高的應(yīng)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