CBCT配準(zhǔn)研究青春生長迸發(fā)期下頜神經(jīng)管的縱向穩(wěn)定性
發(fā)布時(shí)間：2018-09-01 19:15
【摘要】：目的本研究以正畸矯治前后的CBCT數(shù)據(jù)為依據(jù),研究青春生長迸發(fā)期下頜神經(jīng)管的縱向穩(wěn)定性,從三維角度進(jìn)一步評價(jià)Bjork結(jié)構(gòu)化重疊方法的有效性,為下頜神經(jīng)管在影像重疊技術(shù)中的臨床應(yīng)用提供重要的理論依據(jù)。材料和方法本研究選取2011到2014年間接受非拔牙正畸治療的30名患者,其中包括16名女性(平均年齡為12.31±0.60),14名男性(平均年齡為12.69±0.79),這些患者均處于青春生長迸發(fā)期階段,即CVM頸椎評價(jià)方法的CS3階段,正畸治療時(shí)間間隔平均為24.47-2.26月,所有研究對象滿足一類(?)關(guān)系及一類骨面型,且無顱面部骨骼發(fā)育畸形。所有患者由同一操作者進(jìn)行頭頸部CBCT掃描,掃描數(shù)據(jù)以DICOM格式輸出并儲存,數(shù)據(jù)導(dǎo)入到Mimics 17.0軟件中,運(yùn)用Mimics手術(shù)仿真模擬工具選取下頜神經(jīng)管,與重建的下頜骨模型合并形成包含下頜神經(jīng)管的下頜骨三維結(jié)構(gòu),所有的三維圖像模型以STL格式導(dǎo)出。利用Mimics軟件打開患者矯治后的CBCT數(shù)據(jù),把該患者矯治前和矯治后的STL文件同時(shí)導(dǎo)入到該CBCT數(shù)據(jù)文件中,利用Mimics軟件的點(diǎn)配準(zhǔn)及局部STL配準(zhǔn)功能,選取頦聯(lián)合內(nèi)部骨皮質(zhì)下緣輪廓作為配準(zhǔn)參考面,對矯治前后的STL數(shù)據(jù)進(jìn)行精確配準(zhǔn),配準(zhǔn)完成后選取下頜骨可見兩側(cè)后牙鄰接面的水平層面,在該水平面上選取下頜神經(jīng)管的矢狀向截面(S截面)和冠狀向截面(C截面,C1-C4截面),S1與矯治后下頜神經(jīng)管內(nèi)側(cè)緣相切,S2為S1與S3的中間截面,S3-S6分別與矯治后第二磨牙、第一磨牙、第二前磨牙以及第一前磨牙外側(cè)緣相切,Cl與矯治后下頜管下緣相切,C2-C4分別與矯治后第二磨牙、第一磨牙以及第二前磨牙下緣相切,C5為經(jīng)矯治后頦孔最下緣的水平面上與下頜神經(jīng)管下緣相切的冠狀截面。在S截面測量下頜神經(jīng)管矢狀向和垂直向矯治前后坐標(biāo)變化值,在C截面測量下頜神經(jīng)管冠狀向矯治前后坐標(biāo)變化值,左右兩側(cè)分開測量,用SPSS19.0軟件對左右兩側(cè)各截面相關(guān)測量數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,檢驗(yàn)標(biāo)準(zhǔn)設(shè)為P0.05。結(jié)果1.左側(cè)下頜神經(jīng)管與右側(cè)下頜神經(jīng)管測量坐標(biāo)數(shù)值的比較分析所有矢狀向及冠狀向截面的左右側(cè)下頜神經(jīng)管坐標(biāo)測量數(shù)值均沒有統(tǒng)計(jì)學(xué)差異。2.男性與女性下頜神經(jīng)管測量坐標(biāo)數(shù)值的比較分析所有矢狀向及冠狀向截面的男性與女性下頜神經(jīng)管坐標(biāo)測量數(shù)值均沒有統(tǒng)計(jì)學(xué)差異。3.下頜神經(jīng)管垂直向的變化S1矢狀向截面下頜神經(jīng)管矯治后向下移動了0.75±0.12mm,S2矢狀向截面下頜神經(jīng)管矯治后向下移動了0.32±0.10mm,S3-S6矢狀向截面下頜神經(jīng)管垂直方向的測量值均無統(tǒng)計(jì)學(xué)差異。4.下頜神經(jīng)管矢狀向的變化S1、S2、S3矢狀向截面下頜神經(jīng)管分別向前移動了0.71±0.11mm、0.49±0.09 mm、0.30±0.08mm。S4, S5, S6矢狀截面下頜神經(jīng)管矢狀向的測量值均無統(tǒng)計(jì)學(xué)差異。5.下頜神經(jīng)管水平向的變化C1冠狀向截面下頜左右側(cè)神經(jīng)管外側(cè)位移量分別為0.34±0.09mm和0.44±0.08mm。C2冠狀向截面左右側(cè)神經(jīng)管外側(cè)位移量分別為0.22±0.07mm和0.29±0.08mm。C3冠狀向截面左右側(cè)神經(jīng)管外側(cè)位移量分別為0.13±0.06mm和0.15±0.07mm。C4冠狀向截面左右側(cè)神經(jīng)管外側(cè)位移量分別為0.13±0.06mm和0.14±0.07mm。C5冠狀向截面左右側(cè)神經(jīng)管外側(cè)位移量分別為0.13±0.06mm和0.14±0.07mm。所有冠狀向截面中的下頜左右側(cè)神經(jīng)管均存在外側(cè)移位。結(jié)論(1)在青春生長迸發(fā)期,伴隨著下頜骨的快速生長,下頜神經(jīng)管發(fā)生外側(cè)移位,下頜升支位置神經(jīng)管的外側(cè)位移量大于下頜骨體部神經(jīng)管的外側(cè)位移量。(2)在垂直向和矢狀向上,下頜神經(jīng)管在下頜體前部接近頦孔的部分存在穩(wěn)定性,在下頜體接近升支部分及升支部分的下頜神經(jīng)管存在顯著地向前、向下移位。
[Abstract]:Objective To study the longitudinal stability of mandibular nerve canal during puberty outburst and to evaluate the effectiveness of Bjork's structural overlap method from three-dimensional perspective based on CBCT data before and after orthodontic treatment. Thirty patients who received non-extraction orthodontic treatment from 2011 to 2014 were selected, including 16 females (mean age 12.31 0.60), 14 males (mean age 12.69 65507 All patients were scanned by the same operator on CBCT. The scanned data were output and stored in DICOM format. The data were imported into Mimics 17.0 software. The mandibular nerve canal was selected by Mimics simulation tool and the mandibular bone model was reconstructed. All three-dimensional image models were derived in STL format. The CBCT data of the patients were opened by Mimics software. The STL files of the patients before and after treatment were imported into the CBCT data files simultaneously. The point registration and local STL registration functions of Mimics software were used. STL data before and after orthodontic treatment were accurately registered. Horizontal planes of mandibular visible posterior teeth adjacent to each other were selected. Sagittal section (S section) and coronal section (C section, C1-C4 section) of mandibular nerve canal were selected on the horizontal plane. After treatment, the lateral margin of the mandibular nerve canal is tangent, S2 is the middle section of S1 and S3, S3-S6 is tangent with the second molar, the first molar, the second premolar and the lateral margin of the first premolar respectively, Cl is tangent with the lower margin of the mandibular canal, C2-C4 is tangent with the second molar, the first molar and the lower margin of the second premolar respectively, C5 is tangent after treatment. The coordinate changes of the mandibular nerve canal before and after sagittal and vertical correction were measured on the S-section. The coordinate changes of the mandibular nerve canal before and after the coronal correction were measured on the C-section. The measurement data were statistically analyzed, and the test standard was set as P 0.05. Results 1. Comparing the measured coordinates of the left mandibular canal with that of the right mandibular canal, there was no statistical difference between the measured coordinates of the left and right mandibular canal in all sagittal and coronal sections. There was no significant difference between male and female mandibular canal coordinate measurements in all sagittal and coronal sections. There was no significant difference in the sagittal direction of the mandibular canal between - S6 and - S6. There was no significant difference in the sagittal direction of the mandibular canal between - S6, S5 and S6. The lateral displacement of the left and right mandibular canals on the coronal section of C1 was 0.34 (+ 0.09mm) and 0.44 (+ 0.08mm). The lateral displacement of the left and right canals on the coronal section of C2 was 0.22 (+ 0.07 mm) and 0.29 (+ 0.08mm). The lateral displacement of the left and right canals on the coronal section of C3 was 0.13 (+ 0.06mm) and 0.15 (+ 0.07 mm) respectively. The lateral displacement of the left and right canals on the coronal section were 0.13 (+ 0.06mm) and 0.14 (+ 0.07 mm) respectively. The lateral displacement of the left and right canals on the coronal section were 0.13 (+ 0.06mm) and 0.14 (+ 0.07 mm) respectively. There were lateral displacements of the left and right canals of the mandible in all coronal sections. The lateral displacement of the mandibular nerve canal was greater than that of the nerve canal in the mandibular body. (2) In the vertical and sagittal directions, the mandibular nerve canal was stable in the anterior part of the mandible near the mandibular foramen, and in the mandible near the ascending branch and the mandibular part. The neural tube is significantly moving forward and downward.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R783.5
本文編號：2218100
[Abstract]:Objective To study the longitudinal stability of mandibular nerve canal during puberty outburst and to evaluate the effectiveness of Bjork's structural overlap method from three-dimensional perspective based on CBCT data before and after orthodontic treatment. Thirty patients who received non-extraction orthodontic treatment from 2011 to 2014 were selected, including 16 females (mean age 12.31 0.60), 14 males (mean age 12.69 65507 All patients were scanned by the same operator on CBCT. The scanned data were output and stored in DICOM format. The data were imported into Mimics 17.0 software. The mandibular nerve canal was selected by Mimics simulation tool and the mandibular bone model was reconstructed. All three-dimensional image models were derived in STL format. The CBCT data of the patients were opened by Mimics software. The STL files of the patients before and after treatment were imported into the CBCT data files simultaneously. The point registration and local STL registration functions of Mimics software were used. STL data before and after orthodontic treatment were accurately registered. Horizontal planes of mandibular visible posterior teeth adjacent to each other were selected. Sagittal section (S section) and coronal section (C section, C1-C4 section) of mandibular nerve canal were selected on the horizontal plane. After treatment, the lateral margin of the mandibular nerve canal is tangent, S2 is the middle section of S1 and S3, S3-S6 is tangent with the second molar, the first molar, the second premolar and the lateral margin of the first premolar respectively, Cl is tangent with the lower margin of the mandibular canal, C2-C4 is tangent with the second molar, the first molar and the lower margin of the second premolar respectively, C5 is tangent after treatment. The coordinate changes of the mandibular nerve canal before and after sagittal and vertical correction were measured on the S-section. The coordinate changes of the mandibular nerve canal before and after the coronal correction were measured on the C-section. The measurement data were statistically analyzed, and the test standard was set as P 0.05. Results 1. Comparing the measured coordinates of the left mandibular canal with that of the right mandibular canal, there was no statistical difference between the measured coordinates of the left and right mandibular canal in all sagittal and coronal sections. There was no significant difference between male and female mandibular canal coordinate measurements in all sagittal and coronal sections. There was no significant difference in the sagittal direction of the mandibular canal between - S6 and - S6. There was no significant difference in the sagittal direction of the mandibular canal between - S6, S5 and S6. The lateral displacement of the left and right mandibular canals on the coronal section of C1 was 0.34 (+ 0.09mm) and 0.44 (+ 0.08mm). The lateral displacement of the left and right canals on the coronal section of C2 was 0.22 (+ 0.07 mm) and 0.29 (+ 0.08mm). The lateral displacement of the left and right canals on the coronal section of C3 was 0.13 (+ 0.06mm) and 0.15 (+ 0.07 mm) respectively. The lateral displacement of the left and right canals on the coronal section were 0.13 (+ 0.06mm) and 0.14 (+ 0.07 mm) respectively. The lateral displacement of the left and right canals on the coronal section were 0.13 (+ 0.06mm) and 0.14 (+ 0.07 mm) respectively. There were lateral displacements of the left and right canals of the mandible in all coronal sections. The lateral displacement of the mandibular nerve canal was greater than that of the nerve canal in the mandibular body. (2) In the vertical and sagittal directions, the mandibular nerve canal was stable in the anterior part of the mandible near the mandibular foramen, and in the mandible near the ascending branch and the mandibular part. The neural tube is significantly moving forward and downward.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R783.5
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