【摘要】：目的:通過對單側(cè)完全性牙槽突裂患者術(shù)前及術(shù)后不同時間段拍攝錐形束CT(cone beam computed tomography CBCT),準(zhǔn)確測量出單側(cè)完全性牙槽突裂患者植骨術(shù)前裂隙區(qū)缺損的大小及術(shù)后不同時期植骨區(qū)的骨剩余量的多少,準(zhǔn)確地了解在植骨區(qū)域的骨量變化情況,為臨床醫(yī)生做植骨術(shù)前的評估及植骨術(shù)后各時期的評價提供參考。方法:選取南昌大學(xué)附屬口腔醫(yī)院26例單側(cè)完全性牙槽突裂的住院患者,行常規(guī)髂骨松質(zhì)骨植入術(shù)。根據(jù)尖牙是否萌出于牙齦,分為兩組(A組和B組)。裂隙側(cè)尖牙已萌出的患者歸為A組,裂隙側(cè)尖牙未萌出的患者歸為B組,其中A組14例,B組12例。A、B兩組所有人員均在術(shù)前1周及術(shù)后1周、1個月、3個月、6個月在我院影像科行CBCT拍攝,并將文件導(dǎo)入Ka Vo e Xam Vision軟件及Image-J軟件中,從而獲取術(shù)前牙槽突裂的體積及術(shù)后骨剩余量的體積,并計算術(shù)后各階段的植入骨體積的吸收量及吸收率。結(jié)果:A、B兩組術(shù)后1個月骨吸收量分別為0.47±0.11cm3、0.25±0.09cm3;術(shù)后3個月骨吸收量分別為0.57±0.14cm3、0.45±0.18cm3;術(shù)后6個月骨吸收量分別為0.84±0.17cm3、0.63±0.20cm3。A、B兩組術(shù)后1個月骨吸收率分別為29±4%、16±3%;術(shù)后3個月骨吸收率分別為36±5%、28±4%;術(shù)后6個月骨吸收率分別為52±2%、42±3%。AB組內(nèi)比較:A組術(shù)后1周內(nèi)植骨區(qū)的平均體積與術(shù)后1個月相比P0.05,差異有統(tǒng)計學(xué)意義。術(shù)后1個月植骨區(qū)的平均體積與術(shù)后3個月相比P0.05,差異無統(tǒng)計學(xué)意義。術(shù)后3個月植骨區(qū)的平均體積與術(shù)后6個月植骨區(qū)的平均體積相比P0.05,差異無統(tǒng)計學(xué)意義;B組術(shù)后1周內(nèi)植骨區(qū)的平均體積與術(shù)后1個月相比P0.05,差異有統(tǒng)計學(xué)意義。術(shù)后1個月植骨區(qū)的平均體積與術(shù)后3個月相比P0.05,差異無統(tǒng)計學(xué)意義。術(shù)后3個月植骨區(qū)的平均體積與術(shù)后6個月植骨區(qū)的平均體積相比P0.05,差異無統(tǒng)計學(xué)意義。AB組間比較:術(shù)前1周裂隙區(qū)體積A、B兩組間無統(tǒng)計學(xué)差異(P0.05);術(shù)后1周骨體積A、B兩組間無統(tǒng)計學(xué)差異(P0.05);術(shù)后1個月骨吸收量體積A、B兩組間有統(tǒng)計學(xué)差異(P0.05);術(shù)后3個月骨吸收量體積A、B兩組間有統(tǒng)計學(xué)差異(P0.05);術(shù)后6個月骨吸收量體積A、B兩組間有統(tǒng)計學(xué)差異(P0.05)。結(jié)論:1、通過CBCT軟件并結(jié)合Image-J軟件來計算牙槽突裂術(shù)前缺損體積及術(shù)后骨剩余量的體積,是既科學(xué)又可行的一種方法。2、無論在行牙槽突裂植骨手術(shù)時,患者的尖牙是否萌出,術(shù)后1個月內(nèi)為體積吸收高峰期,3個月時為相對穩(wěn)定狀態(tài)�；颊呖梢栽谛g(shù)后1-3個月先行正畸治療,3個月時進(jìn)行后期的修復(fù)治療。3、術(shù)后6個月內(nèi)發(fā)生的骨吸收量及吸收率,尖牙未萌的患者一直小于尖牙已萌患者,植骨前要重點考慮患者的牙齡。4、通過計算術(shù)前裂隙區(qū)的體積及術(shù)后植骨區(qū)的體積,為臨床醫(yī)生手術(shù)入路、植骨的超填及術(shù)后評價各時間段植入骨的吸收情況提供了具有參考意義的理論依據(jù)。
[Abstract]:Objective: to accurately measure the size of fracture area defect before and after bone grafting in unilateral complete alveolar process fissure patients by using CT (cone beam computed tomography CBCT), of conical beam at different time points before and after operation. The amount of bone remaining in the bone graft area during the period, To accurately understand the changes of bone mass in the area of bone graft and to provide references for clinicians to evaluate before and after bone grafting. Methods: 26 inpatients with unilateral complete alveolar process fractures in the affiliated Stomatological Hospital of Nanchang University were selected and treated with conventional iliac cancellous bone implantation. They were divided into two groups (group A and group B) according to whether the canines were cute or not. The patients whose fissured canines had erupted were classified as group A, and those whose fissures did not erupt were classified as group B. There were 14 cases in group A and 12 cases in group B. all the people in group A and group B were photographed by CBCT in our department of imaging at 1 week before operation and 1 week, 1 month, 3 months and 6 months after operation, and the files were imported into Ka Vo e Xam Vision software and Image-J software. The volume of alveolar process fissure before operation and the volume of bone surplus after operation were obtained, and the absorption and absorptivity of implanted bone volume were calculated. Results: the bone resorption was 0.47 鹵0.11 cm _ 3 0.25 鹵0.09 cm _ 3 at one month, 0.57 鹵0.14 cm _ 3 0.45 鹵0.18 cm _ 3 at 3 months after operation, 0.84 鹵0.17 cm _ 3 0.63 鹵0.20 cm ~ (-3) bone resorption at 6 months after operation, and 29 鹵4 ~ 16 鹵3 cm ~ (th) at 1 month after operation in group A and B, and the bone resorption rate was 29 鹵4 ~ 16 鹵3 in group B at 1 month after operation, respectively, and at 3 months after operation, the bone resorption was 0.84 鹵0.17 cm ~ (3) and 0.63 鹵0.20 cm ~ (-3) in group A and B, respectively. The bone absorptivity at 6 months after operation was 52 鹵2 and 42 鹵3%.AB, respectively. The mean volume of bone graft area in group A was significantly higher than that in group A at 1 week after operation (P 0.05). There was no significant difference in the mean volume of bone graft area between 1 month and 3 months after operation (P 0.05). There was no significant difference between the average volume of bone graft area 3 months after operation and the average volume of bone graft area 6 months after operation (P 0.05), but the average volume of bone graft area in group B was significantly higher than that in group B (P 0.05) within 1 week after operation compared with that at 1 month after operation. There was no significant difference in the mean volume of bone graft area between 1 month and 3 months after operation (P 0.05). There was no significant difference between the average volume of bone graft area 3 months after operation and the average volume of bone graft area at 6 months postoperatively, there was no significant difference between the two groups in AB group: the volume of fissure area was no significant difference between the two groups at 1 week before operation (P0.05), and the bone body volume at 1 week after operation was not significantly different between the two groups (P0.05). There was no statistical difference between the two groups (P0.05), the volume of bone resorption at one month after operation was significantly different between the two groups (P0.05), the volume of bone resorption at 3 months after operation was significantly different between the two groups (P0.05), and the volume of bone resorption at 6 months after operation was significant between the two groups (P0.05). There was statistical difference between the two groups (P0.05). Conclusion: 1. It is a scientific and feasible method to calculate the volume of alveolar process fissure defect before operation and the volume of bone surplus after operation by CBCT software and Image-J software. The volume absorption peak within 1 month after operation was relatively stable at 3 months. Patients can be treated with orthodontic treatment in 1-3 months after operation, and later repair treatment at 3 months. 3. Bone resorption and absorption rate occurred within 6 months after operation. Before bone grafting, we should consider the patient's tooth age. 4. By calculating the volume of the fracture area before and after the operation, the volume of the bone graft area should be used as the clinician's operative approach. The overfilling of bone graft and the evaluation of bone resorption in each time period provide a theoretical basis for reference.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R783.6

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