文章摘要
万蕾蕾,张纪春,马静雯,王 莉,宋 萌.锥形束CT测量上颌第一磨牙根分叉形态的临床研究[J].,2018,(11):2081-2085
锥形束CT测量上颌第一磨牙根分叉形态的临床研究
Clinical Research of Cone-beam computed Tomography in Assessing the Furcation Involvement of Maxillary Molar
投稿时间:2017-11-15  修订日期:2017-12-12
DOI:10.13241/j.cnki.pmb.2018.11.017
中文关键词: 锥形束CT  上颌第一磨牙  根分叉形态
英文关键词: CBCT  First maxillary molars  Furcation involvement
基金项目:国家自然科学基金青年基金项目(11602140)
作者单位E-mail
万蕾蕾 上海交通大学附属第一人民医院口腔科 上海 200080 shiyiwll@163.com 
张纪春 上海交通大学附属第一人民医院口腔科 上海 200080  
马静雯 上海交通大学附属第一人民医院口腔科 上海 200080  
王 莉 上海交通大学附属第一人民医院口腔科 上海 200080  
宋 萌 上海交通大学附属第一人民医院口腔科 上海 200080  
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中文摘要:
      摘要 目的:评价锥形束CT(cone beam computed tomography,CBCT)对于上颌第一磨牙根分叉形态的评估价值。方法:选取14例被诊断为广泛性重度慢性牙周炎的患者,给予规范化牙周基础治疗,在再评估阶段,选取由于牙周袋探针深度>6 mm或者有根分叉病变需要进一步手术治疗的患牙,利用CBCT行术前影像学检测并评估根分叉形态和病变程度。共计20颗上颌第一磨牙被纳入研究,比较术中所见根分叉形态与CBCT影像学测量结果。结果:总的CBCT检查与术中结果所得根分叉病变分度完全一致率为80%,两种方法检测的根分叉结果一致性在颊侧最高,之后依次为远中腭部、近中腭部。CBCT测得的根分叉区垂直骨缺损[(4.29±1.67)mm]与术中直接测量值[(4.67±1.77)mm]差异无统计学意义(p>0.05);此外,CBCT测得的骨嵴顶水平根分叉开口宽度为[(4.69±2.48)mm],术中探查为[(5.02±2.34)mm],两者比较差异无统计学意义(p>0.05);两者测得的根分叉角度差异亦无统计学意义(p>0.05),CBCT为35.9±10.4,术中为37.4±9.5。而根分叉水平骨吸收[(2.31±1.12)mm]与术中测量值[(2.67±1.14)mm],但差异的平均值为0.36 mm。结论:CBCT影像在临床诊断评估根分叉病变的分型和牙周组织的丧失有很高的准确性。
英文摘要:
      ABSTRACT Objective: To investigate the accuracy of cone beam computed tomography (CBCT) in detecting the furcation involvement (FI) of the first maxillary molars. Methods: Fourteen patients with generalized advanced chronic periodontitis were consecutively recruited after non-surgically therapy. In the first maxillary molars considered for furcation surgery due to advanced FI and/or increased probing pocket depths of ≥6 mm during re-evaluation, CBCT was performed and the degree of FI was evaluated from the CBCT images. Furcation surgery was performed in 20 first maxillary molars. Lastly, intra-surgical FI assessments werecompared with CBCT images-based data. Results: Overall, 80% of the CBCT data were confirmed by the intra-surgical findings. The agreement between both assessments was the highest in buccal furcation entrances, followed by distopalatal and mesiopalatal. Of the four parameters tested of detailed root furcation morphology, the vertical bone loss, the mesial-distal bone loss and root furcation angle revealed by CBCT were consistent with their associated intra-surgical values (p>0.05): for vertical bone loss, CBCT was (4.29±1.67)mm, but in surgery was (4.67±1.77)mm; for the mesial-distal bone loss, CBCT was (4.69±2.48)mm, but in surgery was (5.02±2.34)mm; for the root furcation angle, CBCT was 35.9±10.4。, but in surgery was 37.4±9.5. However, for the horizontal bone loss, CBCT was (2.31±1.12)mm, which is significantly smaller than that in surgery (2.67±1.14)mm. The mean difference was only 0.36 mm. Conclusion: CBCT images demonstrated a high accuracy in assessing the classifying the degree of FI and root morphologies in maxillary molars.
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