锥形束CT对上颌后牙区正畸微种植体支抗植入安全区的测量研究

发布时间：2018-04-10 14:16

本文选题：微种植体 + 安全区　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：利用锥形束CT(CBCT)测量上颌双侧后牙区相邻两牙牙根之间的近远中距离，以及上颌窦最低点与水平面的垂直距离，结合正畸石膏模型中的上颌双侧后牙牙冠高度的测量值以及口内上颌双侧后牙相应附着龈宽度的测量值进行综合分析，最终确定上颌后牙区正畸微种植体支抗植入的安全区，以期为正畸医师的临床操作提供参考。方法：选择2012年1月至2012年12月期间于沈阳军区总医院口腔门诊正畸诊室就诊符合研究条件的正畸前患者病例资料21例，其中男性患者病历资料8例，女性患者病例资料13例，年龄范围为15-30岁，平均年龄为（19.5±4.6）岁。使用德国卡瓦公司生产的由扫描仪和计算机工作站组成KaVo3D exam Vision成像系统来获取患者头颈部的锥束容积断层图像并进行数据重建，重建结果以DICOM3.0的格式输出并进行保存。口腔颌面部锥形束CT重建后的数据使用InvivoDental5.0三维头影测量分析软件以三维影像的形式呈现，在Invivo Dental5.0软件的Scetion窗口中确定测量的水平面、矢状面以及冠状面，然后使用软件自带的测量功能分别测量上颌左右两侧后牙区相邻两牙牙根在距水平面6、8、10、12、14、16mm处的近远距离,以及上颌窦最低点与水平面的垂直距离。同时，在患者口外使用游标卡尺测量患者正畸前上颌牙列石膏模型中的上颌后牙牙冠高度；在患者口内使用牙周探针以牙体长轴为标准，分别测量游离龈的宽度以及龈缘至膜龈联合的宽度，并最终得出患者附着龈的宽度。综合分析测量所得的数据及上述各解剖结构之间的关系，最终得出上颌后牙区正畸微种植体支抗植入的安全区。结果：1.上颌后牙区相邻两牙牙根近远中距离的测量结果显示上颌第二前磨牙和第一磨牙近中颊根之间的近远中距离最大，上颌第一前磨牙和上颌第二前磨牙牙根之间的近远中距离次之，而上颌第一磨牙远中颊根与上颌第二磨牙近中颊根之间的近远中距离变异较大。2.上颌窦底与水平面的距离从前磨牙至磨牙逐渐降低，在上颌第二磨牙区上颌窦底的位置与水平面距离最低。3.上颌后牙牙冠高度测量结果显示由上颌第一前磨牙至上颌第二磨牙牙冠高度依次减小，上颌第一前磨牙的牙冠高度最大。4.最终得出的上颌后牙区附着龈宽度结果显示由附着龈宽度由上颌第一前磨牙至上颌第二磨牙依次增大，上颌第二磨牙区的附着龈宽度最大。结论：上颌后牙区正畸微种植体支抗植入的安全区位于上颌第二前磨牙与上颌第一磨牙之间，距上颌第二前磨牙颊尖与上颌第一磨牙近中颊尖连线所确定水平面的垂直高度为10-11mm，过上颌第二前磨牙与上颌第一磨牙邻接点的切线偏远中并且正畸微种植体支抗植入时与水平面所成的角度不大于59°。
[Abstract]:Objective: to measure the proximal and distal distance between the roots of the two adjacent teeth and the vertical distance between the lowest point of maxillary sinus and the horizontal plane in the maxillary bilateral posterior region by CT-CBCT.Combined with the measurement value of crown height of maxillary bilateral posterior teeth and the width of corresponding attachment gingival of maxillary bilateral posterior teeth in orthodontic gypsum model, the safety zone of orthodontic micro-implant Anchorage in maxillary posterior teeth was determined.In order to provide reference for orthodontists' clinical operation.Methods: from January 2012 to December 2012, 21 cases of pre-orthodontic patients, including 8 male patients and 13 female patients, were selected from orthodontic clinic of Shenyang military region General Hospital.The age range was 15 to 30 years old, the average age was 19.5 卤4.6 years old.The KaVo3D exam Vision imaging system, which is made up of scanner and computer workstation, is used to obtain the volume tomography image of the head and neck of the patient and reconstruct the data. The reconstruction result is output and saved in the format of DICOM3.0.The data of conical beam CT reconstruction in oral and maxillofacial region were presented by InvivoDental5.0 three-dimensional cephalometric analysis software. The horizontal plane, sagittal plane and coronal plane were determined in the Scetion window of Invivo Dental5.0.Then the distance between the two adjacent roots of the maxillary left and right posterior teeth and the vertical distance between the lowest point of the maxillary sinus and the horizontal plane was measured by using the software's own measurement function at a distance of 6101012121416mm from the horizontal plane.At the same time, Vernier calipers were used to measure the crown height of maxillary posterior teeth in the plaster model of orthodontic maxillary dentition.The width of free gingiva and the width of gingival ligament to membranous gingival union were measured, and the width of adhesive gingiva was obtained.Finally, the safety zone of orthodontic micro-implant Anchorage in maxillary posterior teeth was obtained by synthetically analyzing the measured data and the relationship between the above anatomical structures.The result is 1: 1.The results of the measurement of the proximal distance between the two adjacent teeth in the maxillary posterior region showed that the proximal distance between the maxillary second premolar and the first molar proximal buccal root was the largest.The distance between the maxillary sinus floor and the horizontal surface gradually decreased from the anterior molar to the molar, and the distance between the position of the maxillary sinus floor and the horizontal plane was the lowest at the maxillary second molar region.The crown height of maxillary posterior teeth decreased from maxillary first premolar to maxillary second molar, and the crown height of maxillary first premolar was the largest.The results showed that the width of attachment gingival increased from maxillary first premolar to maxillary second molar, and the maxillary second molar was the largest.Conclusion: the safety zone of orthodontic microimplant Anchorage in the maxillary posterior region lies between the maxillary second premolar and the maxillary first molar.The vertical height of the horizontal plane from the buccal tip of the maxillary second premolar to the proximal middle buccal tip of the maxillary first molar is 10-11mm, the vertical height of the horizontal plane is 10-11mm, and the orthodontic implant Anchorage is located in the remote tangent of the adjacent point between the maxillary second premolar and the maxillary first molar.The angle between the implant and the horizontal plane was not greater than 59 掳.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.5

【参考文献】