锥束CT评价下颌磨牙根分叉病变再生治疗疗效

发布时间：2018-04-15 08:30

本文选题：锥束计算机体层摄影术 + 根分叉部缺损　；参考：《北京大学学报(医学版)》2014年05期

【摘要】：目的:利用锥束计算机体层摄影术(cone-beam computed tomography,CBCT)分析和评价下颌磨牙根分叉病变再生治疗的疗效。方法:纳入需进行牙周手术的38例下颌磨牙根分叉病变,随机分为2组,实验组采用引导性组织再生术+植骨术进行治疗,对照组进行单纯翻瓣术。在术前和术后1年时分别对患牙进行临床检查,并拍摄CBCT。比较实验组和对照组各自手术前后临床数据和CBCT数据的变化,并比较两组数据变化间的差别。结果:基线时两组的探诊深度、垂直向附着丧失和水平向附着丧失差异均无统计学意义(P0.05)。术后1年时,除牙龈退缩外,两组临床指标均有显著改善(P0.001),但实验组垂直向附着获得和水平向附着获得分别为(3.20±1.82)mm和(2.05±1.27)mm,显著高于对照组相应指标的变化(P0.001)。基线时两组CBCT显示的水平骨丧失、垂直骨丧失差异均无统计学意义(P0.05);术后1年时,实验组垂直向骨缺损和水平向骨缺损较基线时和对照组均有显著改善(P0.001),分别减少(2.82±0.97)mm和(2.24±0.92)mm。结论:引导性组织再生术+植骨术对于下颌磨牙Ⅱ度根分叉病变的治疗效果显著优于翻瓣术,CBCT可以较好地反映下颌磨牙根分叉区域的水平向和垂直向的骨缺损改善情况,较为全面地补充临床检查和传统X线根尖片的不足。
[Abstract]:Objective: to evaluate the efficacy of cone-beam computed tomphography in the treatment of mandibular molar root bifurcation.Methods: 38 cases of mandibular molar root bifurcation were randomly divided into two groups. The experimental group was treated with guided tissue regeneration and bone graft, while the control group was treated with simple flap.The teeth were examined before operation and 1 year after operation, and CBCTs were taken.The changes of clinical data and CBCT data before and after operation were compared between the experimental group and the control group, and the differences between the two groups were compared.Results: there was no significant difference in probing depth, vertical attachment loss and horizontal attachment loss between the two groups at baseline (P 0.05).At 1 year after operation, the clinical indexes of both groups were significantly improved except gingival retraction, but the vertical attachment and horizontal attachment in the experimental group were 3.20 卤1.82)mm and 2.05 卤1.27 mm, respectively, which were significantly higher than those in the control group (P 0.001).At baseline, there was no significant difference in horizontal bone loss and vertical bone loss in CBCT between the two groups. At 1 year after operation, the vertical bone defect and horizontal bone defect in the experimental group were significantly improved than those in the baseline and control group (P 0.001), reducing 2.82 卤0.97)mm and 2.24 卤0.92mmm. respectively.Conclusion: the therapeutic effect of guided tissue regeneration and bone grafting on mandibular molar secondary root bifurcation is significantly better than that of CBCT in reflecting the improvement of horizontal and vertical bone defects in mandibular molar.The deficiency of clinical examination and traditional X-ray apical film was completely supplemented.
【作者单位】：北京大学口腔医学院·口腔医院第一门诊部;北京大学口腔医学院·口腔医院放射科;
【分类号】：R781.42

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