替牙期单侧完全性唇腭裂患者下颌骨对称性的锥形束CT研究

发布时间：2018-06-05 07:06

本文选题：单侧完全性唇腭裂 + 锥形束CT　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:对替牙期单侧完全性唇腭裂(Unilateral cleft lip and palate,UCLP)患者与非CLP(Cleft lip and palate,CLP)患者的下颌骨的锥形束CT(Cone-beam computed tomography,CBCT)影像资料进行对比分析,研究该类患者下颌骨的对称性、探讨替牙期UCLP患者下颌骨不对称的部位和原因,为了解该类患者颌骨的形态特点、正畸临床准确诊断、治疗提供理论依据和支持。方法:选取在青岛大学附属医院口腔正畸科就诊的替牙期UCLP患者20例(男12例,女8例,年龄9.24±1.56岁,颈椎骨龄9.13±1.53岁)作为UCLP组,另选替牙期非CLP患者20例(男12例,女8例,年龄9.22±1.39岁,颈椎骨龄9.20±1.46岁)作为对照组。对以上所有研究对象进行CBCT扫描,获得CBCT影像,利用Mimics17.0软件对下颌骨进行三维重建,在重建的三维图像上确定髁突顶点Con、髁突外点Conl、髁突内点Conm、喙突顶点Cor、下颌孔下点F等26个标志点,并对双侧下颌骨喙突长度、髁突长度、下颌角长度、下颌体中段长度、颏部长度、下颌升支长度、下颌体长度、髁突横径、尖牙区高度、尖牙区宽度、磨牙区高度、磨牙区宽度、下颌升支体积以及半侧下颌骨体积进行测量。所得数据使用SPSS22.0统计软件进行统计分析,对UCLP组裂隙侧和非裂隙侧、对照组的左右两侧分别进行配对t检验,比较UCLP组患者和对照组双侧下颌骨各段长度、宽度、高度和体积的差异,分析UCLP组与对照组下颌骨对称性的差异。结果:1.替牙期UCLP组患者裂隙侧与非裂隙侧下颌骨对称性比较:替牙期UCLP患者裂隙侧喙突长度、磨牙区颌骨高度、下颌升支体积均大于非裂隙侧,且差异具有统计学意义(P0.05);其余各项测量项目比较无统计学差异(P0.05)。2.对照组左右两侧下颌骨对称性比较:替牙期非CLP患者左右两侧各测量项目比较无统计学意义(P0.05)。结论:1.替牙期UCLP患者下颌骨存在不对称性:其中裂隙侧喙突长度、磨牙区颌骨高度、下颌升支体积大于非裂隙侧;其余下颌骨结构基本对称。2.替牙期非CLP患者左右两侧下颌骨具有较好的对称性。
[Abstract]:Objective: to study the symmetry of mandible in patients with unilateral cleft lip and palate (unilateral cleft lip and palate or UCLP) and those without CLP(Cleft lip and palateur (UCLP) with conical bundle CT(Cone-beam computed tomographyCT-CTs (CBCTs), and to study the symmetry of mandible in patients with unilateral cleft lip and palate. To investigate the position and cause of mandibular asymmetry in patients with UCLP in dental replacement stage, and to provide theoretical basis and support for understanding the morphological characteristics of mandible, accurate diagnosis of orthodontic clinic and treatment of this kind of patients. Methods: twenty patients (male 12, female 8, age 9.24 卤1.56 years, cervical vertebra bone age 9.13 卤1.53 years) with UCLP in the orthodontic department of affiliated Hospital of Qingdao University were selected as UCLP group. Age 9.22 卤1.39 years old, cervical spine bone age 9.20 卤1.46 years old) as control group. All the subjects were scanned by CBCT, CBCT images were obtained, and the mandible was reconstructed by Mimics17.0 software. The condylar vertex Conl, condylar outer point, condylar internal point Conm, coracoid vertex Corm, mandibular foramen inferior point F were determined on the reconstructed 3D images. The bilateral mandibular coracoid process length, condylar process length, mandibular angle length, and middle mandibular length were determined. Chin length, mandibular ramus length, mandibular body length, transverse diameter of condyle, height of canine region, width of canine region, height of molar region, width of molar region, volume of mandibular ascending branch and volume of hemilateral mandible were measured. The data were statistically analyzed by SPSS22.0 software. The fracture side and non-fissure side of UCLP group and the left and right sides of the control group were matched with t test respectively. The length and width of bilateral mandibular segments in UCLP group and control group were compared. The height and volume of mandibular symmetry in UCLP group and control group were analyzed. The result is 1: 1. Comparison of mandibular symmetry between fissure side and unfractured side in UCLP group: the length of coracoid process, the height of mandible in molar region, and the volume of mandibular ascending branch in patients with UCLP at replacement stage were all larger than those in non-fractured side. The difference was statistically significant (P 0.05), and there was no statistical difference between the other items (P 0.05). 2. Symmetry comparison of left and right mandibles in the control group: there was no significant difference between the left and right sides of the patients with CLP in the stage of tooth replacement (P 0.05). Conclusion 1. There were asymmetry in mandible of UCLP patients in replacement stage: the length of coracoid process of fissure, the height of mandible in molar region, the volume of mandibular ramus was larger than that of non-fissure side, and the other mandibular structure was basically symmetrical. 2. The left and right mandibles of non-CLP patients at dental replacement stage have good symmetry.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.2

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