颌骨囊肿邻近牙在手术前后牙髓活力变化的临床研究

发布时间：2018-06-19 22:12

  本文选题：颌骨囊肿邻近牙 + 牙髓活力变化　； 参考：《青岛大学》2017年硕士论文

【摘要】：目的:分析比较颌骨囊肿邻近牙齿在手术前后的牙髓活力变化,探讨颌骨囊肿邻近牙齿根尖孔至囊肿的最近距离与牙髓活力变化的关系,从而为颌骨囊肿病变邻近牙齿的术前处理提供临床借鉴。方法:1、收集2016年4月至2016年12月期间,青岛大学附属医院收治的33例颌骨囊肿(牙源性)患者的邻近囊肿的57颗牙齿,应用牙髓活力电测试仪分别检测这些牙齿在手术前1周内与手术后3个月的牙髓活力值,并计算两者之间的差值(记为d,d=术后3个月的牙髓活力值-术前1周内的牙髓活力值)。2、手术前在CBCT(植入物屏幕)扫描图像上,利用系统自带的线性测量软件测量颌骨邻近牙齿的根尖孔至囊肿的最近距离(以D表示),以颌骨囊肿邻近牙齿的根尖孔至囊肿的最近距离为依据设置为4个组,分别为:(1)R1组:D≤1mm,(2)R2组:1mmD≤2mm,(3)R3组:2mmD≤3mm,(4)R4组:D3mm。3、对4个组牙齿的术前术后牙髓活力值的差值及差值与根尖孔至囊肿的最近距离分别应用SPSS 22.0统计学软件中的方差分析和spearman关联性分析的统计学方法进行分析。结果:1、57颗牙齿在术后3个月有16颗死髓牙,占总数的28.07%。4个组在术前1周内与术后3个月测试的牙髓活力值的差值的统计结果显示:F=5.916,P=0.0010.05(检验水准α=0.05),差异具有统计学意义;R1组(D≤1mm)与其他3个组之间的比较结果中,标准误sx分别为:8.353、7.953、7.519,P值均小于0.05(检验水准α=0.05),差异具有统计学意义,R2组(1mmD≤2mm)、R3组(2mmD≤3mm)、R4组(D3mm)间两两比较时,P值均大于0.05,差异无统计学意义。2、颌骨囊肿邻近牙齿在手术前1周内与手术后3个月的牙髓活力变化的差值(d)与这些牙齿的根尖孔至囊肿的最近距离(D)的关联性分析结果显示:r=-0.345,P=0.0090.05(检验水准α=0.05),两者之间呈负相关,且差异具有统计学意义。结论:1、囊肿邻近牙齿术后死髓的概率为28.07%。2、囊肿邻近牙齿的根尖孔至囊肿的距离≤1mm时,术后牙髓活力受损的机率高达64.71%,建议术前行根管治疗,囊肿邻近牙齿的根尖孔至囊肿的距离为1mm~3mm时,可予以观察,囊肿邻近牙齿的根尖孔至囊肿的距离3mm时,术前无需行根管治疗。
[Abstract]:Objective: to compare the changes of pulp activity in teeth adjacent to maxillary cyst before and after operation, and to explore the relationship between the proximal distance from apical foramen to cyst and the change of pulp activity. Therefore, it can provide clinical reference for the preoperative treatment of adjacent teeth with jaw cyst disease. Methods from April 2016 to December 2016, 57 teeth were collected from 33 patients with maxillary cyst (odontogenic) treated in Qingdao University affiliated Hospital. The pulp activity of these teeth was measured 1 week before operation and 3 months after operation by using dental pulp activity test. The difference between the two was calculated (denoted d = the pulp activity value of 3 months postoperatively) and the pulp activity value of 1 week before operation was calculated. The CBCT (implant screen) scan image was performed before the operation. The proximal distance from apical foramen to cyst of adjacent teeth of jaw was measured by linear measurement software (expressed as D), and four groups were set according to the closest distance from apical foramen of teeth adjacent to maxillary cyst to cyst. The two groups were divided into two groups: 1: D 鈮，

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