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中华口腔医学研究杂志(电子版)

中华口腔医学研究杂志(电子版) ›› 2015, Vol. 09 ›› Issue (04) : 313 -317. doi: 10.3877/cma.j.issn.1674-1366.2015.04.011

所属专题： 专题评论； 文献；

临床研究

锥形束CT辅助美学区种植评价唇侧骨量的应用研究
封伟1, 耿进友2, 孙园园1, 耿海霞1,†(), 薛敏3()   
  1. 1. 272000　济宁医学院附属医院口腔科
    3. 272100　济宁医学院附属医院兖州院区口腔科
  • 收稿日期:2015-03-11 出版日期:2015-08-01
  • 通信作者: 耿海霞, 薛敏
  • 基金资助:
    山东省医药卫生科技发展计划(2013WS0343); 济宁市科技计划(医疗卫生，2014jnyx11); 济宁医学院青年基金(JYQ14KJ35)

The evaluation of CBCT in evaluation of post-implant labial bone mass during esthetic zone

Wei Feng1, Min Xue2, Jinyou Geng1, Yuanyuan Sun1(), Haixia Geng3,†()   

  1. 1. Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining 272000, China
    2. Department of Stomatology, Yanzhou Branch of Affiliated Hospital of Jining Medical University, Jining 272100, China
  • Received:2015-03-11 Published:2015-08-01
  • Corresponding author: Yuanyuan Sun, Haixia Geng
  • About author:
    Corresponding author: Geng Haixia, Email: , Tel: 0537-2903132
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引用本文：

封伟, 耿进友, 孙园园, 耿海霞, 薛敏. 锥形束CT辅助美学区种植评价唇侧骨量的应用研究[J]. 中华口腔医学研究杂志(电子版), 2015, 09(04): 313-317.

Wei Feng, Min Xue, Jinyou Geng, Yuanyuan Sun, Haixia Geng. The evaluation of CBCT in evaluation of post-implant labial bone mass during esthetic zone[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2015, 09(04): 313-317.

目的

应用锥形束CT(CBCT)比较拔牙后即刻种植与延期种植术后1年唇侧骨量变化的差异，评价CBCT在美学区种植唇侧骨量的诊断价值。

方法

选择2009年6月至2013年6月上颌前牙区完成单颗种植的患者22例，共22颗种植体，拔牙后即刻种植与延期种植各11颗。分别在种植术前1周、术后即刻与术后1年进行CBCT影像学检查，根据设计的测量位点评价唇侧骨高度与骨厚度变化，采用SPSS 13.0软件包对测量数据进行统计学分析，采用配对t检验比较所有病例术后即刻与术后1年唇侧骨高度与骨厚度的变化。

结果

即刻种植术后1年唇侧牙槽嵴高度变化差异有统计学意义(t=3.316，P=0.009)，延期种植差异无统计学意义(t=2.073，P=0.068)；两组术后1年唇侧骨厚度在距离种植体基台连接处1 mm处(t=2.369，P=0.042)与种植体中点处(t=3.474，P=0.007)差异均有统计学意义，在距离种植体底1 mm处差异均无统计学意义(t=1.596，P=0.145)。

结论

CBCT可用于美学区种植唇侧骨量的价值诊断，可以准确评价拔牙后即刻种植与延期种植术后1年唇侧骨量变化。

关键词: 锥形束CT, 美学区, 即刻种植, 延期种植
Objective

To determine the change of labial bone mass 1 year after immediate implant placement and delayed implant placement by cone beam computed tomography(CBCT), and to evaluate the diagnostic value of CBCT for post-implant labial bone mass during esthetic zone.

Methods

A total of 22 implants from 22 patients in maxillary anterior region were followed up with 11 immediate implant placements and 11 delayed implant placements. CBCT images were obtained at three different time point: one week before surgery, immediately after surgery, and one year after implant placement. Labial bone thickness and height were recorded with four sites identification designed by ourselves in this study. The software of SPSS 13.0 was used for statistical analysis.

Results

Significant vertical reduction of labial bone was found in immediate implant placements after 1-year(t=3.316, P=0.009), while no significant difference in delayed implant placement(t=2.073, P=0.068). The 1-year horizontal bone alteration was significantly different at 1 mm apical to the implant/abutment interface(t=2.369, P=0.042)and midimplant(t=3.474, P=0.007); while no significant difference was found at 1 mm coronal to implant bottom both in immediate implant and delayed implant(t=1.596, P=0.145).

Conclusion

CBCT can be used to evaluate the post-implant labial bone mass in esthetic zone. Labial bone and alteration one year after implant placement can be qualitatively assessed by CBCT.

Key words: Cone beam computed tomography, Esthetic zone, Immediate implant, Delayed implant
表1 22颗种植体植入位置分布[例(%)]
组别 合计
即刻种植 7(63.6) 4(36.4) 0(0) 11(100.0)
延期种植 4(36.4) 5(45.5) 2(18.2) 11(100.0)
表2 22颗种植体长度分布[例(%)]
组别 10 mm 12 mm 14 mm 合计
即刻种植 2(18.2) 4(36.4) 5(45.5) 11(100.0)
延期种植 1(9.1) 4(36.4) 6(54.5) 11(100.0)
表3 22颗种植体直径分布[例(%)]
组别 3.3 mm 4.1 mm 4.8 mm 合计
即刻种植 5(45.5) 5(45.5) 1(9.1) 11(100.0)
延期种植 8(72.7) 2(18.2) 1(9.1) 11(100.0)
图1 Romexis Viewer影像分析测量软件界面
图2 唇侧牙槽骨CBCT测量图像
表4 即刻种植与延期种植术后1年唇侧骨量变化[均值(P值)]
组别 A B C D
即刻种植 1.761(0.009)a 0.579(0.042)a 0.637(0.007)a 0.205(0.145)
延期种植 0.517(0.068) 0.441(0.011)a 0.189(0.041)a 0.165(0.109)
图3 上颌前牙区单颗牙即刻种植术后1年唇侧骨量变化
图4 上颌前牙区单颗牙延期种植术后1年唇侧骨量变化
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