CT三维容积重建在颌骨疾病诊治中的应用

自螺旋CT问世后 ,可以容积采集数据 ,使三维立体重建技术成为现实。国内应用于口腔颌面部病变的报道不多 ,所应用于临床大多为颌面部骨折 ,以及骨折复位后的判断 ,且均采用螺旋CT三维表面遮蔽 (SSD)重建技术[1,2 ] 。据报道其平滑作用会掩盖骨折线[3 ] ,又不能反映骨质病变的内     

三维CT在颌骨肿瘤中的应用

目的 :探讨三维CT成像技术在颌骨肿瘤中的临床应用价值。方法 :对 17例颌骨肿瘤进行螺旋CT扫描成像 ,8例做了增强扫描 ,全部病例均手术和病理证实。结果 :全部病例能清楚地显示颌骨肿瘤的骨质改变及与邻近结构关系的立体解剖图像。结论 :三维CT简化了观察者的思维过程 ,可直观地了解颌骨肿瘤在三维空间的破坏范围与周围结构的关系 ,特别对已波及颅底的颌骨肿瘤诊断价值最大 ,能帮助确定手术中骨质切除或保留的量 ,为手术计划的制定提供依据。     

液氮冷冻在颌骨病变手术中的运用

颌骨恶性肿瘤、较大良性肿瘤或某些临界瘤的手术治疗常需要切除较大范围的颌骨,有的病例还需要植骨修复,从而造成严重面容损害和咬合功能障碍。我科近5年来利用液氮冷冻处理颌骨手术后骨创治疗颌骨病变65例,避免了常规手术需要的大范围截骨,临床疗效满意。     

三维CT影像在颌骨骨折诊断与治疗中的临床价值

目的：探讨三维ＣＴ影像在颌面部骨折中的诊断价值。方法：对１７例颌骨骨折的三维ＣＴ影像及二维ＣＴ影像进行观察，分析其各自的特征并者比较。结果；三维ＣＴ影像在显示骨折的空间位置方面，如骨折线的行走路线，骨折片的移位距离与方向等都有独到的优势，但在显示上窦前壁线型骨折，骨折断端周围的软组织改变等方面不如二维ＣＴ像。结论：三维ＣＴ影像在显示颌面骨折处的空间关系上有很大的诊断意义及治疗指导意义，可以弥补二维     

三维CT影像在颌骨骨折诊断与治疗中的临床价值

目的 :探讨三维CT影像在颌面部骨折中的诊断价值。方法 :对 17例颌骨骨折的三维CT影像及二维CT影像进行观察 ,分析其各自的特征并进行比较。结果 :三维CT影像在显示骨折的空间位置方面 ,如骨折线的行走路线 ,骨折片的移位距离与方向等都有独到的优势 ,但在显示上窦前壁线型骨折 ,骨折断端周围的软组织改变等方面不如二维CT影像。结论 :三维CT影像在显示颌面骨折处的空间关系上有很大的诊断意义及治疗指导意义 ,可以弥补二维CT影像的不足 ,但不能取代二维CT影像。     

颌骨牙列曲面体层技术和根尖定位片在埋伏阻生牙定位中的应用评价

目的:比较颌骨牙列曲面体层技术和根尖定位片在埋伏阻生牙及多生牙定位中的应用价值。方法:对43例埋伏阻生牙及多生牙分别采用颌骨牙列曲面体层技术和临床上最常用的根尖定位片进行投照定位,对这2种方法的符合率进行χ2检验。结果:颌骨牙列曲面体层技术和根尖定位片均能较准确显示埋伏阻生牙及多生牙在颌骨中的位置,与手术结果符合率分别为93.02%和95.35%,两者无显著性差异(P>0.05)。结论:颌骨牙列曲面体层技术能较准确地显示埋伏阻生牙及多生牙在颌骨中的位置。     

锥形束CT在上颌埋伏中切牙诊断中的应用

目的:探讨锥形束CT(CBCT)在上颌埋伏中切牙诊断中的作用。方法:选择正畸临床33例上颌中切牙埋伏阻生患者作为研究对象,拍摄全景片和CBCT,由10位正畸医生对33例埋伏牙患者的全景片和CBCT分别进行测量、分析,填写研究表格。所得数据用SPSS 17.0软件,采用McNemar检验、Kappa检验和配对t检验进行统计学分析。结果:CBCT与全景片对埋伏牙是否弯根、近中切角距中线距离和有无多生牙等分析项目没有统计学差异,其余分析项目均有统计学差异。结论:对上颌埋伏中切牙诊断,CBCT更直观、三维测量更精确,更好地指导临床。     

锥形束CT在颌骨囊肿诊治中的临床应用

目的探讨锥形束CT影像在颌骨囊肿治疗中的应用价值。方法选择25例曲面断层片难以确定颌骨囊肿边缘的患者进行锥形束CT扫描,依据锥形束CT图像,观察囊肿三维方向上的位置、与颌骨骨壁的距离,了解囊肿与牙齿、周围解剖结构的毗邻关系,采用相应的术前准备和手术方案。术中核对锥形束CT观察结果。结果锥形束CT清楚地显示了颌骨囊肿的准确部位、边缘位置、受累牙情况、与周围解剖结构的毗邻关系,与术中所见完全吻合。锥形束CT对手术方案、手术入路、切口设计和受累牙处理具有良好的指导作用。结论锥形束CT在颌骨囊肿诊治上的临床应用价值明显优于传统的曲面断层片和根尖片。     

曲面体层与普通X线片在下颌骨骨折诊断中的对比观察

通过对４１例（４９处）下颌骨骨折的对比观察，显示了曲面体层在下颌骨骨折的诊断中，有较高的准确率，能取代常规下颌骨系列片，具有费用低，减少投照曝光时间等优点。     

三维CT成像在颌骨疾病诊断中的应用

三维ＣＴ在口腔颌面部骨组织疾病诊断的临床应用研究揭示：三维ｃＴ成像是以人们所熟悉的方式，立体地显示骨组织结构和病变，显示人体复杂区域的解剖关系，提高了观察者对二维图像病变的认识能力。简化了大脑思维综合过程。三维ＣＴ通过不同轴面的旋转以及切割方法，立体地表现其本身及其与周围组织的关系，对诊断和治疗提供了积极有益的帮助。     

Assessment of periodontal conditions and systemic disease in older subjects. II. Focus on cardiovascular diseases

BACKGROUND: Panoramic radiographs (PMX)s may provide information about systemic health conditions. AIMS: i). To study clinical periodontal conditions and collect self-reported health status in a cohort of 1084 older subjects; ii). to study signs of alveolar bone loss and carotid calcification from panoramic radiographs obtained from these subjects; and iii). to study associations between study parameters. MATERIAL AND METHODS: PMXs from 1064 adults aged 60-75 (mean age 67.6, SD +/- 4.7) were studied. Signs of alveolar bone loss, vertical defects, and molar furcation radiolucencies defined periodontal status. Medical health histories were obtained via self-reports. Signs of carotid calcification were identified from panoramic radiographs. RESULTS: The PMX allowed assessment of 53% of the films (Seattle 64.5% and Vancouver 48.4%). A self-reported history of a stroke was reported by 8.1% of men in Seattle and 2.9% of men in Vancouver (P < 0.01). Heart attacks were reported by 12% of men in Seattle and 7.2% in Vancouver (N.S.). PMX evidence of periodontitis was found in 48.5% of the subjects, with carotid calcification in 18.6%. The intraclass correlation score for PMX findings of carotid calcification and stroke was 0.24 (95% CI: 0.10-0.35, P < 0.001). The odds ratio for PMX carotid calcification and periodontitis was 2.1 (95% CI: 1.3-3.2, P < 0.001), and for PMX carotid calcification and stroke 4.2 (95% CI: 1.9-9.1, P < 0.001). The associations disappeared when smoking was accounted for. A history of a heart attack was associated with stroke, gender, age, and PMX scores of alveolar bone loss. CONCLUSIONS: PMXs may provide valuable information about both oral conditions and signs of carotid calcification, data that are consistent with self-reported health conditions. Alveolar bone loss as assessed from PMXs is associated with cardiovascular diseases.     

Observation on the closure of lambdoid suture in relation to age,sex and population variations using a novel radiographic technique – a prospective study

Objectives: To study and compare the patterns of lambdoid suture closure bilaterally; to specify any relationship between progression of the union of lambdoid suture and age; to detect sexual and population variations in lambdoid suture closure.

Methodology: A total of 98 subjects of both sexes, 20 years and beyond were included in the study. The state of fusion of the lambdoid suture was examined using a modified reverse panoramic radiograph (RPRg). Frederic’s five-point rating scale was used to assess lambdoid suture closure status. Data obtained were subjected to statistical analysis.

Results: Cohen’s Kappa measure of the agreement gave a figure of 0.96 for intra-examiner testing and 0.97 for inter-examiner testing. These values represent a good agreement. Grade 0 was observed in 16 (16.3%), grade 1 in 44 (44.9%), grade 2 in 09 (9.2%), grade 3 in 13 (13.3%) and grade 4 in 16 (16.3%) of the cases. The maximum numbers of cases were in age group 35–39 (24 (24.4%)) followed by age group 25–29 (19 (19.4%)). In the present study, there were 64 (65.3%) males and 34 (34.7%) females. When the comparison between males and female subjects was made, the closure was earlier in females. Most of the participants belonged to Arabian population (38 (38.7%)) followed by South Asian (33 (33.7%)) and least were from South East Asian population (27 (27.6%)). There were significant differences in suture closure in relation to age but insignificant with respect to sex and population.

Conclusions: Assessment regarding the age of an individual is possible but the sex and population of an individual cannot be determined.     

应用宝石能谱 CT 评估 TMD 患者的髁突位置

目的：通过应用宝石能谱CT对比分析颞下颌关节紊乱病（ temporomandibulardisorders,TMD）组和正常组的髁突位置。方法：通过参考颞下颌关节紊乱的研究诊断标准（ RDC／TMD）随机选择TMD患者与颞下颌关节正常的对照组病例各30名,均为放射科能谱CT检查的患者。通过在矢状位确定标志点后测量2组病例颞下颌关节关节窝上、前、后间隙的距离,以及关节结节倾角角度。结果：正常组和TMD组关节前间隙分别为2．44±0．49 mm和2．96±0．68 mm,两组之间关节前间隙的距离是对比差异具有统计学意义（P＜0．05）。结论：能谱CT为一种可有效诊断TMD的实用影像学方法。     

Relation of bone turnover markers to periodontal disease and jaw bone morphology in elderly Japanese subjects

Objective:  The purpose of this study was to evaluate the relation of bone turnover markers such as bone formation and resorption to periodontal disease and jaw bone morphology in elderly Japanese subjects.
Subjects and methods:  We selected 148 subjects for participation in this study. All subjects were aged 77 years. The periodontal examination included the assessment of clinical attachment level (CAL). Biochemical parameters of bone turnover measured included urinary deoxypyridinoline, serum osteocalcin (S-OC), and serum bone-specific alkaline phosphatase. In addition, to evaluate the jawbone, we used the mandibular inferior cortex classification (MIC).
Results:  Serum osteocalcin had significantly higher (males: P  =   0.038, females: P  =   0.041) tendency for MIC Class (ANOVA). Multiple linear regression results showed that the number of remaining teeth and S-OC were negatively associated with the percentage of sites with ≥6 mm CAL ( R ² = 0.322, P  < 0.001). Coefficients and betas were −0.71, −0.46 ( P  <   0.001) and −1.11, −0.28 ( P  =   0.002), respectively.
Conclusion:  In conclusion, this study suggests that there is a significant relation of bone turnover markers to periodontal disease and jaw bone morphology in elderly Japanese subjects.     

Changes in activity and structure of jaw muscles in Parkinson's disease model rats

Parkinson's disease (PD), a major neurological disease, is characterised by a marked loss of dopaminergic neurons in the substantia nigra. Patients with PD frequently show chewing and swallowing dysfunctions, but little is known about the characteristics of their stomatognathic functions. The purpose of this study was to evaluate the influence of PD on jaw muscle fibre and functions. PD model rats were made by means of the injection of 6‐hydroxydopamine (6‐OHDA) into the striatum of 8‐week‐old Sprague‐Dawley male rats. Five weeks after the injection, a radio‐telemetric device was implanted to record muscle activity continuously from the superficial masseter and anterior belly of digastric muscles. Muscle activity was recorded for 3 days and was evaluated by the total duration of muscle activity per day (duty time). After recording the muscle activities, jaw muscles were isolated for immunohistochemical and PCR analyses. In PD model rats, the following findings of the digastrics muscles verify that compared to the control group: (i) the higher duty time exceeding 5% of the peak activity level, (ii) the higher expression of the mRNA of myosin heavy chain type I, and (iii) the tendency for fast to slow fibre‐type transition. With respect to the masseter muscle, there were no significant differences in all analyses. In conclusion, PD leads to the changes in the jaw behaviours, resulting in a PD‐specific chewing and swallowing dysfunctions.     

锥形束CT在颞下颌关节疾病诊断和治疗中的应用

近年来,锥形束CT(CBCT)越来越多地应用到颞下颌关节(TMJ)疾病的诊断和治疗中.因其可在不同方向、不同层面同时显示TMJ骨质及关节间隙的改变,与其他影像学方法相比有着巨大的优势,为提高TMJ疾病诊断水平,选择TMJ疾病的合理治疗方案提供了新的平台和探索途径.本文将介绍CBCT在TMJ疾病的诊断与治疗中的应用进展,...     

颌骨囊性病变开窗减压术及义齿式囊肿塞的应用与疗效观察

目的研究颌骨囊性病变采用开窗减压术和刮治截骨术的治疗效果及义齿式囊肿塞的应用。 方法81例颌骨囊性病变患者,分别采用开窗减压术（36例）和刮治截骨术（45例）,比较两组术中相关情况和术后并发症及复发情况。采用SPSS 13.0统计软件进行统计分析,资料以 ±s表示,对两种治疗方法手术用时、出血量、受累牙拔除、下唇麻木情况及术后治疗效果与复发率采用χ²检验进行比较分析,P<0.05为差异有统计学意义。 结果开窗减压术患者手术时间为（31.2 ± 4.1）min,术中出血量为（20.3 ± 7.2）ml、受累牙拔除为（0.7 ± 0.04）个,术后疼痛、下唇麻木、感染及术后3年咀嚼功能下降等指标均明显低于刮治截骨术患者,差异有统计学意义（P<0.05）,而术后3年刮治截骨术组有6例面形发生轻度不对称,2例复发（4.44%）,开窗术组无面形改变和复发,复发率差异无统计学意义（P>0.05）。 结论开窗减压术手术创伤小、并发症少,保留了颌骨的完整性及病变区的患牙,相对应刮治截骨术是一种简单实用有效的方法。