中重度慢性牙周炎上颌中切牙区解剖形态的锥形束CT测量分析

目的应用锥形束CT（CBCT）测量分析中重度慢性牙周上颌中切牙区牙槽骨的骨量和牙齿偏移度，为上颌中切牙区的种植治疗和方案制定提供解剖学依据。 方法选取2015年1月至2017年12月深圳爱康健口腔医院内150例中重度牙周炎患者的CBCT影像资料，测量共290颗上颌中切牙唇/腭侧骨壁厚度、牙槽骨骨宽/高度、骨内根长、牙体长轴和牙槽骨走行方向的夹角共7个项目，采用SPSS 19.0统计软件包对测量结果进行相关统计分析。 结果中重度慢性牙周炎上颌中切牙牙槽嵴顶处和根尖处的唇腭向骨厚度分别为（7.68 ± 0.78）mm和（8.52 ± 1.55）mm，牙槽骨高度平均为（18.35 ± 3.45）mm，骨内根长1/2处的唇侧和腭侧的骨壁厚度分别为（0.62 ± 0.45）mm和（3.18 ± 1.00）mm，牙体长轴与牙槽骨走行方向夹角的平均值为18.80° ± 5.46°。不同性别间对比测量结果，在牙槽嵴顶骨宽度和根尖区骨宽度处差异均有统计学意义（P<0.05），男性优于女性。 结论中重度慢性牙周炎上颌中切牙的唇侧骨壁菲薄甚至缺如，骨量条件不理想，牙体长轴与牙槽骨偏移度明显，在制定种植方案时有必要充分利用CBCT了解骨量情况并评估解剖形态，为达到上颌中切牙种植效果长期美观、稳定的需求应有更多的考量。

Cone-beam CT measurement and analysis of anatomical morphology of maxillary central incisor in chronic periodontitis

ObjectiveCone beam CT (CBCT) was used to measure and analyze the bone mass and tooth deviation in the region of maxillary central incisors with moderate and severe chronic periodontitis, so as to provide anatomical basis for implant treatment. MethodsCBCT images of 150 patients with moderate and severe chronic periodontitis in Shenzhen C.K.J Stomatological Hospital from January 2015 to December 2017 were selected. A total of 290 maxillary central incisors were used to measure the thickness of labial/palatal bone wall, the alveolar bone thickness/height, internal root length and the tooth deviation. All data were analyzed statistically by using the SPSS 19.0 software. ResultsThe thickness of labial to palatal bone at the crest and apex of maxillary central incisors with moderate and severe chronic periodontitis were (7.68 ± 0.78) mm and (8.52 ± 1.55) mm, respectively. The average height of the alveolar bone was about (18.35 ± 3.45) mm. The thickness of the labial and palatal bone walls at half of the length of the internal root length were (0.62 ± 0.45) mm and (3.18 ± 1.00) mm, respectively. The average angle between the long axis of the tooth and the direction of the alveolar bone was 18.80° ± 5.46°. The width of alveolar crest and apical bone in male was significantly higher than that in female (P<0.05) . ConclusionsIn patients with moderate and severe chronic periodontitis, the labial bone wall of maxillary central incisors was thin or even absent, indicating poor bone mass condition. The long axis of tooth and alveolar bone deviation was substantial. Therefore, it is necessary to evaluate the anatomy of the maxillary central incisor area with chronic periodontitis by CBCT before implant treatment, so as to obtain a long-term aesthetic and stable success of implant supported restoration for central incisors.