翼上颌区种植相关解剖结构的影像学测量及分析研究

目的 通过锥形束CT图像分析上颌游离端与非游离端缺牙患者翼上颌区骨量差异，为临床能否将翼上颌区种植技术作为解决上颌后牙区骨量不足的常用方法提供依据。方法 选取2018年1月至6月在南京医科大学附属口腔医院行种植术前检查者中上颌一侧游离端缺失至前磨牙且骨高度低于5 mm、另一侧非游离端缺失且未曾行上颌后牙区种植手术者的锥形束CT数据（共26例），测量翼上颌区牙槽骨在缺牙侧与非缺牙侧宽度、高度、翼突高度和体积的差异。结果 除翼突高度外，翼上颌区骨宽度、高度及体积均因上颌后牙缺失而显著减少（P=0.000），其中游离端缺失侧和非游离端缺失侧骨宽度分别为（6.11±1.05）mm、（6.81±0.99）mm，骨高度分别为（15.16±1.39）mm、（16.73±1.44）mm，体积分别为（388.84±81.26）mm3、（465.85±91.98）mm3。结论 上颌游离端与非游离端缺牙患者翼上颌区骨量存在显著差异，但仍可在该区域倾斜植入种植体，配合近中短种植体或基牙完成上颌后牙游离端缺失种植修复。

Radiological measurement and analysis for pterygomaxillary implant

Objective To analyze the differences of bone mass between sides of distal extended tooth missing and non distal extended tooth missing in the maxilla and to provide the basis for pterygomaxillary implant placement as a common method for dental implant in the posterior atrophic maxilla. Methods At the Affiliated Stomatological Hospital of Nanjing Medical University from January to June of 2018, patients with one side of distal extended tooth missing to the premolar region with the bone height less than 5 mm and the other side of non distal extended tooth missing in the maxilla (26 cases in total) were selected. Their cone beam computed tomography files were collected to compare the width, height, pterygoid process height and volume of pterygomaxillary area between sides of distal extended tooth missing and non distal extended tooth missing. Results Aside from the height of pterygoid process, the width, height and volume of pterygomaxillary area were significantly reduced for the absence of maxillary posterior tooth (P=0.000). The width, height and volume of pterygomaxillary area were （6.11±1.05）mm and （6.81±0.99）mm, （15.16±1.39）mm and（16.73±1.44）mm, （388.84±81.26）mm3 and（465.85±91.98）mm3 respectively on the sides of distal extended tooth missing and non distal extended tooth missing. Conclusion The bone mass of pterygomaxillary area is significantly different between sides of distal extended tooth missing and non distal extended tooth missing. However, this area is still sufficient for long implant placement, which should be combined with short implants and/or abutment teeth in the anterior maxilla to solve the difficulties in implant restoration caused by severe atrophy of posterior maxilla