不同垂直骨面型成人上下颌后牙区皮质骨密度测量研究

目的探讨不同垂直骨面型成人上下颌后牙区微螺钉种植体（MSI）常植入部位的皮质骨密度，为临床成功植入MSI提供参考。 方法采用整群抽样的方法从2015年1月至2018年12月广州市花都区妇幼保健院（胡忠医院）口腔正畸科就诊并拍摄锥形束CT（CBCT）的20 ~ 40岁成人患者中抽取57例患者，其中高角组患者20例、均角组患者22例和低角组患者15例。应用Ez3D-i软件重建上下颌骨三维模型，测量上下颌骨12个牙根间部位（距离牙槽嵴顶4 mm处）皮质骨密度（HU值），运用单因素方差分析（ANOVA）比较3组各测量部位皮质骨密度均数的差异。 结果3组间上下颌后牙区颊侧多数测量部位皮质骨密度差异有统计学意义（P<0.001），其中高角组最小。上颌腭侧多数测量部位差异无统计学意义。各组中相同牙位上颌后牙区颊侧、腭侧、以及下颌颊侧皮质骨密度差异有统计学意义（P<0.001），其中上颌腭侧最小，下颌颊侧最大。 结论成人上下颌后牙区颊侧皮质骨密度受垂直骨面型影响，高角成人在上颌后牙区颊侧植入MSI需谨慎；上颌后牙区腭侧皮质骨密度几乎不受垂直骨面型影响，但骨密度低，植入MSI时也需谨慎。

Cortical bone density measurement in the posterior area of maxilla and mandible in adults with different vertical facial types

ObjectiveTo investigate the cortical bone density in the posterior maxillary and maxillary region of adults with different vertical facial types, and to provide a reference for the successful clinical implantation of MSI. MethodsThe cluster sampling method was used to select 57 scanned patients from 20-40 years old in Huadu District Maternal and Child Health Hospital (Hu Zhong Hospital) from January 2015 to December 2018. There were 20 patients in high-angle group, 22 patients in mean-angle group and 15 patients in low-angle group respectively. Three dimensional model was reconstructed by Ez3D-i software, and the cortical bone density (HU value) was measured in 12 interradicular sites of maxilla and mandible (4 mm from the top of alveolar ridge) . One-Way analysis of variance (ANOVA) was applied to compare the difference of mean cortical bone mineral density (BMD) and mean cortical bone density of the three groups. ResultsThere was statistical difference of the cortical bone density in the buccal posterior area of maxilla and mandible in three groups (P<0.001) , with the smallest cortical bone density of the high-angle group. There was no significant difference of the cortical bone density in the palatal posterior area of maxilla. Significant difference of the cortical bone density was found among maxillary buccal posterior area, maxillary palatal posterior area and mandibular buccal posterior area in each group (P<0.001) , with the smallest cortical bone density at maxilla palatal side and the largest cortical bone density at the mandibular buccal side. ConclusionsCortical bone density in the buccal posterior area of maxilla and mandible was affected by different vertical facial types which indicated that it must be cautious for high-angle adults to implant MSI in the buccal posterior area of maxilla. Cortical bone density in the palatal posterior area of maxilla was hardly affected by different vertical facial types, but with low density, which also showed that it should be cautious to implant MSI in the palatal posterior area of maxilla.