切牙管与上颌中切牙牙根位置关系的CBCT研究

目的:应用锥形束CT(Cone Beam Computed Tomography,CBCT)分析切牙管与上颌中切牙牙根的位置关系。方法:选取2009~2013年来我院种植科拟行上中切牙即刻种植患者180例,男女比例为1:1,通过CBCT的水平位、矢状位、冠状位及三维图像对析切牙管与上颌中切牙牙根位置关系进行定量分析及准确测量,采用单因素方差分析,t检验及Bonferroni法对结果进行统计分析。结果:上颌中切牙根中1/2点-切牙管、根尖点-切牙管的最小距离的人群中频率分布统计显示分别在1.01~2.00mm(26.67%)和4.01~5.00mm(29.44%)比例最高。对不同性别患者的上颌中切牙根中1/2点、根尖点与切牙管的最小距离行组间比较,结果显示男性的最小距离均大于女性(t=3.15,P=0.002;t=4.19,P0.001)。对不同年龄组患者的上颌中切牙根中1/2点、根尖点与切牙管的最小距离进行两两比较,结果发现随年龄增长,两个位点的最小距离也逐渐增加(F=99.06,P0.001;F=102.47,P0.001)。结论:关于切牙管与上颌中切牙牙根位置关系,CBCT能提供更准确的信息。在上颌中切牙即刻种植中,应该更加重视女性及青年患者的上颌中切牙牙根与切牙管的关系,优化种植方案以及种植体的选择。

Study on the positional relation of incisive canal and maxillary central incisor root by Cone-beam Computed Tomography

Objective Analyze the positional relation of incisive canal （IC） and maxillary central incisor root （MCIR） by using CBCT （Cone Beam Computed Tomography）. Methods Select 180 patients who came to our hospital implant department to have maxillary central incisor immediate implantation from 2009 to 2013, and the gender ratio is 1：1.Through CBCT＇s horizontal position, sagittal position, coronal position and three-dimension images to quantitative analysis and accurate measure the closest distances between the IC and MCIR （IC-to-MCIR）. And then analyze the result by using one-factor analysis of variance, testing and Bonferroni Method. Results According to the frequency distribution statistics of the population, the closest distances of IC-to-MCIR at the midroot and apex levels have the highest proportion in 1.01-2.00mm （26.67%） and 4.01-5.00mm （29.44%）,respectively. Compared the minimum distance IC-to-MCIR at the midroot and apex levels in different gender patients, it shows that males are larger than females （t=3.15, P=0.002; t=4.19, P〈0.001）.The same comparison in different ages shows that along with the age growth the minimum distance between two sites would be gradually increased（F=99.06, P〈0.001;F=102.47, P〈0.001）. Conclusion CBCT canprovide more accurate information about the positional relation of IC and MCIR. In the maxillary central incisor immediate implantation, more care must be exercised at the midroot and apex levels of a maxillary central incisor in women and younger patients, and the optimization implantation scheme and the selection of implant should be paid great attention.