无牙颌下颌骨前、后牙区骨量相关性的CBCT研究

摘要/Abstract

摘要： ［摘要] 目的测量牙列缺失的下颌骨前、后牙区余留骨量，研究其相关关系，为临床种植计划的制订提供参考。方法研究纳入了2016年7月至2018年8月于南京医科大学附属口腔医院拍摄CBCT的27例（54侧）成年下颌无牙颌患者。运用Simplant Pro 11.04软件导入所有研究对象的DICOM数据，测量下颌骨前、后牙区的骨高度及宽度。运用统计软件分析数据，采用皮尔森相关系数计算下颌骨前牙区与前磨牙区、磨牙区骨高度及宽度测量值的相关性。结果在牙槽嵴顶的宽度上，前、后牙区无明显相关关系(前磨牙与前牙区P=0.27＞0.05, r=0.22，磨牙与前牙区P=0.95＞0.05,r=0.01)，牙槽嵴顶下3 mm、5 mm宽度、下颌骨高度、下牙槽神经管以上骨高度均显示前、后牙区不同程度的相关关系。牙槽嵴顶下3 mm前磨牙与前牙区P＜0.001,r=0.74强相关，磨牙与前牙区P=0.02＜0.05,r=0.44中等程度相关；牙槽嵴顶下5 mm前磨牙与前牙区P＜0.001,r=0.78强相关，磨牙与前牙区P=0.003＜0.05,r=0.55中等程度相关；下颌骨高度前磨牙与前牙区P＜0.001,r=0.79强相关，磨牙与前牙区P＜0.001,r=0.70强相关；下牙槽神经管以上骨高度前磨牙与前牙区P＜0.001,r=0.64强相关，磨牙与前牙区P=0.001＜0.05, r=0.58中等程度相关。下颌骨前牙区宽度、高度随着后牙区宽度、高度的减少而减少。结论下颌无牙颌，前牙区与后牙区骨吸收程度基本一致。下颌无牙颌，后牙区骨量严重不足的情况下，前牙区能否选择all-on-4有待考量。

关键词: 下颌骨, 无牙颌, 骨高度, 骨宽度, CBCT

Abstract: Objective　To measure the dimension of alveolar crest bone left in the anterior and posterior region of the edentulous mandible and sort out their relationship, providing reference for making a clinical implantation plan. Methods The study included 27 adult patients (54 hemi-mandible) with edentulous mandible who were taken CBCT at the Affiliated Stomatological Hospital of Nanjing Medical University from July 2016 to August 2018. The DICOM data of all subjects were imported into the Simplant Pro 11.04 software to measure the alveolar crest bone height and width of the anterior and posterior mandible. The statistical software was used to analyze the data. Pearson correlation coefficient was used to calculate the correlation of bone height and width between anterior area and premolar area or molar area of the edentulous mandible. Results　For the width of the alveolar crest, there was no significant correlation between the anterior and posterior area of the mandible (comparing premolar area with anterior area, p=0.27>0.05, r=0.22; comparing molar area with anterior area p= 0.95>0.05, r=0.01). It showed different degrees of correlation between anterior and posterior area of the edentulous mandible in terms of the width of 3minimeters below the alveolar crest, the width of 5minimeters bel ow the alveolar crest, the height of the mandible, the height of the mandible above the inferior alveolar nerve tube. For the width of 3mm below the alveolar crest, the premolar area was strongly correlated with the anterior area (P<0.001, r=0.74), while the molar area was moderately correlated with the anterior area (P=0.02<0.05, r=0.44). For the width of 5mm below the alveolar crest, the premolar area was strongly correlated with the anterior area (P<0.001, r=0.78), while the molar area was moderately correlated with the anterior area (P=0.003<0.05, r=0.55). For the height of the mandible, the premolar area was strongly correlated with the anterior area (P<0.001, r=0.79), and the molar area was also strongly correlated with the anterior area (P<0.001, r=0.70). For the height of the mandible above the inferior alveolar nerve tube, the premolar area was strongly correlated with the anterior area (P<0.001, r=0.64), while the molar area was moderately correlated with the anterior area (P=0.001<0.05, r=0.58). With the decrease of the width and height of the posterior area of the mandible, the width and height of the anterior area decreased. Conclusion　The progress of bone resorption in anterior and posterior region of edentulous mandible is almost the same. Whether all-on-4 can be applied in the anterior region is still to be considered in the case of serious bone defects in the posterior region of the edentulous mandible.

Key words: mandible, edentulous jaw, bone height, bone width, CBCT

中图分类号:

R782.13

黄佳郑旸宋晓萌吴煜农. 无牙颌下颌骨前、后牙区骨量相关性的CBCT研究[J]. 口腔医学, 2020, 40(5): 421-425.

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