上颌前牙区多生牙的锥形束CT影像学特征研究

doi:10.13591/j.cnki.kqyx.2024.02.007

摘要/Abstract

摘要：

目的利用锥形束CT(cone beam computed tomography,CBCT)分析上颌前牙区多生牙(supernumerary tooth,ST)的影像学特征,为ST的治疗提供帮助。方法共收集805例CBCT数据,利用专用软件NNT评价ST的影像学特征,包括:数目、形态、位置、方向、发育情况和并发症,并分析上述影像学特征的性别差异。结果男女比例2.96∶1,男性和女性ST均以单枚、锥形、牙弓腭侧、倒置和阻生为主,但男性发生2枚ST的比例显著高于女性(P<0.001),女性ST倒置的比例更高(P<0.001)。最常见的ST相关的并发症是鼻腭管管壁骨质吸收,且男性高于女性(P=0.01)。此外,ST累及解剖结构及相关临床并发症还包括鼻底骨质吸收,形成颌骨囊肿,牙滤泡间隙增宽,邻牙阻生、移位或扭转、根吸收。结论男性和女性上颌前牙区的ST以单枚、锥形、牙弓腭侧、倒置和阻生为主,但发病特点存在性别差异。ST可导致多种并发症,CBCT的准确分析有助于ST的诊断和治疗。

关键词: 锥形束CT, 多生牙, 并发症, 影像学特征

Abstract:

Objective To analyze the radiographic characterizations of the supernumerary tooth(ST)in the anterior maxillary region using cone-beam computed tomography(CBCT), in order to help clinicians treat ST. Methods CBCT data of 805 patients were selected. The radiographic characterizations of the ST were evaluated using NNT software, including the number, morphology, location, orientation, growth condition and associated clinical complications. Gender differences of the radiographic characterizations were analysed. Results Male patients outnumbered females with a gender ratio of 2.96∶1. The majority of ST was single, conical shape, palatal, inverted orientation and impacted in both males and females, but the ratio of two ST in males was higher than that in females(P<0.001). Inverted orientation in females was higher than that in males(P<0.001). The most common ST-associated complication was bone resorption of the walls of the nasopalatine canal, and the ratio in males was higher than that in females(P=0.01). In addition, anatomical structures involved by ST and other complications also included bone resorption of nasal floor, odontogenic cyst formation, follicle gap of tooth widen, impaction, malposition, rotation and root resorption of adjacent teeth. Conclusion The majority of ST was single, conical shape, palatal, inverted orientation and impacted in both males and females, but the clinical characterizations between males and females showed significant difference. The presence of ST may produce several complications. The accurate analysis of CBCT scan assists the diagnosis and treatment of ST.

Key words: cone beam computed tomography, supernumerary tooth, complication, radiographic characterization

中图分类号:

R814.4

孙苏, 冷迪雅, 王晶艳, 顾培玉, 杨连丰, 吴大明, 孙超, 张娟. 上颌前牙区多生牙的锥形束CT影像学特征研究[J]. 口腔医学, 2024, 44(2): 115-120.

SUN Su, LENG Diya, WANG Jingyan, GU Peiyu, YANG Lianfeng, WU Daming, SUN Chao, ZHANG Juan. Study on the radiographic characterizations of supernumerary teeth in maxillary anterior region using cone beam computed tomography[J]. Stomatology, 2024, 44(2): 115-120.

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数目	男性	女性	P
1枚	381(64.03)	162(77.14)	0.001
2枚	206(34.62)	47(22.38)	0.001
3枚	6(1.01)	1(0.48)	0.683
4枚	2(0.34)	0(0)	1.000

形态	男性	女性	P
锥形	718(87.67)	235(90.73)	0.184
切牙形	30(3.66)	11(4.25)	0.709
变异形	28(3.42)	5(1.93)	0.301
结节状	18(2.20)	4(1.54)	0.622
蕾状	16(1.95)	2(0.77)	0.270
前磨牙形	9(1.10)	2(0.77)	1.000

位置	男性	女性	P
腭侧	621(75.82)	203(78.38)	0.403
牙弓	139(16.97)	29(11.20)	0.300
上方	49(5.98)	22(8.49)	0.195
下方	9(1.10)	5(1.93)	0.366
唇侧	1(0.12)	0(0)	1.000

方向	男性	女性	P
倒置	403(49.21)	161(62.16)	<0.001
正向	256(31.26)	51(19.69)	<0.001
冠向腭侧水平	68(8.30)	20(7.72)	0.797
冠向腭侧远中	20(2.44)	7(2.70)	0.820
冠向腭侧近中	3(0.37)	0(0)	1.000
冠向腭侧向下	7(0.85)	0(0)	0.206
冠向唇侧近中	13(1.59)	5(1.93)	0.781
冠向唇侧远中	28(3.42)	10(3.86)	0.847
冠向唇侧水平	21(2.56)	5(1.93)	0.654

发育情况	男性	女性	P
阻生	671(81.93)	230(88.80)	0.009
根弯曲	91(11.11)	29(11.20)	1.000
发育不完全	113(13.80)	33(12.74)	0.679