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目的利用数字成像曲面体层摄影技术研究颌骨后部解剖标志显现情况,并进行测量,为正颌外科、智齿拔除术和种植义齿的颌骨手术进路、深度等临床治疗方案提供依据。方法选取种植义齿术前数字曲面断层片100例,均采用标准全口曲面体层位投照,进行图像数字化处理,观察颌骨后部解剖标志显现情况并进行测量。结果颏孔前后位置高低及颏孔区下颌骨体高度左右基本一致,42例患者看到颏管影像。磨牙区下颌管与牙根尖距离从前向后逐渐减小,下颌神经管显现率从后向前逐渐降低,下颌管直径左右两侧无明显差异。磨牙区下颌体高度及磨牙区下颌管上缘至牙槽嵴顶的距离从前向后逐渐减小。下颌第三磨牙阻生组中近中倾斜角平均为48.80°,萌生组中近中倾斜角平均为6.84°。阻生组磨牙后间隙比萌生组小,二者之间具有统计学上差异(P<0.05)。萌生组与阻生组磨牙后间隙/牙冠近远中径的平均值分别为1.17、0.62(P<0.05)。萌生组与阻生组牙冠近远中径之间无统计学差异。下颌第三磨牙阻生的发生率与近中倾斜角呈正相关(P<0.05),而与磨牙后间隙呈负相关(P<0.05)。上颌窦显现情况为90%,最大范围向前达到尖牙区,向后达到上颌结节区。结论数字化曲面体层摄影能够获得正颌外科、智齿拔除术及种植义齿足够的颌骨特征信息,为制定治疗方案提供理论依据。
Objective To study the appearance of posterior anatomical landmarks by digital imaging surface tomography and to provide a basis for the clinical treatment of orthognathic surgery, wisdom tooth extraction and implant denture with maxillary approach. Methods 100 cases of preoperative digital surface tomography of implant denture were selected. All the images were digitally processed with the standard holographic surface body. The appearance of the posterior anatomical landmarks was observed and measured. Results Before and after the position of mental foramen and mandibular body height and mental foramen about the same height, 42 patients saw chin tube image. The distance between the mandibular canal and the apical root of mandibular canal decreased from anterior to posterior, and the appearance rate of mandibular canal decreased gradually from posterior to anterior. There was no significant difference between the left and right sides of mandibular canal diameter. The molar area of the mandibular molar and the distance between the upper edge of the mandibular canal and the crest of the alveolar ridge in the molar area gradually decreased from anterior to posterior. In the mandibular third molar impaction group, the average mesial tilt angle was 48.80 °, and the average mesial tilt angle was 6.84 ° in the sprouting group. There was a statistically significant difference between the two groups (P <0.05). The average molar distance between proximal molars and distal mesial diameter of molars in initiation group and impaction group were 1.17 and 0.62, respectively (P <0.05). There was no significant difference between the proximal and distal diameters of the crown in the initiation group and the impaction group. The incidence of mandibular third molar impaction was positively correlated with near-mid tilt (P <0.05), but negatively with post-molar gap (P <0.05). Maxillary sinus showed 90% of the situation, the largest reach forward canine area, backward to reach the maxillary nodular area. Conclusion Digital surface tomography can obtain enough jaw features information of orthognathic surgery, wisdom tooth extraction and implant denture, and provide theoretical basis for the development of the treatment plan.