北京大学学报(医学版) ›› 2018, Vol. 50 ›› Issue (1): 110-116. doi: 10.3969/j.issn.1671-167X.2018.01.019

• 论著 • 上一篇    下一篇

锥形束CT用于评估牙槽骨骨缺损的情况和骨再生区域骨密度的变化

曹婕1,孟焕新2△   

  1. (1.北京大学口腔医学院·口腔医院,第二门诊部口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室, 北京100101; 2. 北京大学口腔医学院·口腔医院牙周科, 北京100081)
  • 出版日期:2018-02-18 发布日期:2018-02-18
  • 通讯作者: 孟焕新 E-mail: kqhxmeng@bjmu.edu.cn

Evaluation of using cone beam computed tomography as a regular test before and after periodontal regenerative surgery#br#

CAO Jie1, MENG Huan-xin2△   

  1. (1. Second Clinical Division, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100101, China; 2. Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China)
  • Online:2018-02-18 Published:2018-02-18
  • Contact: MENG Huan-xin E-mail: kqhxmeng@bjmu.edu.cn

摘要: 目的:检验牙周再生性手术前用锥形束CT(cone beam computed tomography,CBCT)测量牙槽骨缺损高度和体积的精确性,通过比较手术前后CBCT测得的骨密度值来确定其评估牙周再生性手术疗效的检查时机。方法:对9例患者口内的10颗因牙周破坏造成的三壁骨袋进行再生性手术,术前拍摄CBCT和平行投照根尖片,测量骨缺损的高度,并利用CBCT数据测量骨缺损体积及骨缺损周边区域的骨密度。在牙周再生性手术过程中测量骨缺损的高度,并在术中充填骨蜡以获得缺损区域的体积。术后6、12、24周再次拍摄CBCT,测量原骨缺损区域的骨密度。结果:Wilcoxon检验非参数检验显示,术前用根尖片测量的骨缺损高度比术中测量结果高出(0.822±0.222)mm,差异有统计学意义(P<0.05),但术前CBCT测量结果只较术中测量结果降低(0.150±0.171)mm(P>0.05),可见CBCT测量结果比根尖片更精确。回归分析和BlandAltman图也提示CBCT测量结果较根尖片精确。Wilcoxon检验提示,术前CBCT测量的骨缺损体积与术中测量值的差值在0.38~2.83 mm3之间,差异无统计学意义(P>0.05)。CBCT测量的原骨缺损区域的骨密度(CT值)在再生性手术后第6、12和24周分别是原骨缺损周边区域的(0.49±0.03)倍、(0.74±0.09)倍和(1.16±0.11)倍,可见术后24周时骨再生区域骨密度更接近术前骨缺损周边区域骨密度。结论:CBCT可以在牙周再生性手术前精确测量牙槽骨缺损的高度和体积,可选择在术后24周时拍摄CBCT进行疗效评估。

关键词: 锥束计算机体层摄影术, 牙槽骨质丢失, 骨密度, 牙周组织, 再生

Abstract: Objective:To test the accuracy and credibility of cone-beam computed tomography (CBCT) on measuring the height and volume of alveolar bone defects before periodontal regeneration surgery. By comparing the bone density measured by CBCT before and after the operation, the time to evaluate the efficacy of the periodontal regenerative surgery would be determined. Methods: Periodontal regenerative surgeries were performed on three-wall bone defects of ten teeth in nine patients. The height of bone defects was measured using both periapical film of distant parallel technique and CBCT before periodontal regenerative surgery. Before the surgery, CBCT data were used to measure the volume of the bone defects and the bone density around the defective areas. The height of the bone defects was measured during pe-riodontal regeneration surgery, and the volume of the defective areas was obtained with bone wax in opera-tion. CBCT was taken 6, 12 and 24 weeks after surgery to measure the bone density in the regenerated region. Results: The Wilcoxon test showed that the height of the bone defects measured preoperatively using periapical film was (0.822±0.222) mm deeper than the intraoperative measurement results, and the difference was statistically significant (P<0.05). Whereas CBCT measurement results was (0.150±0.171) mm less than the intraoperative measurement results, without statistical significant (P>0.05). The regression analysis and the Bland-Altman method also showed that the results of CBCT measurement were more accurate. The Wilcoxon test showed that the bone defect volume measured by CBCT preoperatively was accurate, and the difference between the preoperative and the intraoperative measurements was not statistically significant, ranging from 0.38 to 2.83 mm3 (P>0.05). The bone density of the regenerated areas measured by CBCT was (0.49±0.03) times in the sixth week, (0.74±0.09) times in the twelfth week and (1.16±0.11) times in the twentieth week as that of the areas around the bone defects after the surgery. Conclusion: The present data suggest that using CBCT before periodontal regenerative surgery could result in accurate measurement of height and volume of al-veolar bone defects. For the purpose of evaluating the effectiveness of regenerative surgery, CBCT could be taken 24 weeks after surgery.

Key words: Cone-beam computed tomography, Alveolar bone loss, Bone density, Periodontium, Regeneration

中图分类号: 

  • R781.42
[1] 杨刚,胡文杰,曹洁,柳登高. 牙周健康的上颌前牙唇侧嵴顶上牙龈的三维形态分析[J]. 北京大学学报(医学版), 2021, 53(5): 990-994.
[2] 敖英芳,曹宸喜. 解析与重塑软骨组织修复再生微环境[J]. 北京大学学报(医学版), 2021, 53(5): 819-822.
[3] 尤鹏越,刘玉华,王新知,王思雯,唐琳. 脱细胞猪心包膜生物相容性及成骨性能的体内外评价[J]. 北京大学学报(医学版), 2021, 53(4): 776-784.
[4] 黄丽东,宫玮玉,董艳梅. 生物活性玻璃对人脐静脉血管内皮细胞增殖及成血管的作用[J]. 北京大学学报(医学版), 2021, 53(2): 371-377.
[5] 王思雯,尤鹏越,刘玉华,王新知,唐琳,王梅. 两种可吸收生物膜联合去蛋白牛骨基质植入犬拔牙窝成骨的影像学评价[J]. 北京大学学报(医学版), 2021, 53(2): 364-370.
[6] 赵健芳,李东,安阳. TET蛋白家族与5-羟甲基胞嘧啶在干细胞及再生医学表观遗传调控中的作用[J]. 北京大学学报(医学版), 2021, 53(2): 420-424.
[7] 高璐,谷岩. 中国人群腭中缝形态特点分期与Demirjian牙龄的相关性[J]. 北京大学学报(医学版), 2021, 53(1): 133-138.
[8] 吴唯伊,李博文,刘玉华,王新知. 复层猪小肠黏膜下层可吸收膜的降解性能[J]. 北京大学学报(医学版), 2020, 52(3): 564-569.
[9] 李菲,乔静,段晋瑜,张勇,王秀婧. 引导性组织再生术对浓缩生长因子联合植骨术治疗下颌磨牙Ⅱ度根分叉病变临床效果的影响[J]. 北京大学学报(医学版), 2020, 52(2): 346-352.
[10] 曹春玲,杨聪翀,屈小中,韩冰,王晓燕. 可注射羟乙基壳聚糖基水凝胶理化性能及其对人牙髓细胞增殖和成牙本质向分化的作用[J]. 北京大学学报(医学版), 2020, 52(1): 10-17.
[11] 释栋,曹婕,戴世爱,孟焕新. 植体周炎再生治疗短期疗效观察[J]. 北京大学学报(医学版), 2020, 52(1): 58-63.
[12] 王鹏,吴华,车颖,范东伟,刘珏,陶立元. 亚洲骨质疏松筛查工具在健康体检中的筛查准确性评价及适宜切点研究[J]. 北京大学学报(医学版), 2019, 51(6): 1085-1090.
[13] 李博文,吴唯伊,唐琳,张一,刘玉华. 改良猪小肠黏膜下层可吸收膜在兔下颌骨缺损早期愈合中的作用[J]. 北京大学学报(医学版), 2019, 51(5): 887-892.
[14] 张倩莉,袁重阳,刘力,温世鹏,王晓燕. 胶原静电纺纳米纤维膜对人牙髓细胞生物学行为的影响[J]. 北京大学学报(医学版), 2019, 51(1): 28-34.
[15] 姚海红,唐素玫,王志敏,张霞,陈绪勇,高莉,刘婧,戴逸君,胡肇衡,张学武,栗占国. 初发系统性红斑狼疮患者骨密度及血清骨转化因子的研究[J]. 北京大学学报(医学版), 2018, 50(6): 998-1003.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 张燕, 韩志慧, 钟延丰, 王盛兰, 李玲玲, 郑丹枫. 骨骼肌活组织检查病理诊断技术的改进及应用[J]. 北京大学学报(医学版), 2009, 41(4): 459 -462 .
[2] 林红, 王玉凤, 吴野平. 学校生活技能教育对小学三年级学生行为问题影响的对照研究[J]. 北京大学学报(医学版), 2007, 39(3): 319 -322 .
[3] 李岳玲, 钱秋瑾, 王玉凤. 儿童注意缺陷多动障碍成人期预后及其预测因素[J]. 北京大学学报(医学版), 2007, 39(3): 337 -340 .
[4] 牟向东, 王广发, 刁小莉, 阙呈立. 肺黏膜相关淋巴组织型边缘区B细胞淋巴瘤一例[J]. 北京大学学报(医学版), 2007, 39(4): 346 -350 .
[5] 韩金涛, 赵军, 栾景源, 张龙. 多发结核性腹主动脉瘤一例[J]. 北京大学学报(医学版), 2007, 39(4): 361 -364 .
[6] 常杏芝, 卢红梅, 张月华, 秦炯. 以高血压与红斑肢痛为主要表现的汞中毒一例[J]. 北京大学学报(医学版), 2007, 39(4): 377 -380 .
[7] 李西慧, 肖锋, 李岩, 杜迎利, 宋乃庆, 张明礼. 川崎病合并心肌梗死临床治疗一例[J]. 北京大学学报(医学版), 2007, 39(4): 381 -384 .
[8] 郭艳红, 李黔, 于海奕, 高炜. 增殖抑制基因诱导血管平滑肌细胞凋亡[J]. 北京大学学报(医学版), 2007, 39(4): 394 -398 .
[9] 杨阳, 肖锋, 王进, 李简, 周利群. 肿瘤合并冠心病患者的同期外科治疗[J]. 北京大学学报(医学版), 2007, 39(4): 416 -419 .
[10] 杜绍财, 张瑞, 李俊强, 魏来. 尿苷酶在丙型肝炎病毒逆转录-抗污染-联体聚合酶链反应中的应用[J]. 北京大学学报(医学版), 2007, 39(4): 426 -428 .