北京大学学报(医学版) ›› 2017, Vol. 49 ›› Issue (4): 699-703. doi: 10.3969/j.issn.1671-167X.2017.04.027

• 论著 • 上一篇    下一篇

锥形束CT分析下颌无牙颌患者前部颌弓形态对“All-on-4”种植设计的影响

李世赢1,李刚2,冯海兰1,潘韶霞1△   

  1. (北京大学口腔医学院·口腔医院, 1. 修复科,2. 放射科, 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,北京100081)
  • 出版日期:2017-08-18 发布日期:2017-08-18
  • 通讯作者: 潘韶霞 E-mail: panshaoxia@vip.163.com
  • 基金资助:
     教育部留学回国人员科研启动基金(2012-940)资助

Influence of the interforaminal arch form of edentulous mandibles on design of “All-on-4”: preliminary research based on conebeam computed tomography

LI Shi-ying1, LI Gang2, FENG Hai-lan1, PAN Shao-xia1△   

  1. (1. Department of Prosthodontics, 2. Department of Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China)
  • Online:2017-08-18 Published:2017-08-18
  • Contact: PAN Shao-xia E-mail: panshaoxia@vip.163.com
  • Supported by:
    Supported by the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry(2012-940)

摘要: 目的:通过测量分析下颌无牙颌患者的锥形束CT(conebeam computed tomography, CBCT)图像,测量可能植入种植体的A-P距离(anterior-posterior distance),分类前部颌弓形态,探究颌弓形态对“All-on-4”远中倾斜种植体临床设计的影响。方法:收集下颌无牙颌患者的CBCT图像共74例,其中男性35例,女性39例,拟行“All-on-4”种植固定义齿修复。在经颏孔并平行于牙合平面的平面上测量可能植入种植体的A-P距离,分类前部颌弓形态,测量由颏孔往近中方向7.5 mm的颌骨段所跨过的颌弓弧度,探究A-P距离与该弧度的相关性。结果:74例患者测得可植入的颏孔间区种植体的A-P距离为(8.5±1.5) mm(最小为4.5 mm,最大为11.8 mm),其中≤7 mm者占12.2%(男性3例,女性6例),颌弓为方圆形;>7 mm、≤9 mm者占54.0%(男性20例,女性20例), 颌弓为卵圆形;>9 mm者占33.8%(男性12例,女性13例),颌弓为尖圆形。测量患者颏孔前方7.5 mm颌弓段转角弧度,左、右两侧共测得148个数据,平均为15.9°±5.5°(最小为5.6°,最大为35.2°)。统计分析发现,AP距离与转角弧度呈显著负相关。结论:本研究中下颌无牙颌患者的前部颌弓形态中,卵圆形所占百分比最多,尖圆形次之,方圆形最少。女性方圆形颌弓者多于男性,卵圆形和尖圆形颌弓与性别无明显相关。颌弓越方,A-P距离越小,颏孔前区颌弓弧度就越大,远中斜行种植体所需要的骨宽度就越大。下颌无牙颌患者的“All-on-4”种植固定修复采用远中斜行种植体,术前应评估颌弓形态,设计远中种植体的合理倾角,远中种植位点的骨宽度应在常规要求外留有余量。方圆形颌弓是“All-on-4”种植固定修复的不利因素。

关键词: 下颌骨, 颌, 无牙, 牙种植, 牙弓

Abstract: Objective:To classify the interforaminal arch form of edentulous mandibles by measuring the anterior-posterior distance (A-P distance) of implants planned to be inserted in “All-on-4” protocol using conebeam computed tomography (CBCT) data, and to investigate the influence of the arch form on the “All-on-4” distally tilted implants. Methods: Seventy-four CBCT images of edentulous mandibles were collected, including 35 males and 39 females respectively. “All-on4”implant supported fixed prostheses were designed for these patients based on the CBCT data. The A-P distance was measured in the plane which crossed bilateral mental foramens and was parallel to the occlusal plane. The interforaminal arch form of edentulous mandibles were classified according to the A-P distance. The radian of the jaw arch 7.5 mm mesially to the mental foramen was measured bilaterally, and its correlation with the A-P distance was studied. Results: The average A-P distance of implant supported fixed prostheses planned in the interforaminal region was (8.5±1.5) mm (minimum 4.5 mm, maximum 11.8 mm). In the study, 12.2% of the subjects’ mandibles were classified as square arch form with A-P distances ≤7 mm, 54.0% were classified as ovoid with A-P distances >7 mm and ≤9 mm,  33.8% were classified as tapered with A-P distances >9 mm. Bilaterally, 148 results of the radian of the jaw arch 7.5 mm mesially to the mental foramen were obtained, and the average radian was 15.9°±5.5° (minimum 5.6°, maximum 35.2°). The radian and the AP distance showed a negative correlation with statistical significance. Conclusion: In this research, the ovoid arch form was the most common type in edentulous mandibles, followed by tapered arch form. The square arch form showed the lowest percentage. As the arch form went squarer, the A-P distance became shorter, the radian of the jaw arch mesially to the mental foramen went greater, and the bone width that distally tilted implants need became bigger. The interforaminal arch form of the edentulous mandible should be analyzed before an implant supported fixed restoration is designed in the interforaminal region. The angle of inclination of distal implants should be reasonable. The bone width of the distal implant site must be adequate. The square arch form contributes negatively to the structure of implant supported fixed prostheses with distal cantilever design.

Key words: Mandible, Jaw, edentulous, Dental implantation, Dental arch

中图分类号: 

  • R783.4
[1] 唐祖南,胡耒豪,陈震,于尧,章文博,彭歆. 增强现实技术在口腔颌面颈部解剖识别中的应用评价[J]. 北京大学学报(医学版), 2024, 56(3): 541-545.
[2] 李红光,韩玮华,吴训,冯继玲,李刚,孟娟红. 关节腔冲洗联合液态浓缩生长因子注射治疗单侧颞下颌关节骨关节炎的初步研究[J]. 北京大学学报(医学版), 2024, 56(2): 338-344.
[3] 陈晨,梁宇红. 复杂根管上颌磨牙的根管治疗3例[J]. 北京大学学报(医学版), 2024, 56(1): 190-195.
[4] 董佳芸,李雪芬,路瑞芳,胡文杰,孟焕新. 血管化骨瓣重建颌骨种植体周软组织病理学特点[J]. 北京大学学报(医学版), 2024, 56(1): 25-31.
[5] 周颖,赵宁,黄竑远,李庆祥,郭传瑸,郭玉兴. 双层软组织缝合封闭技术在下颌骨中早期药物相关性颌骨骨坏死患者手术治疗中的应用[J]. 北京大学学报(医学版), 2024, 56(1): 51-56.
[6] 徐心雨,吴灵,宋凤岐,李自力,张益,刘筱菁. 基于下颌运动轨迹的正颌外科术中下颌骨髁突定位方法及初步精度验证[J]. 北京大学学报(医学版), 2024, 56(1): 57-65.
[7] 王聪伟,高敏,于尧,章文博,彭歆. 游离腓骨瓣修复下颌骨缺损术后义齿修复的临床分析[J]. 北京大学学报(医学版), 2024, 56(1): 66-73.
[8] 蔡安东,王晓霞,周文娟,柳忠豪. 下颌前突畸形患者上颌骨及髁突虚拟位置与术后现实位置的比较[J]. 北京大学学报(医学版), 2024, 56(1): 74-80.
[9] 李穗,马雯洁,王时敏,丁茜,孙瑶,张磊. 上前牙种植单冠修复体切导的数字化设计正确度[J]. 北京大学学报(医学版), 2024, 56(1): 81-87.
[10] 刘晓强,周寅. 牙种植同期植骨术围术期高血压的相关危险因素[J]. 北京大学学报(医学版), 2024, 56(1): 93-98.
[11] 卢汉,张建运,杨榕,徐乐,李庆祥,郭玉兴,郭传瑸. 下颌牙龈鳞状细胞癌患者预后的影响因素[J]. 北京大学学报(医学版), 2023, 55(4): 702-707.
[12] 黄莹,吴志远,周行红,蔡志刚,张杰. 股前外侧皮瓣修复上颌骨缺损术后面部软组织对称性感观分级[J]. 北京大学学报(医学版), 2023, 55(4): 708-715.
[13] 丁茜,李文锦,孙丰博,谷景华,林元华,张磊. 表面处理对氧化钇和氧化镁稳定的氧化锆种植体晶相及断裂强度的影响[J]. 北京大学学报(医学版), 2023, 55(4): 721-728.
[14] 张雯,刘筱菁,李自力,张益. 基于解剖标志的鼻翼基底缩窄缝合术对正颌患者术后鼻唇部形态的影响[J]. 北京大学学报(医学版), 2023, 55(4): 736-742.
[15] 王哲,孙伟,杨雪,宋颖,姬爱平,白洁. 口腔急诊颌面部感染患者临床分析[J]. 北京大学学报(医学版), 2023, 55(3): 543-547.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!