成人牙周病正畸患者牙槽骨骨矿丢失CBCT研究.pdfVIP

PART 1 A STUDY OF A NEW METHOD OF M EASUREMENT ABSTRUCT OBJECTIVE: The purpose of this study was to evaluate the clinic usage of Cone Beam Computed Tomography in dental aspect and to assess the accuracy of a new method of measurement of alveolar bone density by using CBCT and its image analysis program iDixel. METHODS: The upper anterior dental alveolar bone of ten person were scanned by CBCT . Three interalveolar septum of each sample were selected and divided into three different depth of interest of which the bone density were assessed by using iDexil image analysis program which reproduce 3-dimention images on computer. Ten sample were assessed three times by the same researcher, the alternation was two weeks. The reliability of the method of measurement of bone density was analyzed. RESULTS: There was no significant difference among the three times measurement results. CONCLUSION: The method of measurement of alveolar bone density by CBCT was reliable and effective. 6 KEY WORDS: CBCT , Measuring method 第一部分 Cone Beam CT 测量方法研究 引言 由于牙周炎所致牙槽骨的骨吸收破坏，导致牙齿松动，造成了成年患者正畸治 疗的困难，所以对牙槽骨破坏程度的检查和评价在正畸的诊断，治疗计划的制定， 拔牙的选择，以及治疗的过程中都十分重要。临床上如何正确观察和评估成人牙周 炎正畸患者牙槽骨破坏情况，特别是支抗牙剩余牙槽骨的情况是正畸治疗成功的关 键之一。 20 世纪 70 年代就有学者发表测量牙槽骨高度变化的方法以评价牙槽骨状态。 Stoner （1972）提出了牙槽嵴顶骨密度的变化先于牙槽骨高度的变化。Ortman （1982 年）通过实验证实牙槽骨骨矿含量丧失30% 以上时才能在X 线片上有所表现。牙周 病导致的牙槽骨吸收首先反映在牙槽骨骨密度的改变上。所以对牙槽骨骨密度的测 量能较早的对患者的病情作出准确评价，灵敏程度更高。 骨密度的测量（BMD Bone Mineral Density ）是利用X 线和其他技术对人体骨矿 含量和全身体质成分进行定量分析的方法。定量分析松质骨的方法一般可分为有创 性和无创性两类。有创性方法（如骨组织形态计量学）需要先在人体的骨骼上取活 检，然后在体外对骨组织标本进行分析，存在侵入性、不可重复性和费时费力等缺 点，限制了其临床应用。目前常用无创性的测量方法有X 线光密度法、双能X 线骨 密度仪（DXA Dual energy X-ray Absorptiometry ）、定量超声（Q