中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (22): 4023-4026.doi: 10.3969/j.issn.1673-8225.2010.22.008

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

多层螺旋CT辅助微种植体支抗植入的精确性

陈京奕1，单丽华2，刘英奇1，焦建军1，史东晔1   

  1. 1邯郸市中心医院口腔科，河北省邯郸市  056001；  2河北医科大学第二医院正畸科，河北省石家庄市 050000
  • 出版日期:2010-05-28 发布日期:2010-05-28
  • 作者简介:陈京奕★，女，1972年生，河北省任县人，汉族，2007年河北医科大学毕业，硕士，副主任医师，主要从事口腔正畸及修复专业工作。 ccy0712@yahoo.com.cn

Accuracy of multi-slice spiral CT images assisting mini-implant anchorage surgery

Chen Jing-yi1, Shan Li-hua2, Liu Ying-qi1, Jiao Jian-jun1, Shi Dong-ye1   

  1. 1 Department of Stomatology, Handan Central Hospital, Handan   056001, Hebei Province, China; 2 Department of Orthodontics, Second Hospital of Hebei Medical University, Shijiazhuang   050000, Hebei Province, China
  • Online:2010-05-28 Published:2010-05-28
  • About author:Chen Jing-yi★, Master, Associate chief physician, Department of Stomatology, Handan Central Hospital, Handan 056001, Hebei Province, China ccy0712@yahoo.com.cn

PDF

549

被引次数

10

摘要：

背景：与传统正畸支抗比较，骨性种植支抗解决疑难病例的矫治优势已逐步显现。但仍存在一定失败率。所以在种植前对种植区的骨质骨量做细致精确的评估并制定周密的治疗方案是使用微螺钉作为高效正畸支抗的前提。
目的：比较多层螺旋CT各种重建影像在术前评估种植区骨量的精确性，并探求其影响因素，以辅助提高微种植支抗的稳定性。
方法：采用多层螺旋CT原始轴位像及多种重建影像精确设计种植角度后，在成熟普通猪头颅骨种植32枚纯钛微螺钉，术后分别测量多种影像上的微螺钉角度，并沿微螺钉走向测量局部牙槽突宽度。解剖猪颌骨，测量组织块牙槽突宽度及微螺钉角度。将多层螺旋CT多种影像线段和角度测量值分别与实物测量值进行比较并进行统计学分析。
结果与结论： ①多层螺旋CT二维平面及三维立体影像上的角度与线段测量值与实物相比较均一致性较好，但均略小于实测值。②原始轴位图像精确度最高，二维平面影像精确度高于三维立体影像。③角度测量值精确度高于线段。④无论二维平面或三维立体影像，轴位面影像精确度高于侧断面影像。提示多层螺旋CT图像可提供与实物大小基本接近1∶1的精确信息，能够准确指导微种植体支抗手术，以辅助提高其稳定性；原始轴位图像与多层面重建中的侧断面图像在角度及线距测量上临床应用价值最大；MSCT放射线基准面选择影响侧断面放大率。

关键词: 种植体支抗, 多层螺旋CT, 三维重建, 精确度, 数字化口腔科技术

Abstract:

BACKGROUND: Compared with traditional orthodontic anchorage, bone implant anchorage displays advantages in treating intractable cases. However, the failure rate exists. To extend and apply the miniscrew anchorage system, the key methods  improved the stability of miniscrews, which is based on accurate diagnosis and analysis to the local alveolar bone.
OBJECTIVE: To evaluate the accuracy of various multi-slice spiral CT (MSCT) images assisting implant anchorage surgery and explore the factors associated with the accuracy.
METHODS: Following design of the implant anchorage angles in various MSCT images accurately, 32 titanium miniscrews were implanted in procine skull. The anchorage angles on MSCT images again and the buccalingual breaths of alveolar process by insert angle were measured. The skulls were dissected, and the implant anchorage angles and the breadths of alveolar process were measured on anatomic bone samples. The various MSCT images data and pits’ skull sample data were compared.
RESULTS AND CONCLUSION: Their concordance correlations between MSCT length and angle measurement data and the anatomic bone samples were good. But all MSCT data were smaller than the anatomic samples data. The accuracy of 2D images was better than 3D images. The measurement accuracy of angles was better than lengths. The accuracy of axial sections were better than that of cross-sections in 2D and 3D MSCT images. MSCT images can provide accurate quantity information in the ration 1:1 to material object. It is accurate and reliable that MSCT images assist implant anchorage surgery. On measurement, the 2D axial and 2D cross-sectional images play the most important role on clinical application. The measurement accuracy of cross-sectional images is affected by scanning plane of MSCT radio active rays.

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