上颌第一、第二磨牙间腭侧微种植支抗钉植入安全位置的CBCT研究

目的应用锥形束CT(cone beamCT,CBCT)测量在上颌第一、第二磨牙间腭侧以不同角度植入微种植支抗钉时上颌第一、第二磨牙腭根间近远中向宽度,以及微种植支抗钉植入路径的黏膜厚度和骨组织厚度,为临床选择微种植支抗钉植入位置提供参考。方法选取90例成人患者,以其颌骨进行扫描重建的CBCT资料为研究对象,在上颌腭侧,第一磨牙和第二磨牙之间选取距上颌第一磨牙腭尖12、14、16、18 mm的软组织标志点作为测量位置,分别测量与牙长轴成30°、45°、60°、90°时上颌第一、第二磨牙腭根之间的近远中向宽度及微种植支抗钉植入路径的黏膜厚度和骨组织厚度。采用SPSS 26.0软件进行单因素方差分析及LSD法两两比较。结果植入微种植支抗钉角度越大,上颌第一、第二磨牙腭根间的近远中向宽度越小,差异具有统计学意义(P<0.05),与90°方向相比,以60°方向植入时近远中向宽度更大,接触相邻牙根的概率更小;植入角度越大,黏膜厚度越小,结果具有显著性差异(P<0.001),与30°、45°方向相比,以60°方向植入时黏膜厚度更小,微种植支抗钉进入骨组织内的长度更大更稳定。植入微种植支抗钉位置越高,近远中向宽度越大,差异具有统计学意义(P<0.05),与12、14 mm位置相比,距上颌第一磨牙腭尖16 mm植入时近远中向宽度更大,接触相邻牙根的概率更小;植入位置越高,黏膜厚度越大,差异具有统计学意义(P<0.001),与18 mm位置相比,距上颌第一磨牙腭尖16 mm植入时黏膜厚度更小,微种植支抗钉进入骨组织内的长度更大,更稳定。结论在上颌第一、第二磨牙间腭侧,距上颌第一磨牙腭尖16 mm以60°方向植入微种植支抗钉较为安全。

CBCT study on the safe location of palatal microscrew implant anchorage nail between maxillary first and sec?ond molars

Objective Conebeam CT(CBCT)was used to measure the palatine between the maxillary first and sec?ond molars.The proximal and distal palatal widths of the maxillary first and second molar and the palatal mucosal thick?ness and bone tissue thickness when microscrew implant anchorage nail were implanted at different angles provided a reference for the clinical selection of microscrew implant placement.Methods The image data of 90 adult patients were selected as the research object,and the jaw bone was reconstructed by scanning.In maxillary palatine,selection of distances at 12 mm,14 mm,16 mm,and 18 mm from the palatal apex of maxillary first molar between the maxillary first and second molar were used as measurement,measured the proximal and distal palatal widths of maxillary first and second molar and the palatal mucosal thickness and bone tissue thickness when microscrew implant anchorage nails were implanted at 30°,45°,60°,and 90°.SPSS 26.0 software was used for one?way ANOVA and LSD pair compari?son.Results The larger the angle of the microscrew implant anchorage nail was,the smaller the proximal and distal medial widths between the maxillary first and second molar,and the difference was statistically significant(P<0.05).Compared with the 90°direction,the proximal and distal medial widths of the microscrew implant anchorage nail were larger in the 60°direction.The greater the angle of implantation,the smaller the mucosal thickness and the greater the bone tissue thickness,and the results showed a significant difference(P<0.001).Compared with the direction of 30°and 45°,the mucosal thickness at the direction of 60°was smaller,and the bone tissue thickness was larger.The higher the position of the microscrew implant anchorage nail,the greater the width of the proximal and distal medial,and the difference was statistically significant(P<0.05).Compared with the positions 12 and 14 mm from the palatal tip,the proximal and distal medial widths of the microscrew implant anchorage nail were larger.The higher the implant position was,the greater the mucosal thickness and the smaller the bone tissue thickness.The results showed a significant differ?ence(P<0.001).Compared with the position of 18 mm from the palatal tip of the maxillary first molar,the mucosal thickness was smaller and the bone tissue thickness was larger.Conclusion It is most appropriate to implant micro?screw implant anchorage nail at least 10 mm in length in the direction of 60°at the palatal apex 16 mm from the maxil?lary first molar in palatine between the first and second molar.