应用CBCT回顾分析牙源性上颌窦病变

［摘要］ 目的 通过回顾CBCT资料评估牙源性上颌窦炎的影像学表现及最易引起牙源性上颌窦炎的牙位。方法 将500例CBCT资料分为正常上颌窦、牙源性上颌窦病变、非牙源性上颌窦病变和无法判断来源的上颌窦病变,并进行统计学分析。结果 牙源性上颌窦炎的影像学表现是发生龋病、不良修复体的上颌后牙或对应牙位有未愈合的拔牙创,无论其是否伴有根尖周病变,该病变牙相应上颌窦底黏膜会呈局部隆突性增厚影像。牙源性上颌窦炎发病率占常人的12.4%,占上颌窦病变病人的48.6%。上颌第一磨牙最易引起牙源性上颌窦炎。发生上颌窦炎,即黏膜增厚>2 mm的病例中,黏膜平均增厚(6.11±4.43) mm。结论 牙源性因素占上颌窦炎发病因素的一半;上颌第一磨牙最易引起牙源性上颌窦炎;CBCT能清晰反映上颌窦的解剖解构及上颌窦炎所引起的变化。     

不同矢状骨面型髁突位置的锥形束CT对比研究

目的 比较骨性Ⅰ类和骨性Ⅱ类受试者的髁突位置,为临床诊断与治疗提供指导。方法 选择50例骨性Ⅰ类受试者（A组,男 27例,女 23例,年龄 18~30岁,平均年龄26岁）和50例骨性Ⅱ类受试者（B组,男 24例,女 26例,年龄 18~28岁,平均年龄 25岁）。两组均拍摄锥形束 CT（CBCT）并应用相应软件进行测量分析,测量髁突位置相关测量项目。所有数据采用 SPSS 19.0统计学软件进行统计分析。结果 A组和 B组双侧髁突位置测量值差异无统计学意义（P>0.05）; A组前后间隙与 B组相比较,差异有统计学意义（P<0.05）; A组前后间隙比较 B组大,差异有统计学意义（P<0.05）。结论 骨性Ⅱ类受试者相对骨性Ⅰ类受试者髁突位置为居中位偏后。     

Comparative dosimetry of dental cone beam computed tomography, panoramic radiography, and multislice computed tomography

Objectives  

The aim of this study was to compare the effective organ doses from cone beam computed tomography (CBCT), multislice computed tomography (MSCT), and panoramic radiography.     

单侧后牙长期缺失后髁突形态的锥形束CT研究

目的采用锥形束CT（CBCT）研究单侧后牙长期游离缺失对双侧髁突形态的影响。方法收集30例单侧后牙长期游离缺失患者和30例正常对照者的CBCT图像,应用Mimics 15.0软件测量双侧髁突体积、面积、线距及骨密度,对测量结果进行统计学分析。结果缺牙侧的髁突体积、髁顶体积及其骨密度明显小于非缺牙侧（P<0.05）;髁突横截平面的面积及其骨密度大于非缺牙侧（P<0.05）。结论单侧后牙长期游离缺失后,双侧髁突均发生适应性改建,缺牙侧髁突小于非缺牙侧。     

Three-dimensional evaluation of the posterior airway space: differences in computed tomography and cone beam computed tomography

Clinical Oral Investigations - Obstructive sleep apnea syndrome (OSAS) becomes increasingly important. For diagnosis and surgery, computed tomography (CT), and cone beam computed tomography (CB-CT)...     

特发f生髁突吸收的颞下颌关节锥形束CT分析

目的利用特发性髁突吸收（ICR）患者的锥形束CT（CBCT）资料,探讨其颞下颌关节的变化。方法对39例ICR患者及28例正常人行颞下颌关节的CBCT扫描,测量颞下颌关节结构的各相关指标,并进行统计学分析。结果 ICR组与正常组间髁突内外径、前后径、水平角、关节结节斜度、关节上间隙等测量指标之间的差异均有统计学意义（P＝0.000）,表现为ICR组的髁突内外径、前后径、结节斜度、关节上间隙等减小,水平角则增大。结论 ICR的影像学主要表现是髁突的变小、前斜面的吸收、结节斜度的降低,同时髁突有往前内旋转和往上移动的趋势,这些指标可用来评估ICR的进展、疗效及预后。     

Fundamentals of cone beam computed tomography for a prosthodontist

Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone.[1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10–70 s) and radiation dosages reportedly up to 15–100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.Key Words: Artefact reduction, cone beam computed tomography, dose reduction, fundamentals, imaging accuracy, prosthodontics     

锥形束CT在根尖周病诊断中的临床价值研究

目的对比研究锥形束CT和根尖片对根尖周病的诊断价值。方法分别对35位患者,总共41颗诊断为根尖周病的患牙用锥形束CT和根尖片进行扫描,阅片后作出判断。结果通过锥形束CT发现有37颗牙存在根尖阴影,而根尖片仅发现27颗牙存在根尖阴影。结论锥形束CT比根尖片诊断根尖周病的准确度高,临床上锥形束CT可以辅助诊断疑难病例。     

上颌窦黏膜增厚的锥形束CT影像分析

目的 运用锥形束CT (CBCT)研究牙源性因素对上颌窦黏膜增厚的影响,同时,通过对上颌窦黏膜增厚的随访,研究口腔治疗的作用。方法 回顾性分析2017年8—12月四川大学华西口腔医院就诊的患者,通过CBCT图像筛选出上颌窦最大黏膜厚度>2 mm的患者,评估上颌窦底及上颌窦黏膜增厚与患牙的关系,同时,记录患牙及其治疗的情况,观察随访前后上颌窦黏膜增厚的变化。结果 黏膜厚度与炎症距窦底的距离呈极弱负相关（P<0.05,r=-0.154）,而根尖距窦底的距离与黏膜厚度无直接相关性（P>0.05）。在治疗组中,窦底破坏组的黏膜厚度变化较窦底连续组大,黏膜厚度变化与根尖距窦底的距离呈弱负相关（P<0.01,r=-0.382）,黏膜厚度变化与炎症距窦底的距离呈中等程度负相关（P<0.001,r=-0.524）。结论 上颌窦炎的严重程度可能更大程度上取决于根尖周炎症边缘距窦底的远近而与单纯的根尖位置没有明显的关系。但从治疗效果来讲,炎症病变离上颌窦越近,上颌窦底越易被破坏,上颌窦炎受牙源性因素影响越大,口腔治疗的效果也越好。     

锥形束CT在口腔医学中的应用

与传统的CT相比,锥形束CT具有空间分辨率高、放射剂量低和扫描速度快等优点,为口腔医学解决了许多疑难问题,该文就锥形束CT目前在口腔医学中的应用作一综述.     

锥形束CT应用于头影测量的研究进展

锥形束CT(CBCT)与传统头颅定位侧位片相比,能够对人的颅颌面影像进行三维重建,可提供更多的解剖信息,近年来被越来越多地应用于颅面部形态、结构的分析,但是目前尚没有一套完善的用于颅面部三维结构分析的标准。该文综述了CBCT三维重建图像、CBCT转化侧位片和传统头颅定位侧位片在线距、角度测量结果的对比,以期对临床CBCT在头影测量中的运用提供参考。     

Three-dimensional cone beam computed tomography analysis protocols for condylar remodelling following orthognathic surgery: a systematic review

Orthognathic surgery involving the mandible can lead to remodelling of the temporomandibular joint (TMJ). Cone beam computed tomography (CBCT) provides an easily accessible three-dimensional (3D) approach to study this entity. A systematic review of the literature was performed with the aim of identifying condylar remodelling analysis protocols using CBCT-derived 3D models. The search yielded 10 eligible studies. The systematic review identified three pillars of a condylar remodelling analysis protocol that were retrievable from each of the included studies: (1) registration, (2) segmentation, and (3) analysis. The studies lacked consensus on how these pillars should be transferred to their respective protocol. Through critical assessment, criteria for a universal condylar remodelling analysis are suggested: (1) performance of a regional voxel-based registration of baseline and postoperative CBCT scans using an anatomical region not prone to postoperative changes, (2) application of a (semi-)automated 3D segmentation algorithm, (3) performance of a combination of both volumetric and surface-based 3D condylar analysis, and (4) extensive validation of each step of the protocol. The homogenization of condylar remodelling analysis protocols and their incorporation into virtual planning software suites raises the potential for the inclusion of larger numbers of patients in future prospective studies in order to gain evidence-based data.     

锥形束CT在牙体牙髓病诊治中的研究进展

口腔颌面锥形束CT（CBCT）是近10余年开始应用于临床的一种新型影像学检查方法,因其检查时间短、空间分辨率高、放射剂量低、无图像失真、价格适中等优点,在口腔疾病诊治中得到广泛应用。随着技术的发展,CBCT检查在观察根尖周病变、根管治疗、诊断根管穿孔、观察牙根吸收及诊断根折等方面的优势逐渐显示出来。本文就CBCT在牙体牙髓病诊治方面的最新研究进展做一综述。     

CBCT在牙体牙髓诊治中的应用

口腔颌面锥形束CT(cone-beam computed tomography,CBCT)是一种新型的口腔影像学检查方法,它的放射剂量低、图像失真少、空间分辨率高,正逐步应用于口腔临床各个学科的诊疗中。与传统影像学方法相比,CBCT在诊断遗漏根管、根折和根管穿孔,观察根尖周病变,判断根管疗效及辅助疏通钙化根管等方面具有较大优势。充分利用CBCT的辅助检查,将对牙体牙髓的临床诊疗产生极大的帮助。     

Evaluation of canalis sinuosus in individuals with cleft lip and palate: a cross-sectional study using cone beam computed tomography

Oral and Maxillofacial Surgery - To evaluate the canalis sinuosus (CS) in individuals with cleft lip and palate (CLP) and compare the findings with individual’s NON-CLP using cone beam...     

锥形束CT与曲面断层在诊断下颌骨骨折中的比较研究

目的对比研究锥形束CT与曲面断层对下颌骨骨折的诊断特点及差异。方法收集2010年4月至2010年10月共27例因颌面部外伤行锥形束CT和曲面断层检查的患者的临床资料,比较两种方法对下颌骨不同部位骨折的诊断率。结果锥形束CT在下颌骨各部位的骨折诊断中均能明确观察骨折线及断端移位情况,而曲面断层存在漏诊现象,漏诊率为27.5%（11/40）,特别是髁突及颏部骨折,漏诊率分别为35.3%和27.3%。结论曲面断层检查存在漏诊的可能,特别是髁突或颏部骨折时,漏诊率更高。建议对下颌骨骨折应结合锥形束CT检查,以避免漏诊。同时,锥形束CT三维重建在帮助医生制定手术计划方面有很大优势和广泛应用前景。