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牙颌模型三维CT扫描测量分析系统的建立和研究  [PDF]
严斌,王林,胡遒生,潘林,杨奎,鲍旭东
华西口腔医学杂志 , 2005,
Abstract: 目的 建立计算机辅助牙颌模型三维CT扫描测量分析系统,并研究其可行性。方法 采用高分辨率螺旋CT扫描石膏牙颌模型获得其断层图像,利用VisualC6.0编制在Windows环境下运行的分析软件,完成三维图形重建及测量,并采用该系统与手工方法对20副恒牙期模型进行测量,比较其结果。结果 牙颌模型三维CT系统经检测精度合乎临床要求;且系统与手工方法测量20副恒牙期模型结果比较显示,两者间差异无显著性(P>0·05)。结论 牙颌模型三维CT扫描测量分析系统是一套具有临床实用价值及推广意义的计算机辅助诊疗系统。
颧牙槽嵴区骨宽度及皮质骨厚度的CBCT测量分析
Bone Width and Cortical Bone Thickness of Infrazygomatic Crest Analysed with Cone Beam Computed Tomography.
 [PDF]

陈立艳, 刘志杰, 苑芳连, 张苗苗, 王兰珠
CHEN Li-yan
, LIU Zhi-jie, YUAN Fang-lian, ZHANG Miao-miao, WANG Lan-zhu.

- , 2017, DOI: 10.13701/j.cnki.kqyxyj.2017.06.015
Abstract: 摘要 目的:应用锥形束CT(CBCT)测量成年人与青少年的颧牙槽嵴区域的骨宽度、皮质骨厚度及窦底高度,并评价2组的差异,为临床中颧牙槽嵴区微种植体的植入提供参考。方法:选取成年人个别正常牙合志愿者和安氏Ⅰ类青少年患者各30例,获取其口腔颌面部CBCT扫描影像。测量颧牙槽嵴区域的骨宽度、皮质骨厚度及上颌窦底高度,并对测量数据进行统计学分析。结果:两实验组颧牙槽嵴区域均为第二前磨牙和第一磨牙之间的骨宽度最大,且每层的5个测量值均表现为随测量点向颅方移动骨宽度值逐渐减小。两实验组各层颧牙槽嵴区骨宽度与窦底高度成正相关关系。结论:成年人组各位置骨宽度平均值及皮质骨厚度平均值均较青少年组相应位置大。颧牙槽嵴区骨宽度随窦底高度增大而增大。2组样本上颌窦个体差异均非常大,植入微种植体前需拍摄CBCT以确定是否满足植入条件
Tweed-Merrifield技术矫治成人严重双颌前突的疗效评价
Therapeutic evaluation of the correction of the severe bi-maxillary protrusion cases by Tweed-Merrifield technique
 [PDF]

黄俊强,刘施瑶,江久汇
- , 2016, DOI: 10.3969/j.issn.1671-167X.2016.03.031
Abstract: 目的:利用Johnston分析法评价Tweed-Merrifield技术矫治双颌严重前突成人患者牙性及骨性变化对治疗结果的影响。方法:应用回顾性自身对照方法,对12 例采用Tweed-Merrifield拔牙技术矫治的双颌前突成人患者采用Johnston分析法和华正测量软件对常规测量项目进行矫治前后的X线头影测量对比分析。结果:矢状方向上,上颌骨相对颅底后移1.30 mm,下颌骨相对颅底前移2.12 mm,上下颌骨相对位置变化了3.42 mm;上下切牙均明显后移并直立,上下磨牙略前移,矫治后磨牙关系及前牙覆盖分别改变了3.44 mm和4.23 mm。ANB、U1NA、U1/NA、U1/SN、L1NB、L1/NB、L1/MP值治疗后分别改变 -(1.98±1.55)°(P=0.012)、-(5.08±4.6) mm(P=0.002)、-(11.79±1.21)°(P=0.004)、-(13.55±6.32)°(P=0.047)、-(3.17±3.07) mm(P=0.010)、 -(6.84±2.55)°(P=0.038)、-(4.13±2.24)°(P=0.048),差异均有统计学意义。结论:TweedMerrifield技术通过定向力系统的施行,可以稳定支抗磨牙,内收前牙,显著改善双颌前突患者的软硬组织侧貌,且实现了较好的垂直向控制,适用于需要强支抗的双颌前突患者的拔牙矫治。
Objective: To evaluate the influence of Tweed-Merrifield technique in correction of severe bimaxillary protrusion adult patients on the measurement of the dental and skeletal changes after orthodontic treatment by Johnston analysis and the regular cephalomatric analysis. Methods: Twelve adolescent patients with severe bimaxillary protrusion were included in this self-control retrospective study. Lateral cephalometric radiographs were taken before and after treatments. All the radiographs were traced and analyzed by the method of Johnston analysis. Other measurements were evaluated using a series of 13 linear and angular measurements including SNA, SNB, ANB, U1-SN, U1-NA, U1/NA, L1-NB, U1/NB, L1/MP, U1-L1, (U1+L1)/2-AB, MP/SN and MP/FH from regular cephalomatric analysis. These measurements were also applied to compare the differences between pre-and post-treatments, which clarify the dental and skeletal changes by Johnston analysis. The effect of orthodontic correction was determined using the non-parameters test. Results: The maxillary moved backforward by 1.3 mm according to the stable skull base, while the mandible moved forward by 2.12 mm. The relative position between the maxillary and mandible (ABCH) changed 3.42 mm. The upper and lower incisors retracted significantly. The upper and lower molars moved slightly forward and the relative positions of upper and lower molars and anterior teeth after treatment were 3.44 mm and 4.23 mm respectively. After treatment, the parameters of ANB、U1NA、U1/NA、U1SN、L1NB、L1/NB and L1-M were reduced by -(1.98±1.55)°(P=0.012), -(5.08±4.6) mm (P=0.002), -(11.79±1.21)°(P=0.004), -(13.55±6.32)°(P=0.047), -(3.17±3.07) mm (P=0.010), -(6.84±2.55)°(P=0.038) and -(4.13±2.24)°(P=0.048) on average, whose changes had the statistically significant effects. Conclusion: Tweed-Merrifield technique (directional force technique) can stabilize anchorage molar, retract anterior teeth and significantly improve the hard and soft tissue
正畸牙移入牙槽突裂患者植骨区的牙CT评价  [PDF]
吴军,王国民
华西口腔医学杂志 , 2012, DOI: 10.3969/j.issn.1000-1182.2012.04.013
Abstract: 目的应用牙CT评价正畸牙移入牙槽突裂患者植骨区后牙槽骨的形态变化。方法对3位牙槽突裂患者在植骨前后和正畸治疗后行牙槽突裂裂隙区的三维牙CT检查,分析正畸牙移入植骨区域后,正畸牙位置及牙槽骨的形态变化。结果牙槽突裂植骨术后,正畸牙可以顺利移入植入骨区域,正畸牙的牙根尖位置发生明显的位移,牙槽骨会随正畸牙的移动发生塑形改变,而不仅仅是牙齿在牙槽骨内的移动。结论牙槽突裂植骨及正畸治疗有益于重建牙弓的完整性。
成人安氏Ⅰ类双颌前突患者的上颌切牙区牙槽骨体积
Alveolar bone volume around upper incisors in adult patients with Class Ⅰ bimaxillary protrusion
 [PDF]

刘璐, 李荣荣, 刘梦珺, 张琰, 刘东旭
LIU Lu
, LI Rongrong, LIU Mengjun, ZHANG Yan, LIU Dongxu

- , 2015, DOI: 10.6040/j.issn.1671-7554.0.2015.041
Abstract:
牙合位、颌位与正畸治疗  [PDF]
白丁,韩向龙
华西口腔医学杂志 , 2013, DOI: 10.7518/hxkq.2013.04.001
Abstract: 建立美观、健康、稳定、高效的咬合,是正畸医生的治疗目标之一。然而,目前正畸治疗的咬合标准大都局限于静态牙合,对于动态牙合即功能状态下的咬合状况研究较少。某些患者在治疗中即出现牙合位与颌位不一致,或者是治疗中与治疗前其颌位不尽相同。这无疑会影响正畸治疗结果的稳定性,乃至颞下颌关节以及整个口颌系统的健康。功能牙合理论认为髁突在关节窝内发生移位是导致患者牙合位与颌位不一致、治疗后复发的主要原因。功能理论中包含了如何评价患者牙合、颌关系的手段和方法。本文主要对功能牙合理论的内容和应用方法作简单的介绍。
锥形束CT融合三维面像评估正颌术后软硬组织的变化
Feasibility of integrating 3D photos and cone-beam computed tomography images used to evaluate changes of soft and hard tissue after orthognathic surgery
 [PDF]

王哲,朱榴宁,周琳,伊彪
- , 2016, DOI: 10.3969/j.issn.1671-167X.2016.03.029
Abstract: 目的:探讨锥形束CT(cone-beam computed tomography,CBCT)融合三维面像用于研究牙颌面畸形患者正颌术后软硬组织变化的可行性,并应用此方法初步测量各软硬组织标志点手术前后的位置变化。 方法: 选取10例牙颌面畸形患者,分别于术前(T0)和术后3个月(T1)拍摄大视野CBCT和三维面像。利用MIMICS和Geomagic Studio软件对图像进行处理分析,将CBCT进行阈值分割并与三维面像融合,生成新的三维立体模型,探讨该方法可行性。使用3D 色谱分析(3D color map)和测量平均距离对CBCT与三维面像配准过程的误差进行定性和定量分析。通过CBCT骨组织配准,将新生成的手术前后三维模型置于同一空间坐标系,测量各标志点[鼻尖点( pronasale, Prn )、鼻下点(subnasale, Sn)、上唇突点(labrale superior, Ls)、前鼻棘点(anterior nasal spine, ANS)、上齿槽座点(subspinale, A)、上中切牙点(upper incisor edge, UIE)]手术前后位置变化。结果: CBCT融合三维面像用于研究正颌术后软硬组织变化具有可行性,配准误差在0.3 mm以内,通过3D 色谱分析直观看到,面部区域配准良好。正颌术后唇部各标志点(Ls、ANS、A、UIE)位置差异有统计学意义(P<0.05),而鼻部标志点(Prn、Sn)位置差异无统计学意义(P>0.1)。结论:CBCT融合三维面像作为一种新方法可以用于临床研究正颌术后软硬组织变化,具有较高的精确度和可重复性。正颌术后唇部软硬组织标志点位置明显变化,而鼻部标志点位置受正颌手术影响较小。
Objective: To evaluate the feasibility of integrating 3D photos and cone-beam computed tomography (CBCT) images and to assess the degree of error that may occur during the above process, and to analyze soft and hard tissue changes after orthognathic surgery using this new method. Methods: Ten patients with maxillofacial deformities were chosen. For each patient, CBCT scans and stereophotographic images were taken before and 3 months after surgery. 3D photos were superimposed onto the CBCT skin images using relatively immobile areas of the face as a reference. 3D color maps and mean distances were used to evaluate the errors that might occur during the process. Two reference planes were set up using certain points. The distances between Prn (pronasale),Sn (subnasale),Ls (labrale superior),ANS (anterior nasal spine),A (subspinale),UIE (upper incisor edge) to the coronal plane were calculated before and after surgery. In order to verify the repeatability of this method, we examined the distances twice at two-week intervals. Paired t test was used to evaluate the reproducibility. Results: CBCT and 3D photos could be successfully fused with clinically acceptable errors. This new method could be used to evaluate soft and hard tissue changes after orthognathic surgery. The 3D color maps showed that the two images could be fused with minimal errors. The mean distances were within 0.3 mm, and the locations of landmarks on maxilla and mandible such as Ls, ANS, A, UIE changed significantly after orthognathic surgery (P<0.05).Landmarks on the nose such as Prn,Sn had little changes after surgery (P>0.1). The paired t test showed that the mean value and standard deviation were (0.08±0.98) mm. Conclusion: Fusing of CBCT and 3D stereophotographic images used as a new method in evaluating soft and hard tissue changes after
种植微螺钉支抗矫治下颌磨牙缺失患者的上牙前突伴拥挤  [PDF]
姜世同,姜晓蕾,秦雍,张茹,刘洪杰,焦广军,袁阔
华西口腔医学杂志 , 2007,
Abstract: 目的探讨微螺钉种植体作为支抗用于下颌磨牙缺失患者矫治上牙前突伴拥挤的临床效果。方法选择下颌单侧磨牙缺失、上牙前突伴拥挤的成年错!患者8例(年龄22~38岁),在每位患者下颌磨牙缺失侧的第二前磨牙远中11~13mm颊侧牙槽嵴处各种植1枚纯钛微螺钉,并以栓道固位方式在微螺钉的龈上部分附着自制微螺钉牵引帽,利用微螺钉牵引帽依次牵引同侧的下颌前磨牙、尖牙、切牙向远中移位,并利用牵引帽上的牵引钩行颌间Ⅱ类牵引。结果采用种植微螺钉作为支抗的8例患者治疗后均达到较理想的效果,前牙覆盖覆!和后牙尖窝关系均正常。疗程最长者24个月,最短者15个月,平均20.8个月。结论微螺钉种植体支抗可以用于下颌磨牙缺失的上牙前突伴拥挤患者的矫治。
锥形束CT在颌骨囊肿诊治中的临床应用  [PDF]
廖锐,孙苗根,顾亚军,王仁飞,刘敏
华西口腔医学杂志 , 2012, DOI: 10.3969/j.issn.1000-1182.2012.03.010
Abstract: 目的探讨锥形束CT影像在颌骨囊肿治疗中的应用价值。方法选择25例曲面断层片难以确定颌骨囊肿边缘的患者进行锥形束CT扫描,依据锥形束CT图像,观察囊肿三维方向上的位置、与颌骨骨壁的距离,了解囊肿与牙齿、周围解剖结构的毗邻关系,采用相应的术前准备和手术方案。术中核对锥形束CT观察结果。结果锥形束CT清楚地显示了颌骨囊肿的准确部位、边缘位置、受累牙情况、与周围解剖结构的毗邻关系,与术中所见完全吻合。锥形束CT对手术方案、手术入路、切口设计和受累牙处理具有良好的指导作用。结论锥形束CT在颌骨囊肿诊治上的临床应用价值明显优于传统的曲面断层片和根尖片。
锥形束ct在评价双颌前突患者前牙区牙槽骨缺损中的应用  [PDF]
周琳,李巍然
北京大学学报(医学版) , 2015,
Abstract: ?目的:应用锥形束ct(cone-beamcomputedtomography,cbct)评价治疗前双颌前突患者前牙区牙槽骨缺损情况。方法:选取50名未经正畸治疗的患者,根据年龄分为成人组[30例,平均(22.9±4.2)岁]与青少年组[20例,平均(13.1±1.0)岁],其中成人组根据垂直骨面型分为低角组(9例)、均角组(11例)与高角组(10例),所有患者在相同参数条件下进行cbct扫描,在其cbct图像上诊断牙槽骨开窗与开裂的情况并分析其分布特征。结果:双颌前突患者发生牙槽骨缺损的人数比为94.00%。所有接受检验的牙齿牙槽骨缺损发生率为38.60%。牙槽骨缺损绝大多数发生在唇侧(98.66%);牙槽骨开窗主要发生在上颌,而骨开裂主要发生在下颌。青少年组牙槽骨开裂(3.06%)及骨缺损(30.13%)发生率明显低于成人组的骨开裂(11.73%)及骨缺损(42.46%)发生率,p<0.05;而两组的牙槽骨开窗发生率差异无统计学意义(p>0.05)。低角组骨开窗(22.22%)的发生率低于均角组(33.84%)和高角组(37.50%),p<0.05。牙槽骨缺损发生率最低的牙位为上颌中切牙。结论:双颌前突患者在正畸治疗前即存在广泛的牙槽骨缺损,缺损的发生率受年龄、垂直骨面型等因素影响。
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