现代医药卫生2016，Vol.32Issue(17)：2630-2633,4.DOI:10.3969/j.issn.1009-5519.2016.17.004
锥形束CT在拔除下颌阻生第三磨牙中的应用价值
Application value of cone-beam CT in extraction of impacted mandibular third molar
摘要
Abstract
Objective To study the application value of cone-beam computed tomography(CBCT)in the location and ex-traction of impacted mandibular third molar (IMTM). Methods Thirty-six patients planning to extract IMTM in the Affiliated Stomatology Hospital of Southwest Medical University from May 2014 to April 2015 were selected and took the surface fault panoramic radiograph before operation. The patients were divided into the class 1 and 2 according to the relation between IMTM and position of inferior alveolar neural tube displayed by the surface fault panoramic radiograph. The class 1 was the non-touch or point-like touch of IMTM and inferior alveolar neural tube. The class 2 was partial or large range of overlap of IMTM and inferior alveolar neural tube. The position relation between IMTM and inferior alveolar neural tube could not be accurately judged in the patients with class 2,then CBCT was further taken. After that the CS 3D imaging software was used to conduct the three dimen-sional reconstruction and axial,coronal and sagittal position layer analysis for determining the condition of bone ambush and root furcation and the relation between the adjacent teeth and the inferior alveolar neural tube. The teeth extraction scheme was accord-ingly formulated for extracting IMTM. Results In 36 cases of IMTM,14 cases were the class 1 displayed by the surface fault panoramic radiograph and directly performed IMTM extraction ,all cases were successfully extracted without the inferior lip numb-ness symptom after operation;22 cases were the class 2 displayed by the surface fault panoramic radiograph ,after taking further CBCT,the CS 3D imaging software was used to conduct the three dimensional reconstruction and axial ,coronal and sagittal posi-tion layer analysis for precisely locating IMTM. The extraction scheme was formulated and IMTM was successfully extracted with the operation time of 40-60 min;postoperative wound had the early healing without the occurrence of complications such as infec-tion,adjacent teeth damage and inferior lip numbness. The consistency of IMTM root furcation condition ,its relation with adjacent teeth and inferior alveolar neural tube displayed by CBTB examination with the intraoperative findings was higher than the surface fault panoramic radiograph,the difference was statistically significant(P<0.05). Conclusion Compared with the surface fault panoramic radiograph,CBCT can precisely locate IMTM(especially the patients with the inferior alveolar neural tube overlap dis-played by the surface fault panoramic radiograph),which should be widely used in clinic.关键词
锥束计算机体层摄影术/图像处理,计算机辅助/磨牙,第三/放射摄影术/拔牙Key words
Cone-beam computed tomography/Image processing,computer-assisted/Molar,third/radiography/Tooth extraction引用本文复制引用
李开勇,李勇,赵威,李明霞,肖金刚..锥形束CT在拔除下颌阻生第三磨牙中的应用价值[J].现代医药卫生,2016,32(17):2630-2633,4.基金项目
四川省科技厅项目（2014JY0044）；四川省教育厅项目（10ZB030）；四川省卫生厅项目（80170）。 （）
