【作者】 王艳辉；

【导师】 李宁毅；

【作者基本信息】 青岛大学 ， 口腔颌面外科学， 2003， 硕士

【摘要】 目的：本研究应用螺旋CT扫描，对正常人的上颌骨及上颌窦进行三维重建和测量，以建立国人上颌骨及上颌窦的一些参考数据，为上颌种植义齿的术前设计，手术方案的制定提供理论和临床的参考，确定种植义齿的局部适应症，以提高种植成功率和减少并发症的发生。 方法：选择健康的成人志愿受试者17例(34侧)，对上颌骨进行螺旋CT连续容积扫描，三维重建，扫描层厚3mm，重建层厚1mm。在每一牙位上截取与牙弓曲线垂直的截面，在选取的截面上测量上颌骨的牙槽骨及上颌窦的有关数据，对所测得数据进行统计分析。 结果：1、全部受试者上颌骨三维立体显示良好，获得影象细致逼真、与实体一致的上颌骨模型。2、对测量所得的各项数据进行统计学处理，获得其正常值范围。3、左右两侧各项对应数据经统计学分析，无显著性差异(P＞0.05)。4、牙槽嵴顶及其上方10mm的牙槽骨宽度，总体上从前向后逐渐增宽，而侧切牙的牙槽嵴顶及其上方10mm牙槽骨最窄(P＜0.05)。5、后牙区的牙槽嵴顶与上颌窦底壁之间的距离以第一磨牙最近，依次为第二磨牙、第二前磨牙和第一前磨牙，前三者之间统计学分析无明显差异性(P＞0.05)，与第一前磨牙之间差异有显著性(P＜0.05)。6、尖牙的牙体长轴与牙槽嵴长轴之间的夹角与中、侧切牙之间有显著性差异(P＜0.05)。7、上颌窦的三径左右对比无显著性差异(P＞0.05)。 结论：临床上应用螺旋CT连续容积扫描，三维重建上颌骨及上颌窦，影像细致逼真，可以被任意角度旋转、任选层面切割观察和测量；所得各项数据可靠，总结了上颌骨及上颌窦的解剖特点及一般规律，为牙种植的术前设计提供了准确可靠的数据。从三维的角度确认种植的解剖条件，对指导临床医师选择适宜的种植体及植入数量、植入方向，制定最佳手术方案，对提高种植成功率，减少并发症的发生具有重要意义。更多还原

【Abstract】 Objective: The purpose of this study is to set up a series of data of the maxilla and maxillary sinus for the adults on the basis of three-dimensional reconstruction and measurement by spiral CT scans. The data can provide an objective basis for an exact preoperative layout and the selection of dental implants. Precise planning resulted in good success and decreased complications.Method:17 healthy adult volunteers(34 sides) were selected, and three-dimensional models to the maxilla were reconstructed on the basis of spiral volume scans. Collimation was 3 mm, Reconstruction interval was 1 mm. The slices vertical to the compensating curve were made in every dental position and collected the data of alveoli and maxillary sinus on the advantage workstation (AW 4. 0-3). Then the data were analyzed. The same works were done on both sides.Results: 1.All three-dimensional models of maxilla were constructed. 2. The normal data of maxila was got.. 3. There is no significant difference between the data of the left and right maxilla. 4. The alveolar ridge and the place of it up 10mm were more and more wider from mesial to distal except for lateral incisor. 5. The distance between the alveolar ridge of posterior teeth to the floor of maxillary sinus: the first molar is the nearest, then the second molar, the second bicuspid and the first bicuspid. There is no significant difference among the front there teeth .But it has significant difference with the first bicuspid. 6. The angle between the labial teeth long axis and alveoli long axis: There is no significant difference between maxillary canine and maxillary incisors. Conclusion: Different types of dental implant should be chosenaccording to the anatomic characteristic of the maxillary bone in every dental position before the operation to avoid complications. The data on the basis of spiral CT scans can lead to reliable, precise planning.Postgraduate Yanhui Wang(Oral & Maxillofacial Surgery) Directed by Ningyi Li更多还原