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目的评价锥形束CT(cone beam computed tomography,CBCT)用于颌骨内埋伏牙定位的价值。方法选择2009年9月至2010年3月中山大学附属口腔医院诊治的,用常规口腔全景片和定位片无法清楚判断埋伏牙形态、大小及与邻牙位置关系的颌骨内埋伏牙患者28例。所有患者行CBCT扫描,对所得数据处理后获得牙体表面三维立体图像及任意平面图像和任意曲面断层图像。结果 CBCT从多个角度完整清晰地显示埋伏牙的形态、大小、萌出方向、唇腭侧位置及与邻牙位置的关系。根据CBCT图像,18例26颗埋伏牙采用相应的手术进路拔除,10例10颗形态正常且非倒置的埋伏牙采用去骨开窗正畸治疗。所有患者顺利完成手术,术前诊断与术中判断完全一致,准确率为100%。术后创口均Ⅰ期愈合,无感染、邻牙损伤等并发症发生。结论 CBCT可直接、准确地反映埋伏多生牙的位置,为临床诊断和治疗提供可靠信息。
Objective To evaluate the value of cone beam computed tomography (CBCT) for the localization of impacted teeth in the jaw. Methods From September 2009 to March 2010, Sun Yat-sen Affiliated Stomatological Hospital was diagnosed and treated with conventional oral panoramic films and positioning films can not clearly determine the shape of impacted teeth, the size and location of the adjacent teeth with impacted teeth in patients with jaw in 28 cases . All patients underwent CBCT scan, the obtained data were processed to obtain three-dimensional surface of the tooth surface and any planar images and arbitrary surface tomographic images. Results The CBCT displayed the shape, size, eruption direction, location of the lip and palate and the relationship with the position of the adjacent teeth completely and clearly from multiple perspectives. According to the CBCT images, 18 cases of 26 impacted teeth were removed by corresponding surgical approach, and 10 cases of 10 normal and non-inverted impacted teeth were treated by orthodontic treatment with boneless fenestration. All patients successfully completed the operation, preoperative diagnosis and intraoperative judgment are exactly the same, the accuracy rate of 100%. All the wounds healed in the first stage, no infection, adjacent tooth injury and other complications occurred. Conclusion CBCT can directly and accurately reflect the location of ambush as many as possible to provide reliable information for clinical diagnosis and treatment.