锥形束CT在正畸牙颌模型分析中的应用

李娜，宋锦璘，李丽华，宴燕 ，陈定根

(1.川北医学院附属医院口腔科，四川 南充　637000；2.口腔疾病与生物医学重庆市重点实验室；3.重庆医科大学附属口腔医院，重庆　401147)



锥形束CT在正畸牙颌模型分析中的应用

李娜1，宋锦璘2,3，李丽华1，宴燕1，陈定根1

(1.川北医学院附属医院口腔科，四川 南充637000；2.口腔疾病与生物医学重庆市重点实验室；3.重庆医科大学附属口腔医院，重庆401147)

目的：探讨锥形束CT(cone beam CT,CBCT)数字化牙颌模型测量的精确性。方法：对30例正畸初诊患者制取上下颌牙颌阴模一副灌制成阳模，制做成研究模型。对完成的石膏模型要求牙齿完整，牙列清晰，并用锥形束CT将所有石膏模型进行扫描，重建石膏模型三维图形，对数字化牙颌模型进行测量，将其结果与传统手工测量结果进行比较。采用配对t检验，计算一致性相关系数(concordance correlation coefficient,CCC)及绘制散点图来评价两种方法的一致性。结果：两种测量方法的数据无统计学意义(P>0.05)，CBCT 测量和手工测量的CCC 在0.883～0.999 之间一致性均非常好。结论：CBCT三维重建所得的数字化模型清晰，能分辨出明确的尖、窝和边缘嵴，使操作者的辨认选点可靠。在一定程度上可取代传统手工测量，但石膏的放射阻射性能、石膏模型的厚度对石膏牙颌模型的数字化成像可能有影响，有待以后进一步研究。

锥形束CT；正畸；模型测量

【Abstract】Objective：To discuss the accuracy of Cone Beam CT in the measurement of dental and jaw model.Methods：30 dental casts were fetched from orthodontic patients with malocclusion deformity in preliminary diagnosis.The plaster models were demanded to see the teeth and their adjacent teeth clearly.Then all the models were scanned by cone beam CT to reformat the three-dimensional images.The results of the 3D image were measured and compared with the results from the conventional Manual measurement.Results：There was no statistical difference between two methods(P>0.05).The CCC of CBCT measurement and manual measurement are in good consistency between 0.883 and 0.999.Conclusion：The 3D digital model of CBCT can be viewed to distinguish point,nest and edge ridge clearly,which can help the operator to identify reliable points.And in a certain degree,it can replace the traditional manual measurement.However,the radiation resistance of the gypsum and the thickness of plaster model may have an effect on the digital imaging.Further research is needed.

正畸临床诊断、分析中牙颌模型分析能直观反映牙齿及颌骨的发育情况，是制定治疗计划的重要参考指标，也是比较矫治前后牙、牙弓变化不可缺少的重要资料。长期……