锥束CT三维重建技术在评估上颌窦底提升高度与提升容积关系的应用

doi:10.3760/cma.j.cn101202-20200709-00216

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摘要目的探讨患者上颌窦底提升高度(AH)的不同所对应的容积变化规律,为临床评估上颌窦外提升所需骨移植材料的容积提供参考。方法回顾性研究。纳入2018年10月—2020年4月蚌埠医学院第二附属医院口腔科50 例上颌后牙缺失患者的锥束CT(CBCT)影像资料,其中男24例、女26例,年龄40~78(58.3±12.3)岁。利用 Mimics 21.0软件重建上颌窦三维模型,通过Materialise 3-matic 9.0 Research软件切割获取上颌窦底不同提升高度对应的容积。观察上颌窦底提升一定高度(4~12 mm)所对应的容积,并对各提升高度所对应的容积进行侧别间及性别间比较;采用 Pearson 法对上颌窦底提升高度的不同与容积变化进行相关性分析;利用多元线性回归模型,预测上颌窦底提升容积与提升高度的理论方程。结果当上颌窦底提升高度为4~12 mm(间隔1 mm,取整数)所对应的上颌窦的提升容积分别为(0.41±0.12)、(0.62±0.17)、(0.85±0.23)、(1.13±0.31)、(1.43±0.38)、(1.76±0.46)、(2.11±0.55)、(2.11±0.55)、(2.88±0.77) cm³,各提升高度对应的容积左、右侧别间及不同性别间比较,差异均无统计学意义(P值均＞0.05)。上颌窦底提升高度与提升容积之间呈正相关(r=0.866,P＜0.01)。将性别、侧别、提升高度纳入多元线性回归模型,预测上颌窦底提升容积与提升高度的理论方程:提升容积(cm³)=0.31×提升高度(mm)-0.96,经回归方差分析,模型具有统计学意义(R²=0.750, F=669.258, P＜0.01)。结论 CBCT可以快速获取上颌窦三维模型,并且可以根据上颌窦底提升高度准确预测上颌窦提升容积的量,为临床种植术前评估所需骨移植材料的容积提供指导。

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	薛魁
	王旋宇
	朱晨晨
	朱永娜
	王敏
	辛明明
	李超
	张晓东

关键词 ：上颌窦, 上颌窦底提升容积, 上颌窦底提升高度, 锥束计算机体层摄影术, 骨移植材料

Abstract：Objective This study aimed to explore the law of changes in the corresponding volume according to the augmentation height (AH) of the maxillary sinus floor in patients and to provide a reference for the volume of bone transplantation material required for clinical maxillary sinus elevation.Methods Retrospective analysis was applied. The imaging data of cone-beam computed tomography (CBCT) of 50 patients with maxillary posterior tooth loss at the Department of Stomatology of the Second Affiliated Hospital of Bengbu Medical College from October 2018 to April 2020 were retrospectively analyzed. Among these patients, 24 were males and 26 were females, and their age ranged from 40 years to 78 years (58.3 years±12.3 years). Mimics 21.0 was used to reconstruct a three-dimensional model of the maxillary sinus, and 3matic 9.0 was utilized to cut and obtain the corresponding volume according to the different heights of the maxillary sinus floor. The volume corresponding to a certain height (4-12 mm) of the maxillary sinus floor (4-12 mm) was observed, and the volume corresponding to each height was compared bilaterally and between males and females. Pearson's method was applied to analyze the correlation between the elevation of the maxillary sinus floor and the change in volume. A multiple linear regression model was established to predict the theoretical equation of the lifting volume and height of the maxillary sinus floor.Results When the augmentation height of the maxillary sinus floor was from 4 mm to 12 mm (interval of approximately 1 mm), the corresponding elevation volumes of the maxillary sinus were (0.41±0.12), (0.62±0.17), (0.85±0.23), (1.13±0.31), (1.43±0.38), (1.76±0.46), (2.11±0.55), (2.11±0.55), (2.88±0.77) cm³. No significant differences were observed between the left sides and right sides, and the volumes of each lifting height between the males and females (all P values＞0.05). The augmentation height was positively correlated with the elevation volume of the maxillary sinus (r=0.866, P＜0.01). The gender, side-by-side, and augmentation height were included in the multiple linear regression model to predict the theoretical equation of the augmentation height and elevation volume of the maxillary sinus: elevation volume (cm³)=0.31×augmentation height (mm) -0.96. Regression variance analysis revealed that the model was statistically significant (R²=0.750, F=669.258, P＜0.01).Conclusions CBCT can be applied to quickly obtain a three-dimensional model of the maxillary sinus and accurately predict the elevation volume of the maxillary sinus according to the augmentation height. This study can provide a reference for the volume of bone transplantation materials required before clinical implantation.

Key words： Maxillary sinus Maxillary sinus floor augmentation volume Sinus floor elevation Cone-beam computed tomography Bone grafting

收稿日期: 2020-07-09

通讯作者: 张晓东,Email:1573702676@qq.com

引用本文:

薛魁, 王旋宇, 朱晨晨, 朱永娜, 王敏, 辛明明, 李超, 张晓东. 锥束CT三维重建技术在评估上颌窦底提升高度与提升容积关系的应用[J]. 中华解剖与临床杂志, 2021, 26(1): 34-38.
Xue Kui, Wang Xuanyu, Zhu Chenchen, Zhu Yongna,Wang Min, Xin Mingming, Li Chao,Zhang Xiaodong. Application of 3D digital reconstruction technology of cone-beam CT in evaluating the relationship between the augmentation height and the sinus floor augmentation volume. Chinese Journal of Anatomy and Clinics, 2021, 26(1): 34-38.

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http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20200709-00216 或 http://www.cjac.com.cn/CN/Y2021/V26/I1/34

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