上海口腔医学

上海口腔医学 ›› 2020, Vol. 29 ›› Issue (3): 298-303.doi: 10.19439/j.sjos.2020.03.013

• 论著 • 上一篇    下一篇

牙周支持组织中剩余骨高度与牙周膜面积测量结果的一致性评价

徐晶晶, 徐隽, 徐若男, 郭欣, 帕力旦·吉拉, 古丽努尔·阿吾提   

  1. 新疆医科大学第一附属医院（附属口腔医院） 牙周黏膜病科, 新建维吾尔自治区口腔医学研究所,新疆 乌鲁木齐 830054
  • 收稿日期:2019-06-05 修回日期:2019-07-24 出版日期:2020-06-25 发布日期:2020-07-29
  • 通讯作者: 古丽努尔·阿吾提,E-mail:guawuti@sina.com
  • 作者简介:徐晶晶（1994-）,女,硕士研究生,E-mail:756521484@qq.com
  • 基金资助:
    新疆维吾尔族自治区自然科学基金（2016D01C251）

Evaluation of the consistency between the measurement results of residual bone height and root surface area in periodontal supporting tissue

XU Jing-jing, XU Jun, XU Ruo-nan, GUO Xin, PALIDAN Jila, GULINUER Awuti   

  1. Department of Mucosal Periodontal Diseases, the First Affiliated Hospital of Xinjiang Medical University; Stomatology Research Institute of Xinjiang Uygur Autonomous Region. Urumchi830054, Xinjiang Uygur Autonomous Region, China
  • Received:2019-06-05 Revised:2019-07-24 Online:2020-06-25 Published:2020-07-29

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摘要： 目的 利用曲面建模技术模拟牙周支持组织破坏进程,探讨剩余支持高度百分比（the percentage of residual support height,Ph）与剩余牙周膜面积百分比（the percentage of residual root surface area,Ps）评估牙周支持能力的一致性。方法 纳入15例患者的锥形束 CT（cone-beam CT,CBCT）图像,共计420颗牙。利用Mimics软件重建3D模型,导入Geomagic软件进行曲面优化,最终在Solidworks软件中实现对牙根的精确划分,以此模拟不同的牙周支持高度,测量并计算Ph与Ps。检验不同牙位Ph与Ps结果的一致性。采用SPSS 22.0软件包对数据进行统计学分析。结果 切牙组、尖牙组、前磨牙组牙周膜面积分别为冠1/3>根中1/3>根尖1/3,磨牙组牙周膜面积分别为根中1/3>冠1/3>根尖1/3。上颌第一磨牙牙周膜面积最大,在牙列中占11.60%,约为下颌中切牙的3.18倍。所有牙位 Ph与Ps差异有统计学意义（P<0.01）。上颌切牙组、下颌切牙组、下颌前磨牙组Ph与Ps差值的95%CI在一致性限度专业界值（-15%,15%）之内,其余牙位Ph与Ps差值的95%CI在一致性限度专业界值（-15%,15%）之外。结论 单根牙（上颌尖牙除外）剩余牙周支持高度可以较好地反映牙周支持能力;而对于多根牙,仅以二维指标牙槽骨吸收比值替代三维指标剩余牙周膜面积显然具有局限性,还需充分考虑牙根形态学差异,以明确牙周支持组织的破坏程度。

关键词: 牙周膜面积, 曲面建模, 锥形束CT

Abstract: PURPOSE: To explore the percentage of residual support height (Ph) and the percentage of residual root surface area (Ps) in evaluating periodontal support ability by simulating different stages of periodontitis based on the curved surface modeling. METHODS: Fifteen cone-beam CT (CBCT) images including 420 teeth in total were collected. The data were reconstructed into 3-dimensional teeth models by Mimics software.The 3D surface model of the tooth was then optimized by Geomagic software and then imported into Solidworks software to simulate different periodontal support height. Ph and Ps were measured and calculated to evaluate the consistency of Ph and Ps results in all tooth types. The data were analyzed with SPSS 22.0 software package. RESULTS: RSA in incisors, canines and premolars: coronal 1/3>middle 1/3>apical 1/3. RSA in molars: middle 1/3>coronal 1/3>apical 1/3. Maxillary first molar had the largest RSA, accounting for 11.60% of the dentition, which was about 3.18 times than mandibular central incisor. The difference between Ph and Ps in all types of teeth was statistically significant (P< 0.01). The 95% confidence interval(CI) of the difference between Ph and Ps in the maxillary incisor, mandibular incisor, mandibular canine was between the clinical consistency limit (-15%, 15%). In the remaining tooth types, 95%CI of the difference between Ph and Ps was beyond the clinical consistency limit (-15%, 15%). CONCLUSIONS: For single-root tooth, except maxillary canine, the remaining periodontal support height could replace periodontal support area. For multi-rooted tooth, judging the ability of periodontal support ability only by alveolar bone absorption ratio in 2D index has significant limitations. Full consideration is needed to focus on root morphological discrepancy when determining the extent of periodontal disease.

Key words: Root surface area, Curve surface modeling, Cone-beam CT

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