- 期刊
上顎骨下顴骨脊骨厚度之斷層掃瞄分析：於矯正植體之應用
A CT-Image Study on the Thickness of Infrazygomatic Crest of Maxilla and Its Clinical Implications for Implant Orthodontics
摘要
本研究之目的為測量上顎骨下顴骨脊(infra-zygomatic crest of maxilla)的骨脊厚度，並評估此部位是否適合作為矯正用微型骨釘之植入，以及分析合適的植入角度和位置。本研究使用長庚醫院顱顏中心斷層掃瞄資料庫中的影像資料，從其中隨機選取合適的十六位成人之影像做為研究資料。研究方法為使用斷層掃瞄測量分析軟體Anaylysis 6.0做3D立體影像資料分析，標定出上顎第一大臼齒近心頰側齒根(mesiobuccal root)所在之上顎骨下觀骨脊之縱切斷層切面；並以此斷層切面測量，當矯正用微型骨釘以與咬合面成45度、60度、75度植入上顎骨下顴骨脊時的骨寬度以及植入點的位置。研究結果顯示，上顎竇外壁骨厚度平均為2.9±0.9 mm；上顎骨下觀骨脊比上顎竇外壁更適合矯正用微型骨釘的植入，其骨脊厚度依骨釘植入角度的不同（45度、60度、75度），分別為5.3±1.1、6.3±1.5、8.6±2.3 mm。分析結果顯示，45度植入角的位置並不適合臨床上使用。合適的骨釘植入位置及角度位於上顎第一大臼齒上方、距離上顎咬合平面12.9±4.1至15.4±3.4 mm的高度、且與上顎咬合平面成60-75度處植入。
並列摘要
The purposes of this study were to measure the bone thickness of infrazygomatic crest of maxilla, evaluate its feasibility and accessibility as a bone screw implant site for orthodontics, and to develop guidelines for clinical bone screw insertion at the crest. The material consisted of 3-dimensional CT image data of 16 adult individuals randomly selected from the Database of Craniofacial CT-imaging Library of Chang Gung Memorial Hospital, Taipei, Taiwan. We used Analysis 6.0 CT image analyzing software for three-dimensionally selecting the frontal slice of the infrazygomatic crest where mesiobuccal root of the maxillary first molar is. On this selected frontal slice, reference lines and points were made for measuring the lateral wall thickness of maxillary sinus, crest bone thickness, and the position of insertion when the bone screw was inserted in 45, 60, and 75 degree to the maxillary occlusal plane. The results revealed that the lateral wall thickness of maxillary sinus was 2.9±0.9 mm in average, and the crest bone thickness was 5.3±1.1, 6.3±1.5, 8.6±2.3 mm respectively in different angles of bone screw insertion (45°, 60°, 75°) As a non-tooth bearing area, the crest is a better site for bone screw insertion than the lateral wall of maxillary sinus, because of its thicker bone thickness and better anatomical accessible position. It was inferred that the 45o bone screw insertion angle and position of the crest is not practical clinically. The clinically practical bone screw insertion angle and position in adult patients is at the position of maxillary first molar, 12.9±4.1 to 15.4±3.4 mm above, and 60° to 75° to the maxillary occlusal plane.