牙科電腦斷層與傳統牙科片在牙科人工植牙技術診斷之比較

Comparison Between Dental CT and Traditional Dental Radiography in the Application of Dental Implant Diagnosis

徐國禎(Kuo-Chen Hsu) ； 徐毓菁(Yu-Chiang Hsu) ； 蘇安立(An-Li Su) ； 劉姁雲(Hsu-Yun Liu)

《中華放射線技術學雜誌》 28卷1期 (2004/06) Pp. 49-58

https://doi.org/10.30045/CJRT.200406.0006

摘要

牙科電腦斷層(Dental CT)是近年來在影像醫學科與牙科之間互動最為頻繁、也是最為重要的檢查項目，它不單可提供2D的影像，且可重組3D，並將口腔及顎面區域的組織病變顯示出來，這些是傳統牙科X光片所較難偵測的，但也有其檢查之限制與缺點，故未造成牙科界間之大肆推廣。本次研究探討牙科電腦斷層及各種傳統牙科X光片之間深入比較其差異性和優劣，以做為患者與牙醫師在牙科人工植牙技術上之另一選擇，以達牙科電腦斷層的普及。本研究對象自民國91年2月至92年5月止共30位患者，男性20位，女性10位，年齡層介於15～70歲之間，患者需接受以牙科電腦斷層及一般牙科X光攝影做為植牙前評估，再由醫師做影像上臨床價值判斷。機器在CT是採用德國SIEMENS Plus 4，在傳統牙科片則採用牙科全口X光機：日本ASAHI 10 mA “AUTO ⅢE cm”及牙齒根尖X光機：Trophy(TREX group)兩種機型。結果加做牙科電腦斷層對牙醫師在植牙手術上可準確並直接幫助患者做出評估與計劃者有28位，只有2位其影像因週邊金屬假牙所產生的假影無法改善而影響牙醫師預定為患者植牙部份的判斷，故只能依據傳統全景片(panoramic)及根尖片(periapical)來做術前評估。故牙科電腦斷層還是值得推廣並運用於牙科人工植牙技術上的。

關鍵字

牙科電腦斷層 ； 傳統牙科X光片

並列摘要

Dental CT is one of the most frequently used and important techniques in medical and dental radiographic examination. Other than two-dimensional images, Dental CT can recombine oral and maxillofacial structures and lesions into three-dimensional pictures, which traditional dental radiographic (TDR) techniques cannot achieve. There are limitations and shortcomings of Dental CT, though, and this may be the reason why it has not been widely used in clinical dentistry. The purpose of this study is to compare the advantages and weakness of Dental CT and some TDR techniques in the application of implant dentistry to provide better results for both dentists and patients.
30 patients, 20 males and 10 females; age 15 to 70; who received radiographic examination for pre-implant surgical evaluation; from Feb. 2002 to May 2003 were included in this study. Dentists performing the surgery then analyzed each patient’s Dental CT and TDR films for diagnosis, and decided the size and length of implant(s). The clinical decision was then adjusted during surgical procedures. The results of Dental CT and TDR were compared according to true patient’s situation. The results showed that 28 patients’ implant surgery were benefited from Dental CT examination; only 2 patients who had bridge restorations and the scattering effect made Dental CT images of valueless for decision making. For these 2 patients, panoramic and periapical films were used for pre-surgical evaluation. As a conclusion, Dental CT is of great clinical value to be used for dental implant surgery.

並列關鍵字

Dental CT ； traditional dental x-ray films