利用錐束電腦斷層掃描探討國人鼻腭管形態分支及解剖構造量測

The usage of cone-beam CT in the morphometric analysis of the dimensions and anatomic characteristics of the nasopalatine canal and adjacent alveolar ridge in Taiwanese patients.

任心如(Hsin-Ju Jen)

指導教授 ： 洪純正

高雄醫學大學/口腔醫學院/牙醫學研究所/碩士(2012年)

https://doi.org/10.6832/KMU.2012.00083

摘要

中文摘要
研究目的及背景: 上顎前牙區植體補綴物的美觀呈現是近年受到關注的議題，然而此區植體的角度及位置受到解剖構造的侷限，顎測鼻腭管的位置需在術前精確評估以免造成植體或神經血管損傷的風險，本實驗利用錐束電腦斷層掃描系統，欲分析鼻腭管分支形態及量測相關解剖構造。
材料方法: 55名欲在上顎植牙病患，在術前接受Picasso Trio（E-WOO Technology, Giheung-gu, Republic of Korea）錐束電腦斷層掃描，並利用影像作業軟體Ezimplant-3D Image Viewer (VATECH, Korea)分析鼻腭管分支與形態、孔徑、長度、頰側骨厚度、頰側骨牙嵴高度、與頰側骨所夾角度，並比較性別、年齡、門齒存在情形有無分組差異。
研究結果: 性別分組上，鼻腭管長度及頰側骨厚度男性大於女性且有顯著性差異，在年齡方面可見牙嵴高度隨年齡增加有減少的情形，在門牙顆數方面分組比較可見門齒孔孔徑、頰側骨頭厚度、頰側骨牙嵴高度及鼻腭管與頰側骨所夾角度有顯著差異，在鼻腭管形態方面則在foramen of Stenson孔徑有顯著差異。
結論: 不論是前牙區植牙、腭側翻瓣或是浸潤麻醉，如果能在術前瞭解鼻腭管的形態、解剖構造、個體間多樣的差異性，並且先以電腦斷層掃描做術前分析，對於術後的併發症減少以及手術的成功率提升有相當的幫助。

關鍵字

鼻腭管 ； 門齒孔 ； 錐束電腦斷層掃描 ； 植牙 ； 上顎前牙區

並列摘要

Abstract
Background and Objective: Esthetic of implant prostheses around maxillary anterior area has been an important issue these years. Analyze the dimensions and anatomic characteristics of the nasopalatine canal and the corresponding buccal bone plate by application of CBCT imaging.
Material and methods: 55 Partially edentulous patients scheduled for CBCT imaging （Picasso Trio, E-WOO Technology, Republic of Korea）for further radiographic evaluation of a prospective implant recipient site in the anterior maxilla were consecutively enrolled in this study. Reformatted sagittal、coronal、axial and cross-sectional slices were analyzed with regard to dimensions and anatomic characteristics of the nasopalatine canal as well as the dimensions of the buccal bone wall. Factors influencing these parameters were evaluated.
Result: Stastically,the dimensions of the buccal bone plate and length of the nasopalatine canal were significantly influenced by the gender of the included patients. In addition, the dimensions of the buccal bone plate and diameter of incisive foramen were influenced by the status of incisors. Lastly, statistics also showed that the height of the ridge was significantly influenced by age.
Conclusion: Nasopalatine canal shows important anatomical variations, both with regard to morphology and dimensions. To avoid potential complications during surgical procedures such as implant placement, a careful pre-operative observation is required.

並列關鍵字

Nasopalatine canal ； incisive foramen ； CBCT ； implant ； anterior maxilla

參考文獻

參考文獻

1. Harris, D., et al., E.A.O. Guidelines for the use of Diagnostic Imaging in Implant Dentistry. Clinical Oral Implants Research, 2002. 13(5): p. 566-570.

2. Pohlenz, P., et al., Clinical indications and perspectives for intraoperative cone-beam computed tomography in oral and maxillofacial surgery. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 2007. 103(3): p. 412-417.

3. Angelopoulos, C., et al., Comparison Between Digital Panoramic Radiography and Cone-Beam Computed Tomography for the Identification of the Mandibular Canal as Part of Presurgical Dental Implant Assessment. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2008. 66(10): p. 2130-2135.

4. Low, K.M.T., et al., Comparison of Periapical Radiography and Limited Cone-Beam Tomography in Posterior Maxillary Teeth Referred for Apical Surgery. Journal of endodontics, 2008. 34(5): p. 557-562.