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目的利用锥形束CT(CBCT)研究下颌第一磨牙即刻种植区域与周围牙槽骨及神经管的关系。方法 100例下颌第一磨牙即刻种植的患者,术前CBCT扫描明确下颌第一磨牙周围牙槽骨情况及与下颌神经管的关系确定种植体的选择及植入的角度和长度。结果牙槽间隔顶与下颌神经管垂直和水平的距离分别为(14.21±1.32)、(2.31±0.59)mm,此位置下颌神经管至颊腭侧的水平距离分别为(5.20±1.21)、(5.40±1.28)mm;近中根尖到下颌神经管的垂直和水平距离分别为(7.60±1.26)、(1.28±0.39)mm,此位置下颌神经管至颊舌侧的水平距离分别为(5.81±0.76)、(5.02±1.03)mm;远中根尖到下颌神经管的垂直和水平距离分别为(6.63±0.93)、(3.40±0.36)mm,此位置下颌神经管至颊舌侧的水平距离分别为(4.62±0.87)、(6.43±1.15)mm;近中根尖和牙槽间隔处下颌神经管与舌侧骨板的距离比较差异无统计学意义(P>0.05),其他不同部位处同一测量项目距离比较差异有统计学意义(P<0.05)。结论在即刻种植前进行CBCT扫描可以明确种植体材料的选择及确定植入位置和角度,对下颌第一磨牙的即刻种植起到很好的指导作用。
Objective To study the relationship between immediate implanted area of mandibular first molar and the surrounding alveolar bone and neural tube using cone beam computed tomography (CBCT). Methods 100 patients with immediate implants of mandibular first molars underwent CBCT scanning before surgery to determine the relationship between the alveolar bone around mandibular first molar and the mandibular canal to determine the choice of implant and the angle and length of implants. Results The vertical and horizontal distances between the alveolar septum and the mandibular nerve canal were (14.21 ± 1.32) mm and (2.31 ± 0.59) mm, respectively. The horizontal distances from the mandibular canal to the buccal and palatal side were (5.20 ± 1.21) and 5.40 ± 1.28) mm respectively. The vertical and horizontal distances from the mesiodial tip to the mandibular nerve canal were (7.60 ± 1.26) and (1.28 ± 0.39) mm, respectively. The horizontal distances from the mandibular canal to the buccal and lingual side were (5.81 ± 0.76) and (5.02 ± 1.03) mm, respectively. The vertical and horizontal distances from the distal root tip to the mandibular nerve canal were (6.63 ± 0.93) and (3.40 ± 0.36) mm respectively. The horizontal distance from the neural tube to the buccal and lingual side (4.62 ± 0.87) and (6.43 ± 1.15) mm, respectively. There was no significant difference in the distance between the mandibular canal and the lingual bone at the mesial apical and alveolar septum (P> 0.05) The distance of the project was statistically significant (P <0.05). Conclusions CBCT scan before immediate implantation can confirm the choice of implant material and determine the position and angle of implantation, which can guide the immediate implantation of mandibular first molars.