埋伏阻生上颌尖牙的螺旋CT定位诊断
上颌尖牙,,上颌尖牙；阻生；计算机断层摄影；图像处理,1资料与方法,2结果,3讨论,参考文献
【摘要】 目的 探讨多层螺旋CT图像成像技术在上颌尖牙埋伏阻生定位诊断中的应用。方法 对我院14例(21颗)上颌尖牙埋伏阻生的患者行多层螺旋CT横断面扫描，层厚1 mm；并利用其图像重建技术，进行多平面重建(MPR)、表面遮盖成像(SSD)和最大密度投影法(MIP)处理。最后，根据CT图像处理结果对埋伏阻生的上颌尖牙完成准确定位。结果 21颗阻生尖牙均存在不同程度的扭转和牙齿长轴倾斜。其中，5颗唇侧阻生，4颗腭侧阻生，12颗唇腭向阻生；14颗与上颌窦接近，4颗与鼻腔侧接近。12颗阻生尖牙的牙冠突破唇侧牙槽骨骨皮质，3颗阻生尖牙存在根尖部弯曲，1颗阻生尖牙合并囊肿存在。结论 螺旋CT横断面扫描与MIP、SSD及MPR等图像处理技术相结合能直观、立体、全面地明确埋伏阻生的上颌尖牙的形态、位置及与邻近重要结构的关系，对于复杂埋伏阻生的上颌尖牙的定位诊断具有重要的意义。该技术能实现埋伏阻生上颌尖牙的准确定位，可作为颌面外科手术处理和正畸治疗前的重要检查手段。【关键词】 上颌尖牙；阻生；计算机断层摄影；图像处理
【中图分类号】 R782
The application of spiral computed tomography to the localization of impacted maxillary caniness
WANG Yuliang1 WANG Xu2 HUANG Yumei3 et al
Department of Oral Maxillofacial Surgery,Affiliated Hospital of Binzhou Medical College,Binzhou 256603;
Department of Radiography,Affiliated Hospital of Binzhou Medical College;
Department of Prosthodontics,Affiliated Hospital of Binzhou Medical College
【Abstract】 Objective To study the clinical application of spiral computed tomography and its technique of image reconstruction to the localization of impacted maxillary canines.Methods CT scan with slice thickness of 10 mm was prescribed in the period form July to October,2005 for 14 patients 21 unerupted maxillary canines.The techniques of image reconstruction,including multiplanar reformat (MPR),maximum intensity projection (MIP),and surface shaded display (SSD),were used.Results The axial slices and the reconstructed CT images clearly displayed the morphology and position of the impacted maxillary canine and its relationship to surrounding anatomic structures.The impacted maxillary canines showed different degree of declination,rotation,malalignment,and overlap.Five of 21 maxillary canines were palatally impacted,four were buccally impacted,and others were transversally impacted.Conclusion This study confirms the gain in precision for the CT scan with axial slices and its techniques of image reconstruction when localizing the unerupted maxillary canines.The CT scan therefore presents reliability when considering the treatment of unerupted maxillary canines by providing anatomic information liable to bear on the diagnosis and therapeutic management. ......
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