吸烟对上颌中切牙牙槽骨分型影响——CBCT研究

doi:10.13701/j.cnki.kqyxyj.2020.09.007

摘要/Abstract

摘要： 目的: 评估吸烟因素主导下的上颌中切牙釉牙骨质界(esthetic-enamel junction,CEJ)到牙槽嵴顶(facial bone crest,FBC)的距离和唇侧骨壁厚度(buccal bone wall,BBW),为吸烟患者即刻种植提供风险评估。方法: 将患者以吸烟与不吸烟分为2组,再根据性别、年龄、牙根在牙槽骨内矢状位置(偏唇类、中间类、偏腭类;将偏唇类进一步细分为Ⅰ、Ⅱ、Ⅲ亚类)进行分组,测量CEJ到FBC的距离、CEJ根方4 mm、根中处、根尖处的唇侧骨壁厚度。结果: 645例患者(男性323例,女性322例),平均年龄(38.09±11.78)岁,男性:(39.47±12.80)岁;女性:(36.70±10.51)岁。吸烟患者的CEJ-FBC(2.54±0.78) mm远高于不吸烟的患者(2.29±0.69) mm,且有统计学差异(P<0.05)。在亚类中,吸烟组CEJ-FBC的距离较不吸烟组距离较大,具有统计学差异(P<0.05)。结论: 在行即刻种植时,需对牙槽嵴顶高度及唇侧骨壁厚度进行CBCT精确测量,特别是占绝大多数例数的牙根偏唇侧的患者中,吸烟和年龄因素都是需要重点考虑的因素。

关键词: 吸烟, 即刻种植, 上颌中切牙, 唇侧骨壁

Abstract: Objective: To measure the distance from the CEJ to the FBC and the thickness of the BBW in the maxillary central incisors under the influence of smoking, gender, age, and root position in the alveolar bone. Methods: The patients were divided into two groups by smokers and non-smokers. They were grouped according to gender, age, and root sagittal position in the alveolar bone (general three types: buccal type, middle type, and palatal type, and the buccal type was further classified into three subtypes: subtype Ⅰ, subtype Ⅱ, and subtype Ⅲ). BBW thickness was measured at the following points: the 4 mm apical to the cemento-enamel junction, mid-root, and apex. The distance from CEJ to FBC was also evaluated. Results: CBCT data of the maxillary central incisors of 645 patients (645 incisors, including 323 males and 322 females) were selected and analyzed. The average age of the patients was (38.09±11.78) years, male: (39.47±12.80) years; female: (36.70±10.51) years. The CEJ-FBC distance was significantly higher in the smokers (2.54±0.78) mm than that in the non-smokers (2.29±0.69) mm (P<0.05). Among the subtypes, the CEJ-FBC distance in the smokers was significantly higher than that in the non-smokers (P<0.05). Conclusion: During the immediate implantation, the height of alveolar crest and the thickness of BBW need to be accurately measured by CBCT. Smoking is an important factor to be considered.

Key words: smoking, immediate implantation, maxillary central incisor, buccal bone wall

余慧敏, 徐多玲. 吸烟对上颌中切牙牙槽骨分型影响——CBCT研究[J]. 口腔医学研究, 2020, 36(9): 825-829.

YU Huimin, XU Duoling. Smoking Factor on Classification of Alveolar Bone in Maxillary Central Incisors——CBCT Study[J]. Journal of Oral Science Research, 2020, 36(9): 825-829.

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