口腔医学研究

口腔医学研究 ›› 2023, Vol. 39 ›› Issue (6): 505-509.DOI: 10.13701/j.cnki.kqyxyj.2023.06.008

• 口腔影像学研究 • 上一篇    下一篇

探究后牙区拟种植位点牙槽嵴顶CBCT影像的判读误差

刘亚1, 魏路明2, 李晓飞2, 李晓明2, 袁长永1,2, 王鹏来1,2*   

  1. 1.徐州医科大学口腔医学院 江苏 徐州 221004;
    2.徐州医科大学附属口腔医院种植中心 江苏 徐州 221002
  • 收稿日期:2022-10-27 出版日期:2023-06-28 发布日期:2023-06-21
  • 通讯作者: *王鹏来,E-mail: wpl0771@163.com
  • 作者简介:刘亚(1996~ ),女,江苏徐州人,硕士在读,医师,研究方向:数字化技术在口腔种植临床中的应用。
  • 基金资助:
    徐州市重点研发计划(社会发展)项目(编号:KC21151)徐州市卫生健康委青年医学科技创新项目(编号:XWKYHT20200050)

Study on the Error of CBCT Images of Alveolar Crest of Proposed Implant Site in Posterior Dental Region

LIU Ya1, WEI Luming2, LI Xiaofei2, LI Xiaoming2, YUAN Changyong1,2, WANG Penglai1,2*   

  1. 1. School of Stomatology, Xuzhou Medical University, Xuzhou 221004, China;
    2. Department of Implantology, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou 221002, China
  • Received:2022-10-27 Online:2023-06-28 Published:2023-06-21

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摘要： 目的:探究后牙区拟种植位点拔牙3个月后,牙槽嵴顶CBCT影像边界不连续伴模糊时的显影误差。方法:选择2022年4~9月就诊于徐州医科大学附属口腔医院种植中心,主诉后牙区单牙拔除后3个月,且CBCT检查显示缺牙区牙槽嵴顶影像不连续伴模糊的40例患者纳入研究。试验组使用医学三维重建软件所提供的骨阈值自动分割功能,提取拟种植位点牙槽骨影像的2D蒙版,对照组采用人工判读的方法,提取拟种植位点牙槽骨影像的2D蒙版。最后,基于2D蒙版三维重建出术区牙槽骨的三维数字化模型,并与术中所获取的牙槽嵴顶光学模型进行三维比较,运用偏差分析算法计算出二者间差异的平均偏差(AVG)与均方根值(RMS)。结果:试验组拟种植位点牙槽嵴顶的CBCT重建模型与术中光学扫描模型间差异的AVG与RMS分别为(2.26±0.36) mm和(2.35±0.26) mm,均大于对照组[AVG为(1.25±0.21) mm,RMS为(1.31±0.20) mm],且差异具有统计学意义(P＜0.05)。结论:拔牙3个月后,当牙槽嵴顶的CBCT影像不连续伴模糊时,人工判读的牙槽嵴顶位置,其误差小于经软件自动判读得到的结果,并且二者均与牙槽嵴顶的实际边界存在一定误差。因此,在规划种植方案时应充分考虑其可能产生的影响。

关键词: 锥形束CT, 术前规划, 牙槽嵴顶, 偏差分析, 后牙区

Abstract: Objective: To explore the error of CBCT images of the alveolar crest with discontinuous and fuzzy boundary in the proposed implant site in posterior dental region three months after the extraction. Methods: The trial was conducted at Department of Implantology, affiliated Stomatological Hospital of Xuzhou Medical University, from April 2022 to September 2022. Forty patients with a single molar missing for 3 months and CBCT showing discontinuous and fuzzy alveolar crest boundary in the missing area were included in the trial. The experimental group used the automatic bone threshold segmentation function provided by the medical 3D reconstruction software to extract the 2D mask of the alveolar bone image at the proposed implant site, while the control group used the manual interpretation method to extract the 2D mask of the alveolar bone image at the proposed implant site. Finally, the 3D digital model of the alveolar bone was reconstructed based on 2D mask, and compared with the optical model of alveolar crest obtained during the operation. The mean deviation (AVG) and root mean square (RMS) values of the differences between two groups were calculated using the deviation analysis algorithm. Results: The AVG and RMS of the CBCT reconstruction model and the optical scanning model at the implant site in the experimental group were (2.26±0.36) mm and (2.35±0.26) mm, respectively, which were greater than those in the control group [AVG was (1.25±0.21) mm, RMS was (1.31±0.20) mm], and the differences were statistically significant (P<0.05).Conclusion: Three months after tooth extraction, when the CBCT image of the alveolar crest is discontinuous and fuzzy, the error of the position of the alveolar crest interpreted manually was smaller than that obtained automatically by the software, and both of them had a certain error with the actual boundary of the alveolar crest. Therefore, the possible impact should be fully considered when planning the implant treatment program.

Key words: cone beam computed tomography, preoperative planning, alveolar crest, deviation analysis, posterior dental area