CAJ | 학술논문

目的：应用螺旋CT及其三维重建技术对口腔正畸微种植支抗植入术结果判断，探讨其辅助临床获得明确诊疗结论的应用价值．方法选择20例正畸患者，共植入48颗微种植螺钉．使用 SOMATOM Sensation40/64螺旋CT．将螺旋CT轴位平扫数据使用西门子3D后处理软件进行多平面重建（MPR）、最大密度投影（MIP）、容积再现（VR）和曲面多层面重建（CPR）．将轴位扫描图像与不同方法重建图像之间相互对照、观察和分析．结果37颗微螺钉种植效果满意，无伤及邻近牙根及周围重要组织结构的情况；11颗微螺钉植入不理想，或作观察或作再植入而获成功．螺旋CT横轴位首先观察牙根间距及牙根与微种植螺钉关系效果好；VR观察微种植螺钉与牙齿、颌骨的外表轮廓整体关系表现直观；MIP观察微种植螺钉全貌与牙齿的关系效果理想，可任意旋转，从不同角度进行观察；MPR观察微种植螺钉与牙根局部细微结构及周围组织结构关系从可选择截面上显示清晰，弥补横轴位局限的缺点，同时便于测量长轴间距及倾斜角度．结论螺旋CT及其三维重建可准确地展现颌骨内微种植螺钉的形态、位置及其与邻牙的空间关系，影像显示清晰、直观、明确，作为有力的辅助检查手段在口腔正畸微种植支抗诊疗中有着很高的应用价值.
목적：응용라선CT급기삼유중건기술대구강정기미충식지항식입술결과판단，탐토기보조림상획득명학진료결론적응용개치．방법선택20례정기환자，공식입48과미충식라정．사용 SOMATOM Sensation40/64라선CT．장라선CT축위평소수거사용서문자3D후처리연건진행다평면중건（MPR）、최대밀도투영（MIP）、용적재현（VR）화곡면다층면중건（CPR）．장축위소묘도상여불동방법중건도상지간상호대조、관찰화분석．결과37과미라정충식효과만의，무상급린근아근급주위중요조직결구적정황；11과미라정식입불이상，혹작관찰혹작재식입이획성공．라선CT횡축위수선관찰아근간거급아근여미충식라정관계효과호；VR관찰미충식라정여아치、합골적외표륜곽정체관계표현직관；MIP관찰미충식라정전모여아치적관계효과이상，가임의선전，종불동각도진행관찰；MPR관찰미충식라정여아근국부세미결구급주위조직결구관계종가선택절면상현시청석，미보횡축위국한적결점，동시편우측량장축간거급경사각도．결론라선CT급기삼유중건가준학지전현합골내미충식라정적형태、위치급기여린아적공간관계，영상현시청석、직관、명학，작위유력적보조검사수단재구강정기미충식지항진료중유착흔고적응용개치.
Objective To evaluate the results of orthodontic micro- implant anchorage implantation by application of Spiral CT and three-dimensional reconstruction techniques,so as to explore its application value in assisting clinical diagnosis and treatment. Methods 20 orthodontic patients were implanted with 48 micro-planting screws. SOMATOM Sensation40/64 helical CT scan was performed . The axial unenhanced helical CT data were given multi-planar reconstruction (MPR),maximum intensity projection (MIP),volume rendering (VR) and surface multidimensional reconstruction (CPR) by using the Siemens 3D post-processing software. The axial scanning images and reconstructed images were compared, observed and analyzed . Results The planting results of 37 micro screws were satisfactory without injuring the vital tissues surrounding the root. The planting results of 11 micro-screw were not ideal, and these micro-screws were observed or reimplanted and got success. Spiral CT axial scan showed better the tooth root interval and the relationship between tooth root and the planting screws. VR can directly showed the overall relationship between the planting screws and teeth , jaw contour appearance. The relationship between the screw and tooth was showed satisfactorily by MIP which could rotate freely and observe from different angles. MPR could clearly show the structural relationships between micro-root planting screws and tooth root and surrounding tissues from the cross section, and could make up for the shortcomings of axial limitations, and was easy to measure the distance and tilt angle of the long axis . Conclusion Spiral CT and three-dimensional reconstruction can accurately show the jaw micro planting screw shape,location and spatial relationships with adjacent teeth , the image is clear,intuitive and definite,and spiral CT and three-dimensional reconstruction has high application value in orthodontics micro-implant anchorage clinic as a powerful auxiliary examination means.