CAJ | 학술논문

目的比较锥形束CT曲面重建片与曲面体层X线片牙根近远中倾斜角度的差异,探寻锥形束CT曲面重建片在正畸临床诊断中应用的可行性.方法选用因正畸治疗需要同时接受曲面体层X线片和锥形束CT检查的患者20例,在InvivoDental 5.0软件中按照2种头位(P1:眶耳平面与地平面平行;P2:解剖验平面与地平面平行)和3种断层域中心平面(以中切牙为参考分别设置根尖断层面、牙体中心断层面和牙冠切缘断层面)组合成的6种重建方法,分别生成上、下颌锥形束CT曲面重建片.观察并比较各锥形束CT曲面重建片与曲面体层X线片中的牙体影像形态.在锥形束CT曲面重建片(每例患者上、下颌各6张)和曲面体层X线片上测量上颌前牙牙根夹角((321 |123)相邻牙根间夹角分别命名为UA1～ UA5)和下颌前牙牙根夹角((321 |123)相邻牙根间夹角分别命名为LA1～ LA5),计算各锥形束CT曲面重建片与曲面体层X线片的牙根夹角差值(△UA和△LA),采用Wilcoxon检验比较相同断层面两种头位牙根夹角差值的差异.结果影像学观察显示,无论头位如何设置,以牙体中心断层面重建的锥形束CT曲面重建片的牙体形态与曲面体层X线片较接近.相同断层面设置条件下,共进行15次P1与P2的△UA比较,其中7次P1的△UA显著小于P2(P＜0.05),1次P1的△UA显著大于P2(P＜0.05);15次P1与P2的△LA比较中10次两者差异无统计学意义(P＞0.05),4次P2的△LA显著小于P1(P＜0.05),1次P2的△LA显著大于P1 (P＜0.05).结论上颌采用眶耳平面与地平面平行的头位,下颌采用解剖(牙合)平面与地平面平行的头位,并均采用牙体中心断层面可重建获得与曲面体层X线片相近的锥形束CT曲面重建片用于正畸临床判断牙根近远中倾斜角度.
목적 비교추형속CT곡면중건편여곡면체층X선편아근근원중경사각도적차이,탐심추형속CT곡면중건편재정기림상진단중응용적가행성.방법 선용인정기치료수요동시접수곡면체층X선편화추형속CT검사적환자20례,재InvivoDental 5.0연건중안조2충두위(P1:광이평면여지평면평행;P2:해부험평면여지평면평행)화3충단층역중심평면(이중절아위삼고분별설치근첨단층면、아체중심단층면화아관절연단층면)조합성적6충중건방법,분별생성상、하합추형속CT곡면중건편.관찰병비교각추형속CT곡면중건편여곡면체층X선편중적아체영상형태.재추형속CT곡면중건편(매례환자상、하합각6장)화곡면체층X선편상측량상합전아아근협각((321 |123)상린아근간협각분별명명위UA1～ UA5)화하합전아아근협각((321 |123)상린아근간협각분별명명위LA1～ LA5),계산각추형속CT곡면중건편여곡면체층X선편적아근협각차치(△UA화△LA),채용Wilcoxon검험비교상동단층면량충두위아근협각차치적차이.결과 영상학관찰현시,무론두위여하설치,이아체중심단층면중건적추형속CT곡면중건편적아체형태여곡면체층X선편교접근.상동단층면설치조건하,공진행15차P1여P2적△UA비교,기중7차P1적△UA현저소우P2(P＜0.05),1차P1적△UA현저대우P2(P＜0.05);15차P1여P2적△LA비교중10차량자차이무통계학의의(P＞0.05),4차P2적△LA현저소우P1(P＜0.05),1차P2적△LA현저대우P1 (P＜0.05).결론 상합채용광이평면여지평면평행적두위,하합채용해부(아합)평면여지평면평행적두위,병균채용아체중심단층면가중건획득여곡면체층X선편상근적추형속CT곡면중건편용우정기림상판단아근근원중경사각도.
Objective To evaluate the difference of mesiodistal root angulation between panoramic radiograph and panoramic images reconstructed from cone beam computed tomography (CBCT) by different methods.Methods CBCT and panoramic radiograph of twenty patients were collected.The InvivoDental 5.0 was separately applied for maxillary or mandibular panoramic image reconstruction.The reconstruction method was combined by two head positions,the Frankfort plane horizontal position (P1) and the occlusal plane horizontal position (P2),and three central planes of focal trough (root apical plane,tooth center plane and crown marginal plane referring to the central incisor).Variation of tooth morphology in reconstructed panoramic images and panoramic radiograph was firstly observed.And then measurement for maxillary or mandibular anterior tooth intersection angle (contiguous angles among (321|123) were named as UA1-UA5 ;and those among (321 |123) were named as LA1-LA5) was taken.The difference of intersection angles between reconstructed panoramic images and panoramic radiograph (△UA and △LA) were calculated.Wilcoxon Rank Sum Test was finally applied to compare the intersection angles' differencesbetween P1 and P2 with the same central plane of focal trough.Results Panoramic images reconstructedfrom CBCT by tooth center plane with P1 for maxilla and P2 for mandible appeared to fulfill the clinicallydiagnostic demand through the observation.Among the 15 couples of comparison of intersection angles'differences between P1 and P2 by choosing the same central plane of focal trough for maxilla,7 couples of△UA revealed a statistically smaller value in P1 while 1 couple of △UA showed an adverse result.Inmandible with the same comparison method,10 couples of comparison did not show statistical differencebetween P1 and P2,while 4 couples of △LA revealed a statistically smaller value in P2 and 1 couple △LAshowed an opposite result.Conclusions By choosing the tooth center plane,the panoramic imagesreconstructed from CBCT with the Frankfort plane horizontal position in maxilla and the occlusal planehorizontal position in mandible were equally effective.The reconstructed panoramic images can be used as thepanoramic radiograph in the assessment of the mesiodistal root angulation.