Unit of Oral and Maxillofacial Implantology, Tsurumi University School of Dental Medicine, Yokohama, Japan.
J Periodontol. 2011 Jun;82(6):829-36. doi: 10.1902/jop.2010.100160. Epub 2010 Nov 12.
Assessment of oral mucosal thickness is important in implant surgery; however, examining the soft tissue three dimensionally is difficult. A reamer method is invasive, and a non-invasive ultrasonic method produces only low-resolution images depending on anatomic variations. The emerging technology of spiral computed tomography (CT) is an alternative to the conventional methods. Spiral CT has been a useful diagnostic tool in implant surgery. Although it delivers high radiation doses, spiral CT provides three-dimensional imaging of low-contrast structures. The purpose of the present study is to assess the accuracy of oral mucosal measurements using spiral CT.
Thickness of maxillary oral mucosa was measured in five cadavers. The measurement sites were set up in buccal, palatal, and middle of the crest in the missing tooth area in the incisor, canine, premolar, and molar regions. Each cadaver was exposed to spiral CT after installing the measurement guide. After that, each site was physically measured by reamer. Linear regression and correlation analysis were performed to describe the association between radiographic and physical measurements.
A total of 114 measurements were performed with statistical analyses. Mean values and standard deviations of physical and radiographic measurements were 3.12 ± 1.43 and 2.83 ± 1.70 mm, respectively. The radiographic and physical measurements demonstrate strong correlation (r = 0.90; P <0.01). Measurement error was 0.52 ± 0.36 mm. According to the regions, the measurements in buccal, palatal, and missing tooth region depicted a significant correlation (r = 0.92, r = 0.85, and r = 0.91, respectively). The boundary of the bone and mucosa was indistinguishable at 23 buccal sites. Twenty-three measurements that could not be distinguished with CT had a mean of 0.69 and standard deviation ± 0.13 mm.
The correlation between spiral CT and physical measurement was high except in sites of very thin mucosa. Spiral CT can be considered an alternative method for the measurement of oral mucosal thickness. Because of the higher radiation exposure, caution should be exercised and radiation dosage versus clinical benefit assessment is required.
评估口腔黏膜厚度在种植手术中很重要；然而，对软组织进行三维检查很困难。取芯器方法具有侵入性，而无创超声方法则根据解剖结构的变化产生低分辨率的图像。新兴的螺旋 CT 技术是传统方法的一种替代方法。螺旋 CT 已成为种植手术中有用的诊断工具。尽管它会产生高剂量的辐射，但螺旋 CT 可提供低对比度结构的三维成像。本研究旨在评估螺旋 CT 测量口腔黏膜的准确性。
在五具尸体上测量上颌口腔黏膜的厚度。测量部位设置在切牙、尖牙、前磨牙和磨牙区域缺牙区的颊侧、腭侧和嵴顶中部。每个尸体在安装测量导板后进行螺旋 CT 暴露。之后，通过取芯器对每个部位进行物理测量。进行线性回归和相关分析以描述放射学和物理测量之间的关联。
共进行了 114 次测量并进行了统计学分析。物理和放射学测量的平均值和标准差分别为 3.12 ± 1.43 和 2.83 ± 1.70 mm。放射学和物理测量显示出很强的相关性（r = 0.90；P <0.01）。测量误差为 0.52 ± 0.36 mm。根据区域，颊侧、腭侧和缺牙区的测量值显示出显著相关性（r = 0.92、r = 0.85 和 r = 0.91）。骨和黏膜的边界在 23 个颊侧部位无法区分。23 个无法通过 CT 区分的测量值的平均值为 0.69，标准差为 ± 0.13 mm。
除了非常薄的黏膜部位外，螺旋 CT 与物理测量之间的相关性很高。螺旋 CT 可以被认为是测量口腔黏膜厚度的替代方法。由于辐射暴露较高，应谨慎使用，并需要评估辐射剂量与临床获益。
