Zhao Dan, Chen Xiaolei, Yue Li, Liu Weiqing, Mo Anchun, Yu Haiyang, Yuan Quan
State Key Laboratory of Oral Diseases, Department of Oral Implantology, National Clinical Key Specialty, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Clin Oral Investig. 2015 Sep;19(7):1619-24. doi: 10.1007/s00784-014-1393-0. Epub 2015 Jan 25.
The study aims to assess the residual alveolar bone volume in Chinese chronic kidney disease (CKD) patients undergoing hemodialysis (HD) using cone-beam computed tomography (CBCT).
Two hundred and eight HD patients and healthy controls were enrolled to undergo CBCT examination. To evaluate residual alveolar bone volume, bone height was measured from the alveolar crest (AC) to the maxillary sinus floor or the mandibular nerve canal, whereas bone width was measured at a depth of 1.0, 3.0, and 6.0 mm apical to the AC.
There was no significant difference in demographics and the extent of tooth loss between HD patients and control group. Both groups showed abundant residual bone volume. However, the heights of residual alveolar bone at the upper premolars and first molar in HD patients were significantly lower than those of the control group (p < 0.05). No significant difference was observed for alveolar bone at the lower premolars and molars. The bone width showed statistical differences for HD patients' upper second molars, lower first premolars, and second molars (p < 0.05).
While the residual bone was sufficient for implant placement, HD patients exhibited with significantly lower residual bone height at the sites of the upper premolars and first molar and varied residual bone width depending on the location.
Owing to these changes, special cautions need to be taken for patients undergoing HD or with chronically impaired renal functions during implant treatment planning.
本研究旨在使用锥形束计算机断层扫描（CBCT）评估接受血液透析（HD）的中国慢性肾脏病（CKD）患者的残余牙槽骨体积。
招募208名HD患者和健康对照者进行CBCT检查。为评估残余牙槽骨体积，从牙槽嵴（AC）至上颌窦底或下颌神经管测量骨高度，而在AC根尖1.0、3.0和6.0 mm深度处测量骨宽度。
HD患者与对照组在人口统计学和牙齿缺失程度方面无显著差异。两组均显示有丰富的残余骨体积。然而，HD患者上前磨牙和第一磨牙处的残余牙槽骨高度显著低于对照组（p < 0.05）。下前磨牙和磨牙处的牙槽骨未观察到显著差异。HD患者的上第二磨牙、下第一前磨牙和第二磨牙的骨宽度存在统计学差异（p < 0.05）。
虽然残余骨足以进行种植体植入，但HD患者上前磨牙和第一磨牙部位的残余骨高度显著较低，且残余骨宽度因位置而异。
由于这些变化，在为接受HD或肾功能长期受损的患者进行种植治疗计划时需要特别谨慎。
