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下颌第三磨牙冠切除术后4 - 8.5年牙根迁移模式的三维放射学评估:一项锥形束计算机断层扫描研究

Three-dimensional radiographic evaluation of root migration patterns 4-8.5 years after lower third molar coronectomy: a cone beam computed tomography study.

作者信息

Yeung A W K, Wong N S M, Bornstein M M, Leung Y Y

机构信息

Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong.

Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.

出版信息

Int J Oral Maxillofac Surg. 2018 Sep;47(9):1145-1152. doi: 10.1016/j.ijom.2018.03.014. Epub 2018 Apr 5.

Abstract

This prospective study in patients with a follow-up of 4-8.5years aimed to describe the long-term, three-dimensional changes of coronectomized lower third molar roots. Pre- and postoperative cone beam computed tomography (CBCT) scans were compared. The distance of root migration, the direction of root translation and rotation, and the amount of bone regeneration at the adjacent second molar and superficially to the third molar root were recorded. Age, gender, time elapsed following surgery, the status of the retained root including, impaction pattern and depth of impaction were tested to check if they were influencing factors for the above outcomes. A total of 57 coronectomized third molars from 44 patients were included. The distance of the mean root migration was 2.82mm, and they predominantly translated mesially (76.8%). Age negatively correlated with the distance of migration. Root remnants with a soft tissue coverage had less bone regenerated at the adjacent second molar (1.27mm vs. 2.95mm) in comparison to their impacted counterparts. Based on the present radiographic results and the absence of any pathological findings, coronectomy can be recommended for selected cases of third molar removal as a safe procedure with favourable long-term outcomes.

摘要

这项对患者进行了4至8.5年随访的前瞻性研究旨在描述冠切术治疗下颌第三磨牙牙根的长期三维变化。对术前和术后的锥形束计算机断层扫描(CBCT)进行了比较。记录牙根迁移的距离、牙根平移和旋转的方向,以及相邻第二磨牙和第三磨牙牙根表面的骨再生量。对年龄、性别、术后经过的时间、保留牙根的状态(包括阻生模式和阻生深度)进行了检测,以检查它们是否为上述结果的影响因素。共纳入了44例患者的57颗接受冠切术的第三磨牙。平均牙根迁移距离为2.82mm,且主要向近中方向平移(76.8%)。年龄与迁移距离呈负相关。与阻生牙根相比,有软组织覆盖的牙根残留在相邻第二磨牙处的骨再生较少(1.27mm对2.95mm)。基于目前的影像学结果以及未发现任何病理表现,对于某些选择的第三磨牙拔除病例,可推荐冠切术作为一种安全且具有良好长期效果的手术。

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