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巴西人群中骨-牙骨质发育不良引起的相邻结构改变的锥形束 CT 分析。

Cone-beam computed tomography analysis of cemento-osseous dysplasia-induced changes in adjacent structures in a Brazilian population.

机构信息

Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.

Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.

出版信息

Clin Oral Investig. 2020 Aug;24(8):2899-2908. doi: 10.1007/s00784-019-03154-x. Epub 2020 Feb 19.

Abstract

OBJECTIVES

To describe the effects of cemento-osseous dysplasia (COD) on anatomical structures.

METHODS

CBCT scans were retrospectively selected from a database of individuals who attended an Oral Medicine service. Cases with a confirmed diagnosis of periapical, focal, or florid COD were included. Two oral and maxillofacial radiologists assessed the scans. Frequencies of the variables were described according to COD case, lesion areas, and teeth.

RESULTS

Sixty COD cases affected 244 areas and 426 teeth. Florid COD was the most common (n = 48). Cortical bone (buccal, lingual, palatine, or mandibular) (n = 42) and the maxillary sinus (n = 13) were the structures most frequently affected by displacement or perforation. Thinning (n = 80), expansion (n = 62), and perforation (n = 60) of the cortical bone were common effects. The median size of the lesions was 12 mm in the mesiodistal direction, 8 mm in the buccal-lingual/palatal direction, and 9 mm in the superior-inferior direction. Root resorption was observed in 18.1% of all teeth, while tooth displacement was uncommon (0.6%). All teeth affected by COD had a discontinuous lamina dura and non-uniformly visible periodontal ligament space.

CONCLUSIONS

CBCT images revealed that cortical bone, lamina dura, and periodontal ligament space were the structures most affected by COD and the effects of COD on anatomical structures were more frequent than previously described.

CLINICAL RELEVANCE

CODs are fibro-osseous lesions common in the clinical practice, and relationship with anatomical structures is poorly described. CBCT is an appropriate method for the diagnosis and follow-up of patients with COD.

摘要

目的

描述骨-牙性骨硬化症(COD)对解剖结构的影响。

方法

从一个参加口腔医学服务的数据库中回顾性选择 CBCT 扫描。纳入有明确诊断的根尖、局灶性或弥漫性 COD 的病例。两名口腔颌面放射科医生评估了这些扫描。根据 COD 病例、病变区域和牙齿,描述了变量的频率。

结果

60 例 COD 病例影响了 244 个区域和 426 颗牙齿。弥漫性 COD 最常见(n = 48)。皮质骨(颊侧、舌侧、腭侧或下颌骨)(n = 42)和上颌窦(n = 13)是最常被移位或穿孔影响的结构。皮质骨变薄(n = 80)、扩张(n = 62)和穿孔(n = 60)是常见的影响。病变在近远中方向的中位数大小为 12mm,在颊舌/腭方向为 8mm,在上下方向为 9mm。所有牙齿中有 18.1%观察到牙根吸收,而牙齿移位则不常见(0.6%)。所有受 COD 影响的牙齿均有不连续的骨皮质和不均匀可见的牙周韧带间隙。

结论

CBCT 图像显示皮质骨、骨皮质和牙周韧带间隙是受 COD 影响最严重的结构,而 COD 对解剖结构的影响比以前描述的更为频繁。

临床意义

COD 是临床实践中常见的纤维骨性病变,与解剖结构的关系描述不足。CBCT 是诊断和随访 COD 患者的合适方法。

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