三维转化头影测量法评估咬合垂直距离的研究

doi:10.7518/hxkq.2019.01.010

华西口腔医学杂志 ›› 2019, Vol. 37 ›› Issue (1): 53-57.doi: 10.7518/hxkq.2019.01.010

三维转化头影测量法评估咬合垂直距离的研究

魏雅楠¹,曹志云²(),李罡³,盛迅²,熊依箐¹,李卫¹

^1. 昆明医科大学口腔医学院,昆明 650500
^2. 昆明医科大学附属口腔医院修复科,昆明 650106
^3. 昆明市蓝橙齿科,昆明 650032

收稿日期:2018-07-05 修回日期:2018-10-12 出版日期:2019-02-01 发布日期:2019-02-01
通讯作者: 曹志云 E-mail:626296441@qq.com
作者简介:魏雅楠,住院医师,硕士,E-mail：971718277@qq.com
基金资助:
云南省科技厅—昆明医科大学应用基础研究联合专项基金(2015FB075);昆明医科大学研究生创新基金(2017S003)

Cone-beam computed tomography-synthesized cephalograms for evaluating the vertical dimension of occlusions

Ya’nan Wei¹,Zhiyun Cao²(),Gang Li³,Xun Sheng²,Yiqing Xiong¹,Wei Li¹

1. College of Stomatology, Kunming Medical University, Kunming 650500, China
^2. Dept. of Prosthodontics, The Affiliated Stomatological Hospital of Kunming Medical University, Kunming 650106, China
^3. Lanchie Dental Clinic in Kunming, Kunming 650032, China

Received:2018-07-05 Revised:2018-10-12 Online:2019-02-01 Published:2019-02-01
Contact: Zhiyun Cao E-mail:626296441@qq.com
Supported by:
Joint Special Fund for Applied Basic Research of Yunnan Provincial Science and Technology Department-Kunming Medical University(2015FB075);Postgraduate Innovation Fund of Kunming Medical University(2017S003)

摘要/Abstract

摘要：

目的对三维转化头影测量法、发音法及息止间隙法确定的云南省汉族无牙颌患者咬合垂直距离的准确性进行比较和分析。方法首先建立云南省汉族正常者锥形束CT（CBCT）头颅侧位影像各标志点间相关性数据库,随后选取5名63~78岁云南省汉族无牙颌患者,使用NNT.View软件对由CBCT转化的头颅侧位片的各硬组织标志点进行测量分析,结合正常人群数据库,评估出咬合垂直距离,并对CBCT转化头影测量法、发音法及息止间隙法确定的咬合垂直距离进行分析。结果本研究以发音法为标准参照组,分析了息止间隙法和6种CBCT转化头影测量法（包括N-ANS/ANS-Me、S-Go/N-Me、ANS-Gn/N-ANS、ANS-FH/Me-FH、ANS-Xi-Pm、CA/LA）与发音法的差值,结果发现：7种测量方法与发音法均有很高的一致性（组内相关系数>0.986）;其中息止间隙法、N-ANS/ANS-Me、S-Go/N-Me法差值的绝对值较其他4组更小,而ANS-FH/Me-FH差值的绝对值最大,差异均有统计学意义（P<0.05）。结论三维转化头影测量法除ANS-FH/Me-FH外,其余5种方法均可为临床评估无牙颌患者咬合垂直距离提供参考。

关键词: 锥形束CT, 转化侧位片, 垂直距离, 无牙颌

Abstract:

Objective The accuracy of the occlusion vertical dimensions of edentulous Han patients from Yunnan province was compared and analyzed on the basis of cone-beam computed tomography (CBCT)-synthesized cephalograms, closest speaking space method, and interocclusal distance. Methods A database correlating the CBCT head lateral images of Han patients from Yunnan province with normal occlusal conditions was first constructed. Then, five edentulous Han patients aged 63-78 years old from Yunnan Province were selected. NNT.View software was used to measure and analyze hard tissue cephalometric radiographs that had been transformed by the CBCT marker. The radiographs were then combined with the normal population database for the assessment of occlusion vertical dimensions. The occlusion vertical dimensions determined on the basis of CBCT-synthesized cephalograms, the closest speaking space method, and the free-way space were analyzed. Results The closest speaking space method was used as the standard control group, the differences between seven methods and the closest speaking space method were analyzed. The seven methods include free-way space method and six CBCT-synthesized cephalograms methods (N-ANS/ANS-Me, S-Go/N-Me, ANS-Gn/N-ANS, ANS-FH/Me-FH, ANS-Xi-Pm, and CA/LA). The seven methods were highly consistent with the closest speaking space method (intraclass correlation coefficient>0.986). The absolute values of the differences between the methods of free-way space, N-ANS/ANS-Me, S-Go/N-Me and the closest speaking space method were lower than those of the other four groups (P<0.05), while the differences between ANS-FH/Me-FH and the closest speaking space method was higher than those other groups (P<0.05). Conclusion CBCT-synthesized cephalograms, with the exception of ANS-FH/Me-FH, can provide references for the clinical evaluation of the occlusion vertical dimensions of patients with edentulous jaws.

Key words: cone-beam computed tomography, synthesized cephalograms, vertical dimension, edentulous

中图分类号:

R 783

魏雅楠,曹志云,李罡,盛迅,熊依箐,李卫. 三维转化头影测量法评估咬合垂直距离的研究[J]. 华西口腔医学杂志, 2019, 37(1): 53-57.

Ya’nan Wei,Zhiyun Cao,Gang Li,Xun Sheng,Yiqing Xiong,Wei Li. Cone-beam computed tomography-synthesized cephalograms for evaluating the vertical dimension of occlusions[J]. West China Journal of Stomatology, 2019, 37(1): 53-57.

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参考文献 16

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测量项目	定义
N-FC-ANS（简称CA）/°	由N、CF及ANS构成的面中心角
Go-ANS-Me（简称IGA）/°	由Go、ANS及Me构成的下颌后下角
ANS-Xi-Pm/°	下面高角度,由ANS、Xi及Pm构成
	的角度
Ar-Go-Me（简称GA）/°	由Ar、Go及Me构成的下颌角
ANS-Goc-Me（简称LA）/°	由ANS、Goc及Me构成的面下角
N-ANS/mm	上面高,N至ANS的距离
ANS-Me/mm	下面高,ANS至Me的距离
S-Go/mm	后面高,S至Go的距离
N-Me/mm	前面高,N至Me的距离
ANS-Gn/mm	下面高,ANS至Gn的距离
ANS-FH/mm	ANS至眶耳平面的距离
Me-FH/mm	Me至眶耳平面的距离

测量项目	男性（n=29）	女性（n=31）	P值
N-ANS/ANS-Me	0.802 5±0.009 2	0.805 5±0.009 2	0.207
S-Go/N-Me	0.652 0±0.031 8	0.657 3±0.032 9	0.528
ANS-Gn/N-ANS	1.207 0±0.030 9	1.196 3±0.028 5	0.170
ANS-Xi-Pm/°	49.393 1±4.021 2	49.358 1±3.427 6	0.971
GA/°	122.520 7±6.480 8	124.854 8±4.978 2	0.122
IGA/°	52.837 9±3.293 0	52.125 8±3.732 2	0.438
CA/°	45.886 2±2.923 4	46.264 5±2.704 8	0.605
LA/°	50.741 4±3.648 3	50.203 2±3.464 4	0.560
ANS-FH	25.293 1±2.875 2	24.535 5±2.796 6	0.307
Me-FH	91.596 6±5.547 2	86.432 3±5.800 6	0.001

性别	因变量	自变量	回归方程	R²	P值
男	Me-FH	ANS-FH	Y=53.675+1.499X	0.612	0.000
女	Me-FH	ANS-FH	Y=49.791+1.493X	0.518	0.000

性别	因变量	自变量	回归方程	R²	P值
男	LA	CA	Y=24.769+0.566X	0.206	0.013
女	LA	CA	Y=23.285+0.582X	0.206	0.010

因素	F值	P值
差值	58.219	0.000
医生	7.252	0.001
医生和差值	0.429	0.919

三维转化头影测量法评估咬合垂直距离的研究

Cone-beam computed tomography-synthesized cephalograms for evaluating the vertical dimension of occlusions

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Metrics

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方法	与发音法的差值
息止间隙法/mm	0.880±0.119^a
N-ANS/ANS-Me	0.933±0.488^a
S-Go/N-Me	0.722±0.501^a
ANS-Gn/N-ANS	1.115±0.684^b
ANS-Xi-Pm/°	1.268±0.686^b
CA/LA	1.312±0.662^b
ANS-FH/Me-FH	3.395±0.944^c

方法	ICC（95%CI）*
息止间隙法/mm	0.999 8（0.999 6~0.999 9）
N-ANS/ANS-Me	0.996 7（0.992 5~0.998 5）
S-Go/N-Me	0.991 6（0.9811~0.996 3）
ANS-Gn/N-ANS	0.993 7（0.985 7~0.997 2）
ANS-Xi-Pm/°	0.993 3（0.985 0~0.997 1）
CA/LA	0.994 1（0.986 7~0.997 4）
ANS-FH/Me-FH	0.986 3（0.969 2~0.994 0）

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