基于锥形束CT的1 138颗多生牙影像学特征分析

doi:10.7518/hxkq.2023.2023110

华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (6): 671-677.doi: 10.7518/hxkq.2023.2023110

基于锥形束CT的1 138颗多生牙影像学特征分析

刘晓琳(), 任群, 白九平, 康培, 任贵云, 李向军, 冯晓伟

河北医科大学口腔医学院·口腔医院口腔颌面外科，河北省口腔医学重点实验室，河北省口腔疾病临床医学研究中心，石家庄 050017

收稿日期:2023-04-10 修回日期:2023-10-11 出版日期:2023-12-01 发布日期:2023-11-27
通讯作者: 冯晓伟 E-mail:1048507074@qq.com
作者简介:刘晓琳，主治医师，博士，E-mail：1048507074@qq.com
基金资助:
河北省高等学校科学技术研究项目(QN2021105);河北省政府资助临床医学优秀人才培养项目(361029)

Imaging analysis of 1 138 supernumerary teeth by using cone-beam computed tomography

Liu Xiaolin(), Ren Qun, Bai Jiuping, Kang Pei, Ren Guiyun, Li Xiangjun, Feng Xiaowei.

Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China

Received:2023-04-10 Revised:2023-10-11 Online:2023-12-01 Published:2023-11-27
Contact: Feng Xiaowei. E-mail:1048507074@qq.com
Supported by:
Hebei Province University Science and Technology Research Project(QN2021105);Hebei Provincial Government Funded Clinical Medicine Excellent Talent Training Project(361029);Correspondence: Feng Xiaowei, E-mail: fengxiaowei.good@163.com

摘要/Abstract

摘要：

目的应用锥形束CT（CBCT）分析及总结多生牙的特征，以期为临床诊疗提供参考。方法共收集718例患者（共1 138颗多生牙）的CBCT影像资料作为研究对象，分析了患者就诊年龄、性别、多生牙数目、位置、形态、萌出状态、伴发症状等情况，并进一步统计分析了多生牙上下颌位置、萌出状态和性别与上述特征的相关性。结果患者平均年龄（9.54±5.32）岁，男女比2.88∶1。77.02%在替牙期就诊，数量多为1颗（50.70%）；1 138颗多生牙中，圆锥形最多，85.76%位于切牙区，92.09%位于上颌，46.75%呈倒置位，86.20%未萌出，65.29%牙根发育完全，60.63%对邻近结构造成影响。多生牙位于上颌或下颌在萌出状态、形态、分区、方向、牙根发育以及对邻近结构影响上差异均有统计学意义（P<0.05）；多生牙是否萌出在性别、形态、分区、方向、牙根发育以及对邻近结构影响上差异均有统计学意义（P<0.05）；男性在切牙区发生率高于女性，且男性多生牙牙根发育较女性更完全（P<0.05）。结论 CBCT可精确分析多生牙特征，有助于临床制定诊疗方案。

关键词: 多生牙, 锥形束CT, 影像学特征, 诊断, 治疗

Abstract:

Objective This study aims to analyze and summarize the characteristics of supernumerary teeth by using cone-beam computed tomography (CBCT). Methods A total of 718 patients with 1 138 supernumerary teeth were retrospectively collected. Age, gender, number, location, morphology, eruption status, and accompanying symptoms of the supernumerary teeth were statistically analyzed. The relationship relative to jaws, gender, and eruption status were analyzed and discussed. Results The average age of the patients was 9.54±5.32 years, and the male to female ratio was 2.88∶1. About 77.02% of the patients sought medical advice during the mixed dentition period, and 50.70% had one supernumerary tooth. These supernumeraries were most commonly conical in shape, and 85.76% of them were in the incisor region, 92.09% in the upper jaw, 46.75% in inverted position, and 86.20% unerupted. Overall, 65.29% of them had fully developed roots, and 60.63% had an impact on adjacent structures. Significant differences were found in eruption status, morphology, zoning, direction, root development, and impact on adjacent structures between the supernumerary teeth located in the upper and lower jaws (P<0.05). Significant differences were also detected in gender, morphology, zoning, orientation, root development, and impact on adjacent structures between erupted and unerupted teeth (P<0.05). The incidence of supernumerary teeth in the incisor region was higher in males than that in females. Moreover, the root of supernumeraries was more completely developed in males than in females (P<0.05). Conclusion For supernumerary teeth, CBCT images can provide accurate three-dimensional radiographic data and are valuable for clinical diagnosis and treatment planning.

Key words: supernumerary teeth, cone-beam computed tomography, radiographic features, diagnosis, treatment

中图分类号:

Q 78

刘晓琳, 任群, 白九平, 康培, 任贵云, 李向军, 冯晓伟. 基于锥形束CT的1 138颗多生牙影像学特征分析[J]. 华西口腔医学杂志, 2023, 41(6): 671-677.

Liu Xiaolin, Ren Qun, Bai Jiuping, Kang Pei, Ren Guiyun, Li Xiangjun, Feng Xiaowei.. Imaging analysis of 1 138 supernumerary teeth by using cone-beam computed tomography[J]. West China Journal of Stomatology, 2023, 41(6): 671-677.

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参考文献 27

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项目		多生牙
年龄/岁	<6	4/0.56
	6~12	553/77.02
	13~18	127/17.69
	19~35	28/3.90
	36~60	6/0.84
性别	男	533/74.23
	女	185/25.77
颗数	1	364/50.70
	2	326/45.40
	≥3	28/3.90
上下颌	上颌	666/92.76
	下颌	40/5.57
	上下颌	12/1.67
分区	前牙区	651/90.67
	后牙区	67/9.33

项目		多生牙
性别	男	849/74.60
	女	289/25.40
分区	切牙区	976/85.76
	尖牙区	17/1.49
	前磨牙区	113/9.93
	磨牙区	32/2.81
上下颌	上颌	1 048/92.09
	下颌	90/7.91
萌出状态	萌出	157/13.80
萌出状态	未萌出	981/86.20
方向	正常	275/24.17
	倒置	532/46.75
	水平	180/15.82
	倾斜	151/13.27
形态	圆锥形	527/46.31
	结节形	444/39.02
	牙瘤形	36/3.16
	补充形	131/11.51
牙根发育情况	完全发育	743/65.29
	未发育	243/21.35
	发育1/3	41/3.60
	发育2/3	111/9.75
继发影响	影响邻近恒牙	447/39.28
	多生牙含牙囊肿	80/7.03
	侵入解剖结构	112/9.84
	同时产生上述影响	51/4.48
	无影响	448/39.37

项目		上颌（n=1 048）	下颌（n=90）	χ²值	P值
萌出状态	萌出	155/14.79	2/2.22	11.008	0.001
	未萌出	893/85.21	88/97.78	11.008	0.001
形态	圆锥形	524/50.0	3/3.33	304.134	0.000
	结节形	424/40.46	20/22.22
	牙瘤形	28/2.67	8/8.89
	补充形	72/6.87	59/65.56
分区	切牙区	976/93.13	0/0.0	415.430	0.000
	尖牙区	14/1.34	3/3.33
	前磨牙区	45/4.29	68/75.56
	磨牙区	13/1.24	19/21.11
方向	正常	217/20.71	58/64.44	133.022	0.000
	倒置	530/50.57	2/2.22
	水平	176/16.79	4/4.44
	倾斜	125/11.93	26/28.89
牙根发育情况	完全发育	741/70.71	2/2.22	297.812	0.000
	未发育	181/17.27	62/68.89
	发育1/3	18/1.72	23/25.56
	发育2/3	108/10.31	3/3.33
继发影响	影响邻近恒牙	419/39.98	28/31.11	16.188	0.003
	多生牙含牙囊肿	78/7.44	2/2.22
	侵入解剖结构	105/10.02	7/7.78
	同时产生上述影响	50/4.77	1/1.11
	无影响	396/37.79	52/57.78

项目		萌出状态		χ²值	P值
项目		萌出（n=157）	未萌出（n=981）	χ²值	P值
性别	男	99/63.06	750/76.45	12.318	0.000
	女	58/36.94	231/23.55	12.318	0.000
形态	圆锥形	96/61.15	431/43.93	16.921	0.001
	结节形	41/26.11	403/41.08
	牙瘤形	4/2.55	32/3.26
	补充形	16/10.19	115/11.72
分区	切牙区	152/96.82	824/84.0	21.736	0.000
	尖牙区	0/0.0	17/1.73
	前磨牙区	3/1.91	110/11.21
	磨牙区	2/1.27	30/3.06
方向	正常	138/87.90	137/13.97	407.525	0.000
	倒置	0/0.0	532/54.23
	水平	0/0.0	180/18.35
	倾斜	19/12.10	132/13.46
牙根发育情况	完全发育	126/80.25	617/62.90	97.365	0.000
	未发育	0/0.0	243/24.77
	发育1/3	0/0.0	41/4.18
	发育2/3	31/19.75	80/8.15
继发影响	影响邻近恒牙	90/57.32	357/36.39	74.377	0.000
	多生牙含牙囊肿	0/0.0	80/8.15
	侵入解剖结构	0/0.0	112/11.42
	同时产生上述影响	0/0.0	51/5.20
	无影响	67/42.68	381/38.84

项目		性别		χ²值	P值
项目		男性（n=849）	女性（n=289）	χ²值	P值
形态	圆锥形	388/45.70	139/48.10	1.389	0.710
	结节形	331/38.99	113/39.10
	牙瘤形	27/3.18	9/3.11
	补充形	103/12.13	28/9.69
分区	切牙区	755/88.93	221/76.47	27.913	0.000
	尖牙区	10/1.18	7/2.42
	前磨牙区	67/7.89	46/15.92
	磨牙区	17/2.0	15/5.19
方向	正常	213/25.09	62/21.45	1.589	0.650
	倒置	406/47.82	126/43.60
	水平	135/15.90	45/15.57
	倾斜	95/11.19	56/19.38
牙根发育情况	完全发育	591/69.61	152/52.60	31.514	0.000
	未发育	156/18.37	87/30.10
	发育1/3	32/3.77	9/3.11
	发育2/3	70/8.24	41/14.19

基于锥形束CT的1 138颗多生牙影像学特征分析

Imaging analysis of 1 138 supernumerary teeth by using cone-beam computed tomography

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