基于CBCT对不同性别下颌阻生第三磨牙拔除策略的临床价值研究
目的：基于锥形束CT(CBCT)对影响下颌阻生第三磨牙(impacted mandibular third molar，IMTM)拔除难度的相关因素进行研究。方法：选取2023年3月~2024年6月期间在湖州师范学院附属口腔医院就诊的260例患者的CBCT影像资料进行研究。记录阻生牙相关变量：牙根数、阻生状态、倾斜阻生方向、阻生深度、与下颌神经管的位置关系，统计其构成比。并按照不同性别进行分类，统计分析不同性别之间的差异性。结果：IMTM中，①牙根数：单根18.6%、双根75.5%、三根5.4%、四根0.5%。②阻生状态：倾斜阻生40.6%、垂直阻生29.3%、水平阻生29.0%、倒置阻生1.1%。倾斜方向：近中74.3%、颊向3.9%、舌向16.2%、远中5.5%。③阻生深度：高位64.6%、中位28.1%、低位7.3%。④与下颌神经管的位置关系：根位于下颌神经管舌侧36.1%、颊侧5.0%、上方26.5%、牙根之间0.2%、根进入下颌神经管内31.7%、特殊0.5%。在牙根数、阻生状态、倾斜阻生方向方面，不同性别之间P<0.05，有统计学差异；在阻生深度、与下颌神经管位置关系方面P>0.05，无统计学差异。结论：不同性别的IMTM在形态学特征上存在差异，进而导致其拔除难度不同。CBCT能够从三维角度精准的观测出IMTM的形态学特点，为临床上制定阻生牙的拔除策略提供指导意义。
Objective:To study the factors influencing the difficulty of extracting impacted mandibular third molars (IMTM) based on cone-beam computed tomography (CBCT). Method:CBCT images of 260 patients who visited the Affiliated Stomatological Hospital of Huzhou University from March 2023 to June 2024 were analyzed. Variables related to impacted teeth were recorded, including the number of roots, impacted status, direction of impacted teeth, depth of impaction, and the positional relationship with the mandibular nerve canal. Their composition ratios were calculated. The data were stratified by gender, with statistical comparisons of inter-gender differences.Result:Among IMTM, ① Number of roots: single root 18.6%, double roots 75.5%, triple roots 5.4%, quadruple roots 0.5%. ② Impacted status: mesially impacted 40.6%, vertically impacted 29.3%, horizontally impacted 29.0%, inverted impacted 1.1%. Direction of impacted teeth: mesially 74.3%, buccally 3.9%, lingually 16.2%, distally 5.5%. ③ Depth of impaction: high 64.6%, medium 28.1%, low 7.3%.④The positional relationship with the mandibular nerve canal: the root is located 36.1% on the lingual side, 5.0% on the buccal side,26.5% above the mandibular nerve canal, 0.2% between the roots, 31.7% of the roots enter the mandibular nerve canal, and 0.5% is special.There were statistically significant differences between genders in the number of roots, impacted status, and direction of impacted teeth (P<0.05), but no significant differences in depth of impaction and positional relationship with the mandibular nerve canal (P>0.05).Conclusion:There are differences in morphological characteristics of IMTM between different genders, which leads to different extraction difficulties. CBCT can precisely observe the morphological features of IMTM from a three-dimensional perspective, providing guidance for the clinical formulation of extraction strategies for impacted teeth.
柳佳婕、唐佳妮、宋晓玲、孟祥勇
湖州师范学院医学院、护理学院湖州师范学院医学院、护理学院湖州师范学院医学院、护理学院湖州师范学院附属口腔医院
临床医学口腔科学
锥形束CT下颌阻生第三磨牙形态学特征拔除策略
one-beam computed tomographyimpacted mandibular third molarmorphological characteristicsextraction strategy
柳佳婕,唐佳妮,宋晓玲,孟祥勇.基于CBCT对不同性别下颌阻生第三磨牙拔除策略的临床价值研究[EB/OL].(2024-11-29)[2025-08-16].https://www.biomedrxiv.org.cn/article/doi/bmr.202503.00030.点此复制
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