摘要
目的 利用分形维度分析评价意向性牙再植治疗畸形舌面沟伴牙周牙髓联合病变根尖及根周区骨小梁微观结构的变化,评价骨愈合情况.方法 纳入西南医科大学附属口腔医院就诊的畸形舌面沟伴牙周牙髓联合病变(影像学检查伴有根尖及根周明显暗影)并且在我院完成显微根管治疗及意向性牙再植的患者,分别记录牙再植术后即刻(T0)和术后 1 年(T1)的根尖片进行分形分析研究,在根尖片上裁剪患牙根尖暗影区及根周暗影区这两个区域的影像作为目标区域(ROI),通过ImageJ软件获得骨小梁的二维数据,通过计盒法获得ROI内的分形指数(FD).使用SPSS17.0 统计分析在T0 和T1 时间点上,患牙根尖区的分形维度指数(FDa)及根周区分形维度指数(FDp)是否有统计学差异.结果 共有 10 名患者纳入了本研究,其中男 6 例,女 4 例,年龄组:＜30 岁 6 例,≥30 岁 4 例.所有患者,患牙FDa及FDp随着时间推移均有升高,同时差异具有统计学意义(P＜0.05).年龄分组中,与≥30岁组相比,＜30岁组,FDa升高明显,差异具有统计学意义(P＜0.05),提示可能年轻患者根尖区骨修复速度较年长者快,而FDp的升高不受患者年龄因素的影响,且差异不具有统计学意义(P＞0.05).在根尖区及根周骨愈合过程中,患牙根尖区及根周区域的FD值升高不受患者性别因素影响.结论 意向性牙再植术可能是畸形根面沟致牙周牙髓联合病变的一种可行治疗方法.分形分析可以作为一种无创的、经济的,可定量评价其骨愈合的分析工具.
Abstract
Objective To evaluate the periapical and periodontal bone microstructural changes in patients with the radicular groove and combined endo-periodontal lesion after intentional replantation by using fractal analysis measurements.Methods Ten patients with radicular groove and combined endo-periodontal lesion were included in this study.Two radiographs were taken,the first immediately after retreatment To and the second at the 1-year follow-up Ti.The images from periapical regions of the tooth were cut on the periapical films as the region of interest(ROI),and the fractal index in ROI was obtained by box counting method.SPSS17.0 was used to analyze the fractal dimension(FD)index.Results The mean FD value signifcantly increased at the 1-year follow-up compared to base line.Compared with age≥30 year old group,the FD value of age<30 years old group in apical area increased(P<0.05).Conclusions Intentional tooth replantation may be a feasible treatment for endo-periodontal lesion caused by radicular groove.Fractal dimension analysis can be used as a non-invasive,economic and quantitative analysis tool to evaluate bone healing.
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维普
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