首页|口腔外第三磨牙数字X线摄影成像技术的优化及应用价值

口腔外第三磨牙数字X线摄影成像技术的优化及应用价值

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目的 评估口腔外第三磨牙数字X线摄影(DR)成像技术在阻生齿拔除术前评估中的应用价值。方法 首先对高仿真标准生理模拟人进行DR多参数成像，分别改变模拟人的张口尺寸以及X线投射角度，获得不同成像参数下第三磨牙DR图像，通过对比DR图像选择最佳成像参数，并应用于临床DR成像。根据DR影像的清晰度、患侧第三磨牙牙根显示情况以及上下颌第三磨牙重叠程度对第三磨牙DR影像进行分类并进行临床手术风险评估，对 2 位医生的评估结果进行Cohen's Kappa检验。结果 通过模拟人获得口腔外第三磨牙X线最佳投射角度，受限张口位最佳偏移距离为±15 cm，而最大张口位最佳偏移距离为±20 cm。临床上共 51 例患者完成第三磨牙DR成像，共评估 69 颗磨牙，2 位医生对DR图像评估的一致性较强(Kappa系数为 0。809)。图像一级片 51 张，占总数的 73。91%;二级片 18 张，占总数的 26。09%。对第三磨牙倾斜角度进行分类，其中倾斜阻生 19 例，占 27。54%;垂直阻生 24 例，占 34。78%;水平阻生 26 例，占 37。68%。对第三磨牙牙冠位置进行分类，其中高位 41 例，占 59。42%;中位 21 例，占 30。43%;低位 7 例，占 10。14%。临床医生对第三磨牙拔除风险进行评估，其中低风险阻生齿 33 例，占 47。83%;中风险阻生齿 19 例，占 27。54%;高风险阻生齿 17 例，占 24。64%。结论 采用口腔外侧位DR成像，在受限张口位与最大张口位时采用不同的X线投射角度对第三磨牙进行DR成像，可获得较好的图像质量，为临床阻生齿拔除术前的评估提供可靠信息。
Optimization of DR imaging for extraoral third molar and its application value
Objective To evaluate the value of digital radiography(DR)imaging of extraoral third molar in evaluating impacted teeth before extraction.Methods DR multi-parameter imaging was performed on the highly simulated standard physiological simulator.The mouth opening and X-ray projection angle of the simulator were changed to obtain DR images of the third molar under different imaging parameters.Optimal imaging parameters were selected by comparing the DR images,and were applied in clinic.According to the definition of DR images,the root display of the third molar on the affected side,and the overlap degree of the upper and lower third molars,the DR images of the third molar were classified and the surgical risk was assessed.The evaluation results of two doctors were tested by Cohen's Kappa test.Results The best X-ray projection angle of extraoral third molars was obtained.The optimal offset distance of limited mouth open was±15 cm,and the optimal offset distance of maximum mouth open was±20 cm.A total of 51 patients completed DR imaging of the third molar,and 69 molars were evaluated.The DR images of the two doctors were consistent(Kappa value=0.809).There were 51(73.91%)first-grade images and 18(26.09%)second-class images.There were 19(27.54%)oblique impacted teeth,24(34.78%)vertical impacted teeth,and 26(37.68%)horizontal impacted teeth.The subcrown position of the third molar was classified,and there were 41 cases(59.42%)of high position,21 cases(30.43%)of middle position,and 7 cases(10.14%)of low position.Clinicians assessed the risk of third molar extraction,including 33 low-risk impacted teeth(47.83%),19 medium-risk impacted teeth(27.54%),and 17 high-risk impacted teeth(24.64%).Conclusion DR imaging of extraoral third molar with different X-ray projection angles at limited mouth open and maximum mouth open positions can obtain high image quality and provide reliable information for clinical evaluation of impacted teeth before extraction.

Third molarImpacted toothDigital radiographyOral DR imaging

尹伟、李学周、汪沛、付贝

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200433 上海,海军军医大学第一附属医院放射诊断科

200433 上海,海军军医大学第一附属医院口腔科

第三磨牙 阻生齿 数字化X线摄影 口腔DR成像

2024

10.3969/j.issn.1009-0754.2024.10.020

海军医学杂志
海军医学研究所

海军医学杂志

CSTPCD
影响因子：0.518
ISSN：1009-0754
年,卷(期)：2024.45(10)
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