基于CBCT的儿童上颌正中多生牙的新分类方法及临床应用

doi:10.19438/j.cjoms.2023.06.008

摘要/Abstract

摘要： 目的: 应用CBCT建立新的儿童上颌正中多生牙分类体系,提出相应手术途径,为儿童上颌正中多生牙的诊疗提供参考。方法: 选择2018年1月—2022年12月深圳市儿童医院口腔科收治的4~16岁上颌正中多生牙患儿740例。根据术前CBCT检查,对上颌正中多生牙的位置及手术入路特点进行统计分析。采用SPSS 26.0软件包对数据进行统计学分析。结果: 740例患儿共有上颌正中多生牙991颗,根据多生牙与邻近正常牙或牙胚矢状面的轴向角度关系对所选病例进行分类,锐角（包括同向）型95例(12.8%),垂直型78例(10.5%),钝角型138例(18.7%),倒置型328例(44.3%),混合型101例(13.7%);腭侧龈缘入路是锐角（包括同向）型多生牙、钝角型多生牙和倒置型多生牙病例选择最多的手术入路,腭侧龈缘入路和唇-腭侧联合入路是垂直型多生牙和混合型多生牙病例选择较多的手术入路。结论: 根据CBCT建立新的儿童上颌正中多生牙分类方法,分析新分类方法与多生牙拔除手术不同手术入路之间的关系,更好地指导儿童上颌正中多生牙的临床诊疗。

关键词: 儿童, 上颌, 正中多生牙, 分类方法

Abstract: PURPOSE: To analyze the relationship between the position of embedded mesiodens in maxilla and surgical approach in children, and provide reference for surgical design. METHODS: A total of 740 patients aged 4-16 years old with maxillary embedded mesiodens admitted to the Department of Stomatology, Shenzhen Children's Hospital from January 2018 to December 2022 were selected. According to preoperative CBCT data, the position of the mesiodens in the maxilla and the characteristics of the surgical approach were statistically analyzed. SPSS 26.0 software package was used for statistical analysis. RESULTS: There were 991 embedded mesiodens in 740 children. The selected cases were classified according to the axial angle relationship in sagittal plane between mesiodens and adjacent normal teeth or tooth germs, including 95 cases of acute angle type (including synclastic) (12.8%), 78 cases of vertical type (10.5%), 138 cases of obtuse angle type (18.7%), 328 cases of inverted type (44.3%), and 101 cases of mixed type (13.7%). The palatal gingival margin approach was the most selected surgical approach for the cases of acute angle (including synclastic), obtuse angle and inverted type, and palatal gingival margin approach and combined labial-palatal approach were the most selected surgical approach for the cases of vertical and mixed type. CONCLUSIONS: A new classification method was established based on CBCT data, and the relationship between the new classification method and various surgical approaches for extraction was analyzed, which helped to better guide clinical diagnosis and treatment of children's maxillary mesiodens.

Key words: Children, Maxilla, Embedded mesiodens, Classification method

中图分类号:

R782.1

孔杰, 彭兆伟, 束煌, 王骥, 邝亦元, 钟天航, 丁桂聪. 基于CBCT的儿童上颌正中多生牙的新分类方法及临床应用[J]. 中国口腔颌面外科杂志, 2023, 21(6): 579-585.

KONG Jie, PENG Zhao-wei, SHU Huang, WANG Ji, KUANG Yi-yuan, ZHONG Tian-hang, DING Gui-cong. A new CBCT-based classification method for maxillary mesiodens in children and its clinical applications[J]. China J Oral Maxillofac Surg, 2023, 21(6): 579-585.

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