锥形束CT图像测量牙周炎患者牙槽骨变化及其临床意义

doi:10.3969/j.issn.1006-5725.2026.08.004

摘要/Abstract

摘要：

目的探究锥形束计算机断层扫描（CBCT）图像测量牙周炎患者牙槽骨变化的价值及其临床意义。方法回顾性分析2023年1月至2025年1月于安徽医科大学第一附属医院就诊的126例牙周炎患者的临床资料（纳入2 764颗牙齿），均行牙周基础治疗6个月，对比治疗前、治疗后不同性别、不同年龄、牙周炎不同严重程度、不同位置牙齿的牙槽骨缺损高度（BDH）、牙槽骨密度（BMD）的差异。结果（1）治疗前后，男性BDH、BMD高于女性（P < 0.05）；治疗后，不同性别患者BDH均较治疗前降低，BMD均较治疗前提高（P < 0.05）。（2）治疗前后，不同年龄患者BDH比较：50岁以上>30～50岁>30岁以下，BMD比较：50岁以上<30～50岁<30岁以下；治疗后，50岁以上、30~50岁患者BDH均较治疗前降低（P < 0.05），BMD均较治疗前提高（P < 0.05），30岁以下患者BDH、BMD与治疗前比较，差异无统计学意义（P > 0.05）。（3）治疗前后，不同牙周炎严重程度患者BDH比较：重度>中度>轻度，BMD比较：重度<中度<轻度（P < 0.05），且多数呈近中＞远中＞颊侧＞舌侧；治疗后，轻度、中度、重度患者BDH均较治疗前降低，BMD均较治疗前提高（P < 0.05）。（4）治疗前后，不同位置BDH比较：磨牙区>前磨牙区>前牙区，BMD比较：磨牙区<前磨牙区<前牙区（P < 0.05），且近中＞远中＞颊舌侧；治疗后，磨牙区、前磨牙区BDH均较治疗前降低，BMD均较治疗前增大（P < 0.05）；前牙区BDH、BMD与治疗前比较，差异无统计学意义（P > 0.05）。结论 CBCT图像可有效量化牙周炎牙槽骨变化，可为临床通过影像学手段精准诊疗牙周炎提供科学依据。

关键词: 锥形束计算机断层扫描, 牙周炎, 牙槽骨密度

Abstract:

Objective To explore the value and clinical significance of cone beam computed tomography （CBCT） in measuring alveolar bone changes in patients with periodontitis. Methods The clinical data of 126 patients with periodontitis （2，764 teeth） admitted to the First Affiliated Hospital of Anhui Medical University from January 2023 to January 2025 were retrospectively analyzed， and the above patients received periodental non-surgical treatment for 6 months. The differences in alveolar bone defect height （BDH） and alveolar bone mineral density （BMD） before and after treatment were compared among patients with different genders， different ages， different severities of periodontitis and different teeth positions. Results Before and after treatment， male patients exhibited higher BDH and BMD than female patients （P < 0.05）. After treatment， BDH of patients with different genders was decreased while BMD was increased compared to before treatment （P < 0.05）. Before and after treatment， BDH comparison of patients of different ages was the highest in patients over 50 years old， followed by patients with 30-50 years old and patients under 30 years old. BMD comparison was the lowest in patients over 50 years old， followed by patients with 30-50 years old， and was the highest in patients under 30 years old. After treatment， BDH in patients over 50 years old and 30-50 years old was lowered （P < 0.05） while BMD was elevated compared to before treatment （P < 0.05）. There were no statistical differences in BDH and BMD in patients under 30 years old compared to before treatment （P > 0.05）. Before and after treatment， the BDH of patients with different severities of periodontitis was manifested as severe patients>moderate patients>mild patients， while BMD was shown as severe patients<moderate patients<mild patients （P < 0.05）， mainly revealing mesial side>distal side>buccal side>lingual side. After treatment， BDH in mild， moderate and severe patients was reduced while BMD was enhanced compared to before treatment （P < 0.05）. Comparison of BDH in different positions before and after treatment revealed molar area>premolar area>anterior teeth area， and BMD comparison showed molar area<premolar area<anterior teeth area （P < 0.05）， and mesial side> distal side>buccolingual side. After treatment， BDH in molar area and premolar area was lower than that before treatment while BMD was higher than that before treatment （P < 0.05）. There were no statistical differences in BDH and BMD in the anterior teeth area before and after treatment （P > 0.05）. Conclusion CBCT images can effectively quantify the changes of alveolar bone in periodontitis， and can provide a scientific basis for the accurate diagnosis and treatment of periodontitis by imaging methods.

Key words: cone beam computed tomography, periodontitis, bone mineral density

中图分类号:

R781.42

黄靖,韩爽,赵雪梅,陈渊,钱银锋. 锥形束CT图像测量牙周炎患者牙槽骨变化及其临床意义[J]. 实用医学杂志, 2026, 42(8): 1332-1340.

Jing HUANG,Shuang HAN,Xuemei ZHAO,Yuan CHEN,Yinfeng QIAN. Cone beam CT image measurement of alveolar bone changes in patients with periodontitis and its clinical significance[J]. The Journal of Practical Medicine, 2026, 42(8): 1332-1340.

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性别	n	BDH		BMD
性别	n	治疗前	治疗后	治疗前	治疗后
男	1 744	4.67 ± 0.92	4.48 ± 0.46^*	923.58 ± 103.25	956.28 ± 113.85^*
女	1 020	4.25 ± 0.89	3.87 ± 0.43^*	852.22 ± 109.52	913.26 ± 115.82^*
t值	-	11.721	34.453	17.142	9.525
P值	-	< 0.001	< 0.001	< 0.001	< 0.001

年龄	n	近中		远中		颊侧		舌侧
年龄	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
30岁以下	696	2.96 ± 0.78	2.89 ± 0.81	2.73 ± 0.75	2.68 ± 0.79	2.48 ± 0.78	2.42 ± 0.72	2.23 ± 0.69	2.18 ± 0.61
30~50岁	1 128	3.65 ± 1.05^&	3.43 ± 0.99^*&	3.41 ± 1.12⁷	3.12 ± 0.86^*&	2.91 ± 0.82^&	2.67 ± 0.76^*&	2.34 ± 0.83^&	2.07 ± 0.81^*&
50岁以上	940	6.38 ± 1.28^&#	6.04 ± 1.29*^&#	6.12 ± 1.14^&#	5.76 ± 1.22^*&#	5.48 ± 1.02^&#	5.13 ± 1.12^*&#	4.82 ± 1.13^&#	4.52 ± 1.02^*&#
F值	-	2 483.167	2 229.879	2 587.084	2 576.744	3 017.860	2 571.409	2 364.783	2 517.917
P值	-	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

项目	n	近中		远中		颊侧		舌侧
项目	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
轻度	778	2.90 ± 0.71	2.65 ± 0.73^*	2.76 ± 0.70	2.55 ± 0.72^*	2.59 ± 0.74	2.47 ± 0.65^*	2.32 ± 0.56	2.26 ± 0.64^*
中度	1 003	3.73 ± 0.91^&	3.54 ± 0.94^*&	3.62 ± 1.06^&	3.51 ± 0.98^*&	3.49 ± 0.87^&	3.28 ± 0.85^*&	3.33 ± 0.92^&	3.13 ± 0.88^*&
重度	983	6.49 ± 1.39^&#	6.35 ± 1.21^*&#	6.31 ± 1.26^&#	6.09 ± 1.13^*&#	6.07 ± 1.21^&#	5.87 ± 1.06^*&#	5.92 ± 1.15^&#	5.77 ± 1.22^*&#
F值	-	2 867.352	3 443.790	2 826.656	3 216.370	3 135.207	3 699.494	3 619.088	3 299.546
P值	-	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

项目	n	近中		远中		颊侧		舌侧
项目	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
前牙	1 126	2.86 ± 0.65	2.81 ± 0.73	2.73 ± 0.72	2.68 ± 0.71	2.60 ± 0.67	2.55 ± 0.72	2.71 ± 0.76	2.67 ± 0.65
前磨牙	756	3.64 ± 0.95^&	3.41 ± 0.91^*&	3.41 ± 0.94^&	3.12 ± 0.90^*&	3.05 ± 0.81^&	2.71 ± 0.83^*&	3.25 ± 0.73^&	2.76 ± 0.82^*&
磨牙	882	6.02 ± 1.38^&#	5.71 ± 1.29^*&#	5.59 ± 1.21^&#	5.15 ± 1.13^*&#	5.21 ± 0.92^&#	4.81 ± 1.07^*&#	5.45 ± 1.23^&#	5.13 ± 1.19^*&#
F值	-	2 504.250	2 261.929	2 297.706	1 945.174	2 874.429	1 900.150	2 289.235	2 185.919
P值	-	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001