콘빔형 전산화단층영상을 이용한 자연치 치간거리의 평가
Evaluation of interdental distance of natural teeth with cone-beam computerized tomography
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목적: 본 연구 목적은 이상적인 임플란트 근원심적 식립 위치 결정에 필요한 정보를 제공하기 위해서 콘빔형 전산화단층 영상(cone-beam CT)을 사용하여 건강한 자연치열에서 백악-법랑 경계부와 치조골 흡수를 가정한 그 하방 2 mm에서 전치, 소구치, 대구치의 치간거리를 평가하는 것이다. 연구 재료 및 방법: 원광대학교 치과대학병원에서 cone-beam CT를 촬영한 건강한 치열의 200명 환자를 선정하였다. Cone-beam CT 이미지를 DICOM (digital imaging and communication in medicine) 파일로 전환하여, 3차원 영상으로 재구성하였고, cone-beam CT 이미지를 표준화하기 위하여 head reorientation을 시행한 후, 전용 소프트웨어를 이용해재구성된 파노라마 이미지를 얻었다. 모든 계측은 3명의 치과의사에 의해 최적화된 파노라마 이미지 상에서 시행되었다. 결과: 백악-법랑 경계부에서 상악 평균 치간거리는 전치 1.84 mm, 소구치 2.07 mm, 대구치 2.08 mm 그리고 하악은 전치 1.55 mm, 소구치 2.20 mm, 대구치 2.36 mm였다. 백악-법랑 경계부 하방 2 mm에서 상악 평균 치간거리는 전치 2.19mm, 소구치 2.51 mm, 대구치 2.60 mm 그리고 하악은 전치 1.86 mm, 소구치 2.53 mm, 대구치 3.01 mm였다. 결론: 자연치열에서 치간거리는 전치부보다는 구치부에서 더 컸으며, 백악-법랑 경계부보다 그 하방 2 mm에서 더 크게 나타났다. 전 치열에서 가장 좁은 곳은 하악 전치, 가장 넓은 곳은 하악 대구치였다.
Abstract
Purpose: The aim of this study was to evaluate the interdental distances of anterior, premolar, and molar teeth at the cementoenamel junction (CEJ) and 2 mm below the CEJ in healthy natural dentition with cone-beam computerized tomography (cone-beam CT) in order to provide valuable data for ideal implant positioning relative to mesiodistal bone dimensions. Materials and Methods:Two hundred patients who visited Dental Hospital, Wonkwang University, who had natural dentition with healthy interdental papillae, and who underwent cone-beam CT were selected. The cone-beam CT images were converted to digital imaging and communication in medicine (DICOM) files and reconstructed in three-dimensional images. To standardize the cone-beam CT images, head reorientation was performed. All of the measurements were determined on the reconstructed panoramic images by three professionally trained dentists. Results: At the CEJ, the mean maxillary interdental distances were 1.84 mm (anterior teeth), 2.07 mm (premolar), and 2.08 mm (molar), and the mean mandibular interproximal distances were 1.55 mm (anterior teeth), 2.20 mm (premolar), and 2.36 mm (molar). At 2mm below the CEJ, the mean maxillary interdental distances were 2.19 mm (anterior teeth), 2.51 mm (premolar), and 2.60 mm (molar), and the mean mandibular interproximal distances were 1.86 mm (anterior teeth), 2.53 mm (premolar), and 3.01 mm (molar). Conclusion: The interdental distances in the natural dentition were larger at the posterior teeth than at the anterior teeth and also at 2 mm below the CEJ level compared with at the CEJ level. The distances between mandibular incisors were the narrowest and the distances between mandibular molars were the widest in the entire dentition.
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