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目的:利用全颌曲面断层片预测下颌第三磨牙拔除致下颌角骨折的风险。方法:筛选2009年6月～2010年6月期间我科186张(共347颗下颌第三磨牙)全颌曲面断层片,计算下颌第三磨牙区剩余骨高度(b)与下颌骨高度(a)的比值(b/a值),分析该比值在人群中的分布情况。结合6例智齿拔除致下颌角骨折病例的b/a值,分析该比值用于预测下颌第三磨牙拔除术致下颌角骨折风险的临床意义。结果:347颗第三磨牙区b/a值符合正态分布,比值低于0.3的病例2例,占0.58%;分析文献中6例智齿拔除术致下颌角骨折病例b/a值均小于0.3,符合第三磨牙区b/a值的人群分布特征,属于小概率事件。结论:下颌第三磨牙拔除术后剩余骨高度与该区下颌骨高度的比值低于0.3者有较高下颌角骨折风险,全颌曲面断层片可以作为提示此风险的一种有效手段。
OBJECTIVE: To predict the risk of mandibular angle fractures by mandibular third molar extraction using a total jaw curved plate. Methods: From June 2009 to June 2010, a total of 366 mandibular third molars (347 mandibular third molars) in our department were selected. The remnant bone height of mandibular third molars (b) and mandibular height ) Ratio (b / a value), analysis of the distribution of the ratio in the crowd. Combined with b value of 6 cases of mandibular angle fracture caused by wisdom tooth extraction, the ratio was used to predict the clinical significance of mandibular angle fracture caused by mandibular third molar extraction. Results: The b / a values of 347 third molars were in normal distribution, and the ratio was lower than 0.3 in 2 cases (0.58%). The b / a values of mandibular angle fractures in 6 cases were less than 0.3 , Which is in line with the b / a value of the third molar area, belongs to the small probability event. CONCLUSIONS: The ratio of remnant bone height to mandibular height in mandibular third molar extraction is higher than that in mandibular third molar. There is a high risk of mandibular angle fracture in mandibular third molar extraction. An all-round curved facet slice can be used as an effective tool to indicate the risk.