インプラントリハビリテーションにおける歯槽骨質診断におけるレントゲン評価．

Radiographic Evaluation in the Diagnosis of Alveolar Bone Quality in Implant Rehabilitation.

• Marina Reis Oliveira
• Andréa Gonçalves
• Marisa Aparecida Cabrini Gabrielli
• Valfrido Antonio Pereira-Filho

抄録

本研究では、上顎と下顎の光学的骨密度を評価し、Lekholm and Zarb（L & Z）の骨質の分類と相関させた。60名の無歯部を評価した。パノラマレントゲン写真と周縁部レントゲン写真をアルミスケールで撮影し、光学的骨密度を評価した。また、L&Z分類を適用した。顎周囲X線写真では、上顎後面（2.38"Zs_200A"±"Zs_200A"1.06）と下顎後面（3.84"Zs_200A"±"Zs_200A"0.68）の光学的骨密度に他の部位（P"Zs_200A"≤"Zs_200A"0.015）と比較して統計学的に有意な差が認められた。しかし、パノラマX線写真では、光学的骨密度に差は認められなかった（P"Zs_200A"="Zs_200A"0.6322）。L&Z分類と視床周囲X線写真で得られた光学的骨密度との間には負の相関が認められた（rho"Zs_200A"="Zs_200A"-0.463; P"Zs_200A"<"Zs_200A"0.001）、すなわち骨質が悪いほど骨密度が低いことがわかった。しかし、パノラマX線写真で得られる骨密度との間には有意な相関は認められなかった（rho"Zs_200A"="Zs_200A"-0.009; P"Zs_200A"="Zs_200A"0.948）。性別については、L&Z分類で評価したところ、女性では加齢と髄骨の存在に相関が認められた（rho"Zs_200A"="Zs_200A"0.398; P"Zs_200A"="Zs_200A"0.006）。しかし、L＆Z分類（rho"Zs_200A"="Zs_200A"-650; P"Zs_200A"="Zs_200A"0.016）によって評価された両方の男性の髄質の存在と加齢との間に相関がありました。016）、および肛門周囲（rho"Zs_200A"="Zs_200A"0.621; P"Zs_200A"="Zs_200A"0.023）およびパノラマ（rho"Zs_200A"="Zs_200A"0.588; P"Zs_200A"="Zs_200A"0.035）X線写真によって評価された光学密度を示した。これらの結果から、性別や年齢が骨の質に干渉し、骨密度を評価するための骨周囲X線写真は許容できる方法であることが示唆された。しかし、パノラマX線写真は信頼できる方法ではないことがわかった。

This study evaluated the optical bone density of the maxilla and mandible and correlate with the classification of bone quality of the Lekholm and Zarb (L & Z). Sixty edentulous areas were evaluated. Panoramic and periapical radiographs were performed with an aluminum scale to evaluate the optical bone density. L & Z classification was also applied. By using periapical radiographs, a statistically significant difference was observed in the optical bone density of the posterior maxilla (2.38 ± 1.06) and the posterior mandible (3.84 ± 0.68), when compared to the other regions (P ≤ 0.015). However, with panoramic radiographs, no differences were observed in the optical bone density (P = 0.6322). A negative correlation was observed between the L & Z classification and the optical bone density obtained by the periapical radiographs (rho = -0.463; P < 0.001), that is, the worse the bone quality, the lower the bone density. However, there was no significant correlation with the bone density obtained by panoramic radiographs (rho = -0.009; P = 0.948). As for gender, a correlation between aging and the presence of medullary bone was observed in females, assessed by the L & Z classification (rho = 0.398; P = 0.006). However, there was a correlation between aging and a denser and less medullary presence in males, both assessed by the L & Z classification (rho = -650; P = 0.016), as well as the optical density assessed by periapical (rho = 0.621; P = 0.023) and panoramic (rho = 0.588; P = 0.035) radiographs. These results suggest that gender and age interfere with the bone quality and periapical radiographs are an acceptable method for evaluating bone density. However, a panoramic radiograph was not found to be a reliable method.