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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 鄭景暉 | |
dc.contributor.author | Chih-Chia Huang | en |
dc.contributor.author | 黃智嘉 | zh_TW |
dc.date.accessioned | 2021-06-16T08:11:46Z | - |
dc.date.available | 2019-02-25 | |
dc.date.copyright | 2014-02-25 | |
dc.date.issued | 2014 | |
dc.date.submitted | 2014-02-17 | |
dc.identifier.citation | Reference
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/58336 | - |
dc.description.abstract | 牙齒發生垂直牙根斷裂會因為症狀多樣化且沒有明顯影像證據而困擾牙醫師,臨床牙醫師莫不希望透過問世15年的牙科電腦斷層攝影,以及現今影像醫學技術,協助明確且快速診斷。由於牙齒發生垂直牙根斷裂會造成周邊牙周韌帶的破壞,造成齒槽骨吸收,同時牙齒牙根也會產生斷裂,但是透過根尖X光影像來檢視牙齒是否有產生斷裂,也因為斷裂紋太細致,以致於無法在平面X光影像診斷出來;雖然牙科電腦斷層攝影可以提供立體的影像,但是牙醫師對於垂直牙根斷裂的牙齒牙根斷裂裂縫大小毫無概念,對於牙科電腦斷層攝影相對匹配的解析度大小也無從選擇,造成病人接受了不必要的放射檢查與醫療資源浪費。
本實驗主要是收集臨床上因為垂直牙根斷裂的牙齒,透過不同解晰度的錐狀射束電腦斷層攝影,來找出垂直牙根斷裂牙齒最大裂縫尺度,進而讓牙醫師知道如何在不同解晰度中,選擇最適當牙科電腦斷層攝影。在以碎形維度的影像處理方式,來檢視牙齒的根尖X光影像上骨樑,首先透過根管治療結果評估,來確認牙齒周邊齒槽骨的消失與增長模式,是否與臨床根管治療結果一致,進而發現垂直牙根斷裂周邊齒槽骨破壞的模式。 實驗結果發現每顆垂直牙根斷裂牙齒的裂縫大小都不一致,而且型態不盡相同,一半以上大於100μm,雖然有少數案例大於200μm或是只有20μm。而糗小臼齒牙根如果有兩條裂紋或是斷裂紋延伸到牙根尖3mm,牙齒的裂縫相對也是大於100μm。對於碎形維度法在垂直牙根斷裂牙齒的根尖X光影像影像的應用;首先我們收集臨床根管治療成功與失敗案例的根尖X光影像,在根管治療成功的案例,根尖齒槽骨的碎形維度值是增加;相對失敗的案例,根尖齒槽骨的碎形維度值是減少的。同時我們發現牙齒發生垂直牙根斷裂,周邊齒槽骨雖然沒有統計上的顯著變化,但是比較術前術後的根尖X光影像,我們也發現有減少的趨勢。 透過本實驗,可以提供臨床牙醫師判斷是否需要使用牙科電腦斷層攝影診斷垂直牙根斷裂的依據,減少病人不必要的X光放射劑量;;同時透過碎形維度法,也可以提供臨床牙醫師透過根尖X光影像,來診斷牙齒垂直牙根斷裂的新方法。 | zh_TW |
dc.description.abstract | When the teeth vertical root fracture occurs, it cause damage the surrounding periodontal ligament and alveolar bone resorption quickly. The dentist can not make a correct diagnosis from immediately from these diverse symptoms and no obvious evidence of the image. The purpose of the experiment through medical imaging methods such as fractal dimension in the periapical radiography help dentists diagnose vertical root fracture. Then we used different cone -beam computed tomography with different resolution and find out the width of fracture space of vertical root fracture teeth. Thus dentists realise to choose the proper resolution dental computed tomography to diagnosis vertical root fracture.
It was found that the variable width of fracture space between each vertical root fracture teeth. Although some teeth the width of fracture vrthere are over than 200μm or less than 20μm, but more than half of fracture teeth the maximum width larger than 100μm. If the premolar occurred vertical root fracture, the width of fracture space over 100μm company with the fracture line extending to apical 3mm or two fractur line exist in the same root. We also test fractal dimension method in the successful and failure endodontic treatment teeth. The fractal dimension increased in the successful endodontic tx teeth of root apex bone and the failure tx teeth of the border of reaction bone. The fractal dimension decreased in the country in the failure endodontic tx teeth of root apex bone and thesuccessful tx teeth of the border of reaction bone. We have found that fractal dimension values were decreasing trend from four regions of interesting area around the root surrounding alveolar bone although without statistically significant change from two periapical radiiography. The dentists know how to choise dental computed tomography to diagnosis of vertical root fracture teerth through this experiment. We may usd fractal dimension method to help diagnosis vertical root fracture from periapical radiography in the future. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T08:11:46Z (GMT). No. of bitstreams: 1 ntu-103-D97422005-1.pdf: 3696530 bytes, checksum: 83d7c59bc4980a0e1c4656b040372eb2 (MD5) Previous issue date: 2014 | en |
dc.description.tableofcontents | 口試委員會審定書 i
中文摘要 vii 英文摘要 viii 第一章 緒論 1 1-1研究背景與重要性 1 1-2研究動機與目的 1 1-3研究方法與組織架構 2 第二章 文獻回顧 3 2-1認識牙齒垂直牙根斷裂 3 2-1-1垂直牙根斷裂的原因 3 2-1-2垂直牙根斷裂的臨床診斷 5 2-2.電腦斷層攝影 7 2-2-1電腦斷層攝影(CT)歷史 7 2-2-2電腦斷層攝影(CT)基本原理與架構 7 2-2-3錐狀電腦斷層攝影(CBCT)基本構造與認識 9 2-2-4錐狀電腦斷層攝影(CBCT)的優點與缺點 14 2-3錐狀電腦斷層攝影(CBCT)對於牙科的實驗與應用 15 2-3-1錐狀電腦斷層攝影(CBCT)對於牙科的應用 15 2-3-2錐狀電腦斷層攝影(CBCT)對於牙髓病科的應用 16 2-3-3使用錐狀電腦斷層攝影在診斷垂直牙根斷裂上的應用 21 2-4微型電腦斷層攝影認識與應用 27 2-4-1微型電腦斷層攝影原理 27 2-4-2微型電腦斷層攝影於牙髓病科的應用 27 2-5根尖X光影像在牙髓病科之診斷與應用 28 2-5-1牙齒慢性根尖病變診斷 28 2-5-2影像處理方法:碎形維度法在牙齒慢性根尖病變之診斷 30 第三章 研究方法評估 32 3-1研究已根管治療牙齒產生垂直牙根斷裂方法 32 3-1-1電腦斷層攝影的選擇 37 3-2影像方法的選擇 37 3-2-1影像程式介紹 39 第四章 研究材料與方法 40 4-1使用電腦斷層攝影檢測已根管治療牙齒垂直牙根斷裂 40 4-1-1介紹牙科電腦斷層攝影 41 4-1-2介紹微型電腦斷層攝影 41 4-1-3垂直牙根斷裂牙齒最大裂縫 42 4-2使用碎形維度法評估二維X光影像 43 4-2-1二維X光影像收集 43 4-2-2使用碎形維度法量測成功根管治療影像特色 44 4-2-3使用碎形維度法量測失敗根管治療影像特色 45 4-2-4使用碎形維度法量測垂直牙根斷裂影像特色 45 第五章 實驗結果與討論 47 5-1實驗結果 47 5-2實驗討論 65 第六章 結論與展望 70 6-1研究結論 70 6-1未來展望 71 圖目錄 圖2.1:醫用電腦斷層示意圖 P.8 圖2.2:錐狀電腦斷層示意圖 P.10 圖2.3:等位體素與不等位體素示意圖 P.12 圖2.4:I-CAT使用的標準假體影像校正示意圖 P.14 圖2.5:CBCT可以提供牙齒根尖手術術前影像評估 P.18 圖3.1:CBCT所用的標準假體 P.32 圖3.2:臨床常見標準假體 P.32 圖3.3:樹酯假體評估CBCT解晰度 P.34 圖3.4:同一假體比較兩家CBCT性能 P.35 圖3.5:數位模擬假體 P.36 圖3.6:實驗所使用微型電腦斷層攝影種類與相關照射參數 P.37 圖3.7:齒槽骨骨樑X光影像的自我相似性 P.38 圖4.1:量測牙齒裂紋的軸向長度與裂紋是否延伸到根尖3mm P.40 圖4.2:測試微型電腦斷層攝影的照射劑量 P.42 圖4.3:量測牙齒最大裂縫的方法 P.42 圖4.4:成功根管治療FD測試示意圖 P.44 圖4.5:失敗根管治療FD測試示意圖 P.45 圖4.6:垂直牙根斷裂FD測試示意圖 P.46 圖5.1:不同照射視野下VRF牙齒的CBCT影像 P.47 圖5.2:VRF牙齒的CBCT影像 P.48 圖5.3:VRF牙齒的80μm微型電腦斷層攝影CBCT影像 P.49 圖5.4:垂直牙根斷裂的次序圖 P.52 圖5.5:根尖X光片的影像,經過FD的過程 P.53 圖5.6:評估示意圖 P.57 圖5.7:FD迴歸圖 P.57 圖5.8:小臼齒與大臼齒在微型電腦斷層攝影呈現不同的影像 P.65 圖5.9:正常牙齒垂直牙根斷裂微型電腦斷層攝影影像 P.66 圖5.10:乾燥的牙齒μ-CT的觀察 P.67 圖6.1:連續性案例影像變化 P.72 圖6.2:小臼齒的μCT影像 P.73 圖6.3:光學干涉斷層外型 P.74 圖6.4:垂直牙根斷裂牙根表面光學干涉斷層影像 P.74 表目錄 表3.1:不同文獻製做牙齒垂直牙根斷裂的方法 P.33 表5.1:牙齒牙根表面段裂紋數目與牙齒種類 P.47 表5.2:牙根表面斷裂紋延伸到牙根尖3mm與牙齒種類 P.47 表5.3:牙科電腦斷層不同照射視野對於垂直牙根斷影像觀察 P.48 表5.4:牙齒VRF裂縫大小與齒位分類 P.50 表5.5:牙齒斷裂空間大小與斷裂線條數目的關係 P.50 表5.6:牙齒斷裂空間大小與延伸到牙根尖3mm的關係 P.50 表5.7:各個VRF牙齒的直牙根斷裂牙齒各個裂縫的寬度與斷裂紋 P.51 表5.8:齒槽骨影像上選取4個ROI,作為影像品質的保證參考點 P.54 表5.9:成功案例中控制組的FD值 P.55 表5.10:實驗組的結果 P.57 表5.11:齒槽骨影像上選取4個ROI,作為影像品質的保證參考點 P.60 表5.12:失敗案例控制組的FD P.61 表5.13:28個失敗病例實驗組的結果 P.62 表5.14:齒槽骨影像上選取4個ROI,作為影像品質的保證參考點 P.63 表5.15:垂直牙根斷裂牙齒控制組的FD值 P.63 表5.16:垂直牙根斷裂牙齒實驗組的FD值 P.64 表6.1:根管治療連續性變化案例FD數值的變化 P.71 表6.2:FD數值變化 P.72 表6.3:微型電腦斷層攝影(9μm mode)輻射劑量的檢測 P.75 | |
dc.language.iso | zh-TW | |
dc.title | 使用錐狀射束電腦斷層攝影與根尖X光影像暨碎形維度法分析垂直牙根斷裂及根尖病灶變化 | zh_TW |
dc.title | Using Cone Beam Computed Tomography and Fractal Dimension Analysis of Periapical Radiographs
for Quantification of Vertical Root Fracture and the Changes of Periapical Lesion | en |
dc.type | Thesis | |
dc.date.schoolyear | 102-1 | |
dc.description.degree | 博士 | |
dc.contributor.coadvisor | 陳志成,陳中明 | |
dc.contributor.oralexamcommittee | 鄧延通,林俊彬,李伯訓 | |
dc.subject.keyword | 垂直牙根斷裂,碎形維度值,牙科電腦斷層攝影,微型電腦斷層攝影, | zh_TW |
dc.subject.keyword | vertical root fracture,fractal dimension,cone beam computed tomography,micro computed tomography, | en |
dc.relation.page | 81 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2014-02-17 | |
dc.contributor.author-college | 牙醫專業學院 | zh_TW |
dc.contributor.author-dept | 臨床牙醫學研究所 | zh_TW |
顯示於系所單位: | 臨床牙醫學研究所 |
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