今回は無歯顎における重要なエックス線所見の

部位と頻度を評価し

無歯顎に対する全部床義歯製作前のエックス線検査の

必要性を明らかにすることを目的としています。

無歯顎患者338名（男性183 名，女性155 名）の

パノラマエックス線写真から、以下のエックス線所見を

臨床的に重要であるとしてその発現率を求ています。

①残根，②埋伏歯，③嚢胞に関連する透過像

④局所的硬化性骨増生に関連する不透過像

⑤歯槽頂に位置するオトガイ孔

⑥歯槽頂に近接する上顎洞

Panoramic radiographs often are the first method used to screen edentulous patients before complete denture therapy. However, routine radiographic examination of edentulous patients is being questioned because of the cumulative effects and cost of radiation exposure. The purpose of this study was to determine the frequency and location of significant radiographic findings in edentulous jaws.

Panoramic radiographs from 338 patients were included in the survey (183 men, 155 women; 676 edentulous arches). The radiographs were evaluated by 1 oral radiology specialist for the following clinically significant radiographic findings: retained root fragments, impacted teeth, radiolucencies associated with cysts, radiopacities associated with localized sclerotic bone formation, location of the mental foramen on the crest, and location of the maxillary sinus close to the crest of the ridge. The data were analyzed using descriptive statistics.

Radiographic findings were found in 47.6% (56.5% women, 43.5% men) of the edentulous patients. Fifty-two subjects (29 women, 23 men) had 67 submucosal or intrabony root remains, 50 of which were located in the maxilla. The most frequent finding was retained root fragment, followed by radiopacities. Impacted teeth were found in 11 women and 10 men. In 15 patients the mental foramen was situated at the top of the residual ridge. Of these patients, 13 were women and 2 were men. In 29 patients (14 women, 15 men) the maxillary sinus was close to the crest of the ridge. Six patients (3 women, 3 men) had a bilateral maxillary sinus close to the crest of the ridge. The other 23 patients had a unilateral maxillary sinus close to the crest of the ridge, and except for in 2 men, all were in the left side of the maxilla.

Routine panoramic examination of the jaws is necessary to detect impacted teeth, retained root fragments, and other radiographic findings that may require treatment before construction of complete dentures.

結果は、重要なエックス線所見は676 顎中の47.6％

で認められた。

各所見の発現率は，①残根52 例（15.4％）

②埋伏歯21 例（6.2％），③透過像3 例（0.9％）

④不透過像41 例（12.1％），⑤オトガイ孔15 例（4.4％）

⑥上顎洞29例（8.6％）だった。

結論は、全部床義歯製作前に処置が必要とされる

埋伏歯や残根等を発見するために

ルーチンなパノラマエックス線写真検査が必要である

ということで、義歯ブログ⑪とは対立しています。

引用文献

Sumer AP, Sumer M, Güler AU, Biçer I

Panoramic radiographic examination of edentulous mouths

Quintessence Int 2007 ; 38 : e399−403