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目的：探讨通过锥形束CT（cone-beam computed tomography, CBCT）评判上颌前牙骨开裂和骨开窗的真实性和可靠性。方法：纳入18例安氏III类错牙合行骨皮质切开术的患者，平均年龄23.6岁（18~30岁），其中男3例，女15例，观察108颗上颌前牙。以翻瓣术中所见的骨开裂和骨开窗作为判定金标准，评价CBCT判断骨开裂和骨开窗的灵敏度（sensitivity）、特异度（specificity）、约登指数（Youden index）、阳性似然比（positive likelihood ratio）、阴性似然比（negative likelihood ratio）、阳性预测值（positive predictive value）和阴性预测值（negative predictive value），并将CBCT判定与翻瓣直视判定相比较。结果：上颌前牙骨开裂和骨开窗的发生率分别为10.19%和13.89%，主要见于侧切牙和尖牙。骨开裂长度中位数为5 mm，宽度中位数为4 mm；骨开窗常位于根中部至根尖部，长度中位数为3 mm，宽度中位数为2 mm。骨开裂CBCT判定与临床判定之间有较好的一致性（P<0.05），CBCT判定的灵敏度和特异度均>0.7。骨开窗CBCT判定与临床判定之间一致性一般（P<0.05），灵敏度为0.93，特异度为0.52。结论：CBCT评判上前牙骨开裂与临床情况的一致性较好，判定骨开窗与临床情况的一致性一般。CBCT判定骨开裂与骨开窗在临床中有一定应用价值，但存在局限性。
Objective: To evaluate the authenticity and reliability of anterior maxillary anterior dehiscence and fenestration by cone-beam computed tomography (CBCT). Methods: 18 patients with Class III malocclusion were enrolled in this study. The mean age was 23.6 years (18-30 years), including 3 males and 15 females. 108 maxillary anterior teeth were observed. To see the flap flap seen in the flap and open the window as the gold standard bone evaluation CBCT to determine the sensitivity of bone fracture and fenestration, specificity (specificity, Youden index (Youden index, positive Positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive value, and compared the CBCT decision with the flap-up decision. Results: The incidence of anterior maxillary anterior maxillary rupture and open fenestration were 10.19% and 13.89%, respectively, mainly in lateral incisors and canines. The median length of bone dehiscence was 5 mm, and the median width was 4 mm. The common fenestration was located in the middle of the root to the apical portion, with a median length of 3 mm and a median width of 2 mm. There was a good agreement (P & lt; 0.05) between bone dehiscence CBCT judgment and clinical judgment, and the sensitivity and specificity of CBCT judgment were both & gt; 0.7. The agreement between CBCT judgment and clinical judgment was normal (P & lt; 0.05), with a sensitivity of 0.93 and a specificity of 0.52. Conclusion: The CBCT judges that the congenital anterior superior dehiscence is consistent with the clinical situation, and the concordance between the fenestration and the clinical situation is normal. CBCT determine bone fracture and fenestration in the clinical application of a certain value, but there are limitations.