Dixon Douglas R, Morgan Rudolf, Hollender Lars G, Roberts Frank A, O'Neal Robert B
University of Washington School of Dentistry, Seattle 98195, USA.
J Periodontol. 2002 Oct;73(10):1202-9. doi: 10.1902/jop.2002.73.10.1202.
Placement of endosseous dental implants in edentulous areas of the anterior maxilla poses a unique challenge due to variations in the amount of residual alveolar bone. Implant position becomes crucial in cases demanding high esthetic results but possessing minimal ridge width or in cases requiring augmentation. Recent advances in spiral tomography have allowed for more precise planning and placement of endosseous implants in these challenging areas.
The purpose of this report is to describe a series of clinical cases in which spiral tomography was utilized in the planning and placement of endosseous dental implants. Two cases will be described utilizing initial spiral tomographic radiographs for implant planning and surgical guide fabrication, followed by post-insertion tomography to evaluate the results of implant position and inclination.
Preimplant spiral tomograms revealed that the initial prosthetic trajectory through the proposed incisal edge of each tooth replacement would result in a final osteotomy site that would compromise the overall thickness of the facial cortical plate. After adjusting for magnification and distortion factors, new prosthetic/surgical trajectories were fabricated into the surgical guide, and this information was utilized to prepare the final implant osteotomy site. This adjustment resulted in 2 mm of residual crestal facial bone postimplant insertion, which became wider at more apical measurements. These findings were verified in the postimplant serial tomograms.
Spiral tomography was a valuable adjunct in the treatment planning phases of endosseous dental implant placement especially in cases with minimal crestal width, high esthetic demands, or where exact implant placement is critical for successful treatment outcomes.
由于上颌前部无牙区剩余牙槽骨量存在差异，在此区域植入骨内牙种植体面临独特挑战。在要求高美学效果但牙槽嵴宽度极小的病例中，或在需要骨增量的病例中，种植体位置至关重要。螺旋断层扫描技术的最新进展使得在这些具有挑战性的区域更精确地规划和植入骨内种植体成为可能。
本报告旨在描述一系列临床病例，其中螺旋断层扫描用于骨内牙种植体的规划和植入。将描述两个病例，利用初始螺旋断层X线片进行种植体规划和制作手术导板，随后进行植入后断层扫描以评估种植体位置和倾斜度的结果。
种植前螺旋断层扫描显示，通过每个牙齿替代部位的拟切缘的初始修复路径会导致最终截骨部位损害面部皮质骨板的整体厚度。在调整放大率和失真因素后，将新的修复/手术路径制作到手术导板中，并利用该信息准备最终的种植体截骨部位。这种调整导致植入种植体后牙槽嵴面部剩余2毫米骨，在更根尖的测量中骨更宽。这些发现已在植入后系列断层扫描中得到证实。
螺旋断层扫描在骨内牙种植体植入的治疗计划阶段是一种有价值的辅助手段，特别是在牙槽嵴宽度极小、美学要求高或精确的种植体植入对成功治疗结果至关重要的病例中。
