Diniz Ana Flávia N, Mendonça Elismauro F, Leles Claudio R, Guilherme Adérico S, Cavalcante Marcelo P, Silva Maria Alves G S
Primeira Avenida, sem numero, Campus I, Faculdade de Odontologia, Goiânia, Goiás Goiânia Goiás, Brazil.
Clin Oral Implants Res. 2008 Mar;19(3):249-53. doi: 10.1111/j.1600-0501.2007.01475.x.
To investigate variation in the pre-surgical treatment planning after using conventional spiral tomography in addition to conventional radiographic exams.
Twenty-nine partial or fully edentulous patients referred to implant therapy were selected and submitted to periapical, panoramic and conventional cross-sectional tomography exams. Pre-surgical treatment planning of 120 potential implant sites in 69 edentulous areas was performed by two independent experienced dental implant surgeons. After clinical examination, pre-surgical planning was made using only periapical and panoramic exams. Examiners were requested to reformulated initial planning after assessing tomographic images. Four treatment parameters were evaluated: length and width of implants, need of bone grafting and need of other surgical procedures.
Implant length and width remained unchanged in 60.2% and 87.2% of cases, respectively. No difference in length (P=0.576) and width (P=1) scores was observed in treatment planning with and without tomography. Variation in implant dimension was not affected by location of edentulous areas. Bone grafting and other surgical procedures significantly changed after tomograms (P<0.001), independent of the location of edentulous areas. In 15.8% and 5.3% of cases bone grafting and other procedures were planned only after tomograms, respectively. Significant differences were observed in all maxillary and mandibular regions.
Conventional spiral tomography plays an important role in pre-surgical treatment planning, increasing clinician's certainty of the need of additional surgical procedures (bone grafting, sinus lifting, and others) in pre-surgical treatment stage.
研究在传统放射检查基础上使用传统螺旋断层扫描后手术前治疗计划的变化。
选取29例转诊接受种植治疗的部分或全口无牙患者，进行根尖片、全景片及传统横断面断层扫描检查。由两名经验丰富的独立牙科种植外科医生对69个无牙区的120个潜在种植位点进行手术前治疗计划。临床检查后，仅使用根尖片和全景片进行手术前计划。要求检查者在评估断层扫描图像后重新制定初始计划。评估四个治疗参数：种植体的长度和宽度、骨移植需求及其他手术程序需求。
种植体长度和宽度分别在60.2%和87.2%的病例中保持不变。在有或没有断层扫描的治疗计划中，长度（P = 0.576）和宽度（P = 1）评分均未观察到差异。种植体尺寸的变化不受无牙区位置的影响。断层扫描后骨移植和其他手术程序有显著变化（P < 0.001），与无牙区位置无关。分别有15.8%和5.3%的病例仅在断层扫描后计划进行骨移植和其他手术。在上颌和下颌所有区域均观察到显著差异。
传统螺旋断层扫描在手术前治疗计划中起重要作用，提高了临床医生在手术前治疗阶段对额外手术程序（骨移植、上颌窦提升等）需求的确定性。
