Department of Orthodontics, University Medical Center Mainz, Germany.
Clin Implant Dent Relat Res. 2012 Jun;14(3):400-5. doi: 10.1111/j.1708-8208.2009.00259.x. Epub 2010 Feb 3.
To evaluate (a) the diagnostic value of lateral radiographs and (b) whether computed tomography (CT) or cone beam computed tomography (CBCT) is necessary in preoperative diagnostics for orthodontic anchorage implants.
We reviewed all patients who had presented for insertion of a palatal implant between January 2003 and December 2007 at the University Hospital Mainz. On the basis of lateral radiographs, the palatal bone was assessed as follows: (a) sufficient (bone height > 4 mm in the implant axis), (b) ambiguous, or (c) insufficient (bone height < 4 mm in the implant axis). In group A the surgical insertion procedure was performed without further radiological investigation. Group C required other types of anchorage. In cases of an ambiguous bone situation (group B), further diagnostic procedures (CT/CBCT) were performed.
During the observation period, 105 patients were screened. Fourteen patients opted for alternative treatment leaving 91 patients for final evaluation. In 89 patients (97.8%), the lateral radiographs showed sufficient bone in the vertical dimension. In all of these cases, the availability of sufficient bone was confirmed intraoperatively. Further investigations were performed in two patients (2.2%) of group B (one CT, one CBCT). Finally, one patient had insufficient bone whereas the second had sufficient bone.
Nearly 98% of the patients included in this study had sufficient bone for palatal implant insertion. Lateral radiographs permit correct and reliable evaluation of the quantity of bone in preoperative diagnosis of palatal implants. Additional imaging (CT or CBCT) is only required in rare cases of borderline dimensions.
评估（a）侧位片的诊断价值，以及（b）对于正畸支抗种植体的术前诊断，是否需要计算机断层扫描（CT）或锥形束 CT（CBCT）。
我们回顾了 2003 年 1 月至 2007 年 12 月期间在美因茨大学医院就诊的所有接受腭部种植体植入的患者。基于侧位片，对腭骨进行如下评估：（a）充足（种植体轴骨高度>4mm），（b）不确定，或（c）不足（种植体轴骨高度<4mm）。在 A 组中，手术插入程序在没有进一步影像学检查的情况下进行。C 组需要其他类型的支抗。在不确定的骨情况（B 组）下，进行了进一步的诊断程序（CT/CBCT）。
在观察期间，共筛选了 105 名患者。14 名患者选择了替代治疗，留下 91 名患者进行最终评估。在 89 名患者（97.8%）中，侧位片显示垂直方向的骨量充足。在所有这些情况下，术中均证实了充足的骨量。在 B 组的两名患者（2.2%）中进行了进一步的检查（一名 CT，一名 CBCT）。最后，一名患者的骨量不足，而另一名患者的骨量充足。
本研究中纳入的近 98%的患者有足够的骨量用于腭部种植体植入。侧位片可在腭部种植体术前诊断中准确可靠地评估骨量。只有在边界尺寸的罕见情况下才需要额外的成像（CT 或 CBCT）。
