Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N. University Avenue, Ann Arbor, MI 48109-1078, USA.
Implant Dent. 2012 Apr;21(2):78-86. doi: 10.1097/ID.0b013e31824885b5.
The International Congress of Oral Implantologists has supported the development of this consensus report involving the use of Cone Beam Computed Tomography (CBCT) in implant dentistry with the intent of providing scientifically based guidance to clinicians regarding its use as an adjunct to traditional imaging modalities.
The literature regarding CBCT and implant dentistry was systematically reviewed. A PubMed search that included studies published between January 1, 2000, and July 31, 2011, was conducted. Oral presentations, in conjunction with these studies, were given by Dr. Erika Benavides, Dr. Scott Ganz, Dr. James Mah, Dr. Myung-Jin Kim, and Dr. David Hatcher at a meeting of the International Congress of Oral Implantologists in Seoul, Korea, on October 6-8, 2011.
The studies published could be divided into four main groups: diagnostics, implant planning, surgical guidance, and postimplant evaluation.
The literature supports the use of CBCT in dental implant treatment planning particularly in regards to linear measurements, three-dimensional evaluation of alveolar ridge topography, proximity to vital anatomical structures, and fabrication of surgical guides. Areas such as CBCT-derived bone density measurements, CBCT-aided surgical navigation, and postimplant CBCT artifacts need further research. ICOI RECOMMENDATIONS: All CBCT examinations, as all other radiographic examinations, must be justified on an individualized needs basis. The benefits to the patient for each CBCT scan must outweigh the potential risks. CBCT scans should not be taken without initially obtaining thorough medical and dental histories and performing a comprehensive clinical examination. CBCT should be considered as an imaging alternative in cases where the projected implant receptor or bone augmentation site(s) are suspect, and conventional radiography may not be able to assess the true regional three-dimensional anatomical presentation. The smallest possible field of view should be used, and the entire image volume should be interpreted.
国际口腔种植医师学会支持制定这份共识报告,涉及锥形束 CT(CBCT)在种植牙科中的应用,旨在为临床医生提供基于科学的指导,了解其作为传统影像学检查手段的补充。
对 CBCT 与种植牙科相关文献进行系统回顾。对 2000 年 1 月 1 日至 2011 年 7 月 31 日发表的研究进行 PubMed 检索。2011 年 10 月 6 日至 8 日,在韩国首尔举行的国际口腔种植医师学会会议上,Erika Benavides 博士、Scott Ganz 博士、James Mah 博士、Myung-Jin Kim 博士和 David Hatcher 博士就这些研究进行了口头报告。
发表的研究可分为四大类:诊断、种植体规划、手术指导和种植后评估。
文献支持 CBCT 在牙科种植治疗计划中的应用,特别是在直线测量、牙槽嵴形态的三维评价、与重要解剖结构的毗邻关系以及手术导板的制作方面。CBCT 测量的骨密度、CBCT 辅助手术导航和种植后 CBCT 伪影等领域需要进一步研究。ICOI 建议:所有 CBCT 检查,如同所有其他射线照相检查,必须根据个体需要进行正当化。对于每个 CBCT 扫描,患者的获益必须超过潜在风险。在最初获取详细的病史和进行全面的临床检查之前,不应进行 CBCT 扫描。只有在预计种植体接受区或骨增量部位可疑,且传统放射影像学检查无法评估真实的区域三维解剖结构时,才应考虑 CBCT 作为替代影像学检查。应使用最小的视野,并对整个图像体积进行解读。