Sullivan Maureen, Rossitto Rachael, Casey David
Department of Dentistry and Maxillofacial Prosthetics, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, N.Y. USA.
J Oral Maxillofac Res. 2010 Jul 1;1(2):e4. doi: 10.5037/jomr.2010.1204. eCollection 2010.
Head and neck cancer patients who have lost facial parts following surgical intervention frequently require craniofacial implant retained facial prostheses for restoration. Many craniofacial implant patients require computed tomography and magnetic resonance imaging scans as part of their long-term follow-up care. Consequently removal of implant superstructures and peri-abutment tissue management is required for those studies. The purpose of the present paper was to describe a method for eliminating cranial imaging artifacts in patients with craniofacial implants.
Three patients wearing extraoral implant retained facial prostheses needing either computed tomography or magnetic resonance imaging studies were discussed. Peri-implant soft tissues contracture after removal of percutaneous craniofacial implant abutments during computed tomography and magnetic resonance imaging studies was prevented using a method proposed by authors. The procedure involves temporary removal of the supra-implant components prior to imaging and filling of the tissue openings with polyvinyl siloxane dental impression material.
Immediately after filling of the tissue openings with polyvinyl siloxane dental impression material patients were sent for the imaging studies, and were asked to return for removal of the silicone plugs and reconnection of all superstructure hardware after imaging procedures were complete. The silicone plugs were easily removed with a dental explorer. The percutaneous abutments were immediately replaced and screwed into the implants which were at the bone level.
Presented herein method eliminates the source of artifacts and prevents contracture of percutaneous tissues upon removal of the implant abutments during imaging.
头颈部癌症患者在手术干预后失去面部部分,常常需要使用颅面种植体固位的面部假体进行修复。许多颅面种植体患者需要进行计算机断层扫描(CT)和磁共振成像(MRI)扫描作为其长期随访护理的一部分。因此,对于这些检查,需要移除种植体上部结构并进行基台周围组织处理。本文的目的是描述一种消除颅面种植体患者颅骨成像伪影的方法。
讨论了3例佩戴口外种植体固位面部假体且需要进行CT或MRI检查的患者。在CT和MRI检查期间,采用作者提出的方法防止经皮颅面种植体基台移除后种植体周围软组织挛缩。该操作包括在成像前临时移除种植体上部组件,并用聚乙烯基硅氧烷牙科印模材料填充组织开口。
在用聚乙烯基硅氧烷牙科印模材料填充组织开口后,患者立即被送去进行成像检查,并被要求在成像程序完成后返回移除硅胶塞并重新连接所有上部结构硬件。用牙科探针很容易移除硅胶塞。经皮基台立即被替换并拧入骨水平的种植体中。
本文介绍的方法消除了伪影来源,并防止了成像期间移除种植体基台时经皮组织的挛缩。