Braz Oral Res. 2014;28:46-53. doi: 10.1590/s1806-83242013005000029.
The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compared with those obtained during initial and final planning, using the McNemmar test (p < 0.05). The final sample comprised 95 implants in 27 patients, distributed over the maxilla and mandible. Agreement in implant length was 50.5% between initial and final planning, and correct prediction of the actual implant length was 40.0% and 69.5%, using PAN and CBCT exams, respectively. Agreement in implant width assessment ranged from 69.5% to 73.7%. A paired comparison of the frequency of changes between initial or final planning and implant placement (McNemmar test) showed greater frequency of changes in initial planning for implant length (p < 0.001), but not for implant width (p = 0.850). The frequency of changes was not influenced by implant location at any stage of implant planning (chi-square test, p > 0.05). It was concluded that CBCT improves the ability of predicting the actual implant length and reduces inaccuracy in surgical dental implant planning.
目的在于研究锥形束 CT（CBCT）对种植体规划和最终种植体尺寸预测的影响。连续就诊的行种植治疗的患者均接受临床检查、全景（PAN）射线照相和 CBCT 检查。基于临床和 PAN 检查来评估种植体长度和宽度的初始规划，基于 CBCT 检查来评估最终规划以补充诊断。使用 McNemar 检验（p<0.05）比较手术中植入的实际种植体尺寸与初始和最终规划的尺寸。最终样本包括 27 名患者的 95 个种植体，分布在上颌和下颌。初始和最终规划的种植体长度之间的一致性为 50.5%，PAN 和 CBCT 检查分别正确预测实际种植体长度的比例为 40.0%和 69.5%。种植体宽度评估的一致性范围为 69.5%至 73.7%。对初始或最终规划与种植体放置之间变化频率的配对比较（McNemmar 检验）显示，初始规划中种植体长度的变化频率更高（p<0.001），但种植体宽度的变化频率没有差异（p=0.850）。在种植体规划的任何阶段，种植体位置都不会影响变化频率（卡方检验，p>0.05）。因此，CBCT 提高了预测实际种植体长度的能力，并减少了手术牙科种植体规划的不准确性。
