Braut Vedrana, Bornstein Michael M, Kuchler Ulrike, Buser Daniel
Int J Periodontics Restorative Dent. 2014 Sep-Oct;34(5):639-47. doi: 10.11607/prd.1895.
A precise radiographic evaluation of the local bone dimensions and morphology is important for preoperative planning of implant placement. The purpose of this retrospective study was to analyze dimensions and morphology of edentulous sites in the posterior mandible using cone beam computed tomography (CBCT) images. This retrospective radiographic study measured the bone width (BW) of the mandible at three locations on CBCT scans for premolars (PM1, PM2) and molars (M1, M2): at 1 mm and 4 mm below the most cranial point of the alveolar crest (BW1, BW2) and at the superior border of the mandibular canal (BW3). Furthermore, the height (H) of the alveolar process (distance between the measuring points BW1 and BW3), as well as the presence of lingual undercuts, were analyzed. A total of 56 CBCTs met the inclusion criteria, resulting in a sample size of 127 cross sections. There was a statistically significant increase from PM1 to M2 for the BW2 (P < .001), which was not present for BW1 and BW3 values. For the height of the alveolar process, the values exhibited a decrease from PM1 to M2 sites. Sex was a statistically significant parameter for H (P = .001) and for BW1 (P = .03). Age was not a statistically significant parameter for bone width (BW1: P = .37; BW2: P = .31; BW3: P = .51) or for the height of the alveolar process (P = .41) in the posterior mandible. Overall, 73 (57.5%) edentulous sites were evaluated to be without visible lingual undercuts; 13 (10.2%) sites exhibited lingual undercuts classified as influential for implant placement. Precise evaluation of the alveolar crest by cross-sectional imaging is of great value to analyze vertical and buccolingual bone dimensions in different locations in the posterior mandible. In addition, CBCTs are valuable to diagnosing the presence of and potential problems caused by lingual undercuts prior to implant placement.
对局部骨尺寸和形态进行精确的影像学评估对于种植体植入的术前规划非常重要。本回顾性研究的目的是使用锥形束计算机断层扫描(CBCT)图像分析下颌后牙区无牙颌部位的尺寸和形态。这项回顾性影像学研究在CBCT扫描上测量了下颌骨在三个位置(前磨牙(PM1、PM2)和磨牙(M1、M2))的骨宽度(BW):在牙槽嵴最颅侧点下方1mm和4mm处(BW1、BW2)以及在下颌管上缘(BW3)。此外,还分析了牙槽突的高度(H)(测量点BW1和BW3之间的距离)以及舌侧倒凹的情况。共有56例CBCT符合纳入标准,得到127个横截面的样本量。BW2从PM1到M2有统计学显著增加(P <.001),而BW1和BW3值没有这种情况。对于牙槽突高度,其值从PM1到M2部位呈下降趋势。性别对于H(P =.001)和BW1(P =.03)是一个有统计学意义的参数。年龄对于下颌后牙区的骨宽度(BW1:P =.37;BW2:P =.31;BW3:P =.51)或牙槽突高度(P =.41)不是一个有统计学意义的参数。总体而言,73个(57.5%)无牙颌部位被评估为无可见舌侧倒凹;13个(10.2%)部位表现出被归类为对种植体植入有影响的舌侧倒凹。通过横断面成像对牙槽嵴进行精确评估对于分析下颌后牙区不同位置的垂直和颊舌向骨尺寸具有重要价值。此外,CBCT对于在种植体植入前诊断舌侧倒凹的存在及其引起的潜在问题很有价值。
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