Rokn Amirreza, Rasouli Ghahroudi Amir Alireza, Daneshmonfared Mahdieh, Menasheof Rebecca, Shamshiri Ahmad Reza
*Professor, Dental Implant Research Center and Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. †Associate Professor, Dental Implant Research Center and Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. ‡Assistant Professor, Department of Periodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. §Member of Dental Implant Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. ‖Assistant Professor, Dental Research Center and Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Implant Dent. 2014 Dec;23(6):697-703. doi: 10.1097/ID.0000000000000173.
To evaluate the bone density using the surgeon's tactile sense and compare it to the Lekholm and Zarb classification and computed tomography (CT) scan to see if correlations exist.
Fifty-two implants were inserted in 22 patients. The bone densities of recipient site were preoperatively determined by density value as Hounsfield Units (HU) using CT scans. According to the Lekholm and Zarb classification, the bone quality scored 1 to 4 on cross-sectional CT. The clinical hardness of recipient sites were assessed on drilling by the surgeon's tactile sense and recorded as D1-D4 based on Misch criteria. Linear regression analysis was used to evaluate the relationship between density values of implant sites.
The mean bone density was 536.94 ± 220.39 HU. There were 7.7% implants in bone type D1, 46.2% in D2, 32.7% in D3, and 13.5% in D4. Bone classification according to Lekholm and Zarb was significantly correlated to the surgeon's tactile sense (Spearman's rho = 0.36; P = 0.01) and with HU on CT images (Spearman's rho = -0.61; P < 0.001). The surgeon's tactile sense had a significant correlation with bone density in preoperative CT scans (Spearman's rho = -0.67; P < 0.001). A significant correlation was found between the bone density in HU with age (Spearman's rho = 0.34; P = 0.01).
A high-quality cross-sectional CT may suffice as a site-specific preoperative diagnostic predictor that can confirm and complement the tactile sense of the surgeon to help differentiate good, moderate, and poor bone density.
利用外科医生的触觉评估骨密度，并将其与Lekholm和Zarb分类以及计算机断层扫描（CT）进行比较，以确定是否存在相关性。
对22例患者植入52枚种植体。术前通过CT扫描以亨氏单位（HU）密度值测定受体部位的骨密度。根据Lekholm和Zarb分类，横断面CT上骨质量评分为1至4级。外科医生通过触觉评估受体部位在钻孔时的临床硬度，并根据Misch标准记录为D1 - D4级。采用线性回归分析评估种植部位密度值之间的关系。
平均骨密度为536.94±220.39 HU。骨类型为D1的种植体占7.7%，D2的占46.2%，D3的占32.7%，D4的占13.5%。根据Lekholm和Zarb进行的骨分类与外科医生的触觉显著相关（Spearman秩相关系数ρ = 0.36；P = 0.01），与CT图像上的HU也显著相关（Spearman秩相关系数ρ = -0.61；P < 0.001）。外科医生的触觉与术前CT扫描中的骨密度显著相关（Spearman秩相关系数ρ = -0.67；P < 0.001）。发现HU中的骨密度与年龄显著相关（Spearman秩相关系数ρ = 0.34；P = 0.01）。
高质量的横断面CT可能足以作为特定部位的术前诊断预测指标，能够确认并补充外科医生的触觉，以帮助区分良好、中等和较差的骨密度。
