Pinto A, Raffone C
Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy.
Oral Implantol (Rome). 2017 Apr 10;10(1):71-77. doi: 10.11138/orl/2017.10.1.071. eCollection 2017 Jan-Mar.
The aim of the present study was to describe a postextraction, computer-guided protocol for implant-prosthetic rehabilitations in partially edentate patients with metal restorations.
A 60-year-old man with a loose FDP (fixed dental prosthesis) in the first quadrant was selected for a postextraction computer guided implantology according with the 2-piece radiographic template protocol. A two components radiographic template was produced, with the teeth setup portion based on the wax-up. CBCT (cone beam computed tomography) scans of the patient, wearing the base portion of the radiographic template and of the assembled radiographic template alone, were accomplished. The CBCT volume were imported in a dedicated software (NobelClinician, Nobel-Biocare, Kloten, Switzerland) and a surgical template was produced from the digital planning. The surgery was performed with a flap approach, as a bone regeneration procedure was carried out. A delayed loading protocol was chosen to allow a healing free of masticatory stress. A mobile partial denture was delivered to the patient to grant function and social life until the delivery of the definitive FDP.
The surgery was performed rapidly and free of obstacles. A good primary stability of the implants was achieved. The patient referred an acceptable postoperative pain and swelling.
The 2-piece radiographic template protocol was evaluated as smooth, complication-free and suitable for patients who want to maintain their teeth until the day of implant surgery. A good command of the computer-guided software as well as a comprehensive learning curve in computer-guided implantology is necessary to obtain predictable results.
本研究的目的是描述一种用于部分牙列缺损且有金属修复体患者的种植修复的拔牙后计算机引导方案。
选择一名60岁男性，其第一象限有一个松动的固定义齿（FDP），根据两片式放射影像模板方案进行拔牙后计算机引导种植术。制作了一个由两部分组成的放射影像模板，牙齿排列部分基于蜡型。让患者佩戴放射影像模板的基部以及单独佩戴组装好的放射影像模板时，完成了患者的锥形束计算机断层扫描（CBCT）。将CBCT容积导入专用软件（NobelClinician，诺贝尔生物保健公司，瑞士克洛滕），并通过数字规划制作手术模板。手术采用翻瓣法进行，同时进行了骨再生手术。选择延迟加载方案以实现无咀嚼应力的愈合。在最终的固定义齿交付之前，为患者提供了一副可摘局部义齿以维持功能和正常社交生活。
手术进行迅速且无阻碍。种植体获得了良好的初期稳定性。患者表示术后疼痛和肿胀程度可接受。
两片式放射影像模板方案被评估为操作顺畅、无并发症，适合那些希望在种植手术当天之前保留牙齿的患者。要获得可预测的结果，需要熟练掌握计算机引导软件以及在计算机引导种植学方面有全面的学习过程。
