Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, 309 Dentistry, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
Clin Oral Investig. 2018 Apr;22(3):1215-1222. doi: 10.1007/s00784-017-2203-2. Epub 2017 Sep 20.
Images derived from cone beam computed tomography (CBCT) scans lack detailed information on the dentition and interocclusal relationships needed for proper surgical planning and production of surgical splints. To get a proper representation of the dentition, integration of a digital dental model into the CBCT scan is necessary. The aim of this study was to validate a simplified protocol to integrate digital dental models into CBCT scans using only one scan.
Conventional protocol A used one combined upper and lower impression and two CBCT scans. The new protocol B included placement of ten markers on the gingiva, one CBCT scan, and two separate impressions of the upper and lower dentition. Twenty consecutive patients, scheduled for mandibular advancement surgery, were included. To validate protocol B, 3-dimensional reconstructions were made, which were compared by calculating the mean intersurface distances obtained with both protocols.
The mean distance for all patients for the upper jaw is 0.39 mm and for the lower jaw is 0.30 mm. For ten out of 20 patients, all distances were less than 1 mm. For the other ten patients, all distances were less than 2 mm.
Mean distances of 0.39 and 0.30 mm are clinically acceptable and comparable to other studies; therefore, this new protocol is clinically accurate.
This new protocol seems to be clinically accurate. It is less time consuming, gives less radiation exposure for the patient, and has a lower risk for positional errors of the impressions compared to other integration protocols.
来自锥形束 CT（CBCT）扫描的图像缺乏详细的牙列和咬合关系信息，这对于正确的手术规划和手术夹板的制作是必要的。为了获得牙列的适当表示，需要将数字牙科模型集成到 CBCT 扫描中。本研究的目的是验证一种使用单次扫描将数字牙科模型集成到 CBCT 扫描中的简化方案。
常规方案 A 使用一个上下颌联合印模和两个 CBCT 扫描。新方案 B 包括在上牙龈上放置十个标记，一个 CBCT 扫描，以及上下牙列的两个单独印模。连续纳入 20 名计划接受下颌前伸手术的患者。为了验证方案 B，制作了三维重建，并通过计算两种方案获得的平均表面距离来比较。
所有患者的上颌平均距离为 0.39mm，下颌为 0.30mm。20 名患者中有 10 名患者的所有距离均小于 1mm，另外 10 名患者的所有距离均小于 2mm。
平均距离为 0.39 和 0.30mm 在临床上是可接受的，与其他研究相当；因此，这种新方案在临床上是准确的。
这种新方案似乎在临床上是准确的。与其他整合方案相比，它的耗时更少，对患者的辐射暴露更少，并且印模的位置误差风险更低。
