Evans Zachary P, Renne Walter G, Bacro Thierry R, Mennito Anthony S, Ludlow Mark E, Lecholop Michael K
1 Department of Periodontics, Division of Stomatology, College of Dental Medicine, Medical University of South Carolina, Charleston, SC.
2 Department of Oral Rehabilitation, College of Dental Medicine, Medical University of South Carolina, Charleston, SC.
J Oral Implantol. 2018 Feb;44(1):15-26. doi: 10.1563/aaid-joi-D-17-00090. Epub 2017 Oct 24.
Existing root-analog dental implant systems have no standardized protocols regarding retentive design, surface manipulation, or prosthetic attachment design relative to the site's unique anatomy. Historically, existing systems made those design choices arbitrarily. For this report, strategies were developed that deliberately reference the adjacent anatomy, implant and restorable path of draw, and bone density for implant and retentive design. For proof of concept, dentate arches from human cadavers were scanned using cone-beam computed tomography and then digitally modeled. Teeth of interest were virtually extracted and manipulated via computer-aided design to generate root-analog implants from zirconium. We created a stepwise protocol for analyzing and developing the implant sites, implant design and retention, and prosthetic emergence and connection all from the pre-op cone-beam data. Root-analog implants were placed at the time of extraction and examined radiographically and mechanically concerning ideal fit and stability. This study provides proof of concept that retentive root-analog implants can be produced from cone-beam data while improving fit, retention, safety, esthetics, and restorability when compared to the existing protocols. These advancements may provide the critical steps necessary for clinical relevance and success of immediately placed root-analog implants. Additional studies are necessary to validate the model prior to clinical trial.
现有的牙根模拟牙种植系统在固位设计、表面处理或相对于种植部位独特解剖结构的修复体附着设计方面没有标准化方案。从历史上看，现有系统在这些设计选择上具有随意性。在本报告中，我们制定了一些策略，这些策略特意参考相邻解剖结构、种植体和修复体的就位路径以及用于种植体和固位设计的骨密度。为了进行概念验证，使用锥形束计算机断层扫描对人类尸体的有牙牙弓进行扫描，然后进行数字建模。通过计算机辅助设计对感兴趣的牙齿进行虚拟拔除和处理，以用锆制成牙根模拟种植体。我们创建了一个逐步方案，用于从术前锥形束数据出发，分析和开发种植部位、种植体设计与固位以及修复体的穿出和连接。在拔牙时植入牙根模拟种植体，并就理想的贴合度和稳定性进行影像学和力学检查。本研究提供了概念验证，即与现有方案相比，牙根模拟种植体可根据锥形束数据制作，同时提高贴合度、固位力、安全性、美观性和可修复性。这些进展可能为即刻植入牙根模拟种植体的临床相关性和成功提供必要的关键步骤。在进行临床试验之前，需要进行更多研究以验证该模型。
