Suvarna Suraj, Singh Ravishek K, Pachar Renu B, Kundra Sachin, Arya Sankalp, Mehta Lata K
Department of Prosthodontics, ITS Dental College, Greater Noida, Uttar Pradesh, India, Phone: +919312403324, e-mail:
Department of Prosthodontics, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh, India.
J Contemp Dent Pract. 2018 May 1;19(5):535-540.
Selection of suitable length of dental implants is very subjective and largely depends on clinical evidences and operator's expertise. The present study was aimed to assess the role of cone beam computed tomography (CBCT) and cephalograms as far as the selection of right implant length is concerned.
The study includes 220 patients for whom radiographic and follow-up records were obtained. There were 105 males and 115 females in the age range of 22 to 58 years. A total of 98 implant sites in different edentulous areas were studied. Length of implant was predicted at treatment planning and compared with finally placed implant at surgical stages. It also includes the in-depth exploration of (1) number of implants placed per patient, (2) implant per edentulous areas, (3) implant location, and (4) implant region. For prediction of implant lengths, CBCT results were obtained and compared with cephalometric findings. Accuracies of implant lengths as planned by CBCT and cephalometric images were also studied at treatment planning and surgical stages. Statistical analysis and results: Upon statistical comparisons, we found that larger implant lengths chosen at treatment planning stage did not change in 65.5% of patients. In addition, the smaller length implants were just about the same as that with larger dimensions. The CBCT results were satisfactory (up to 98.5%). Cephalometry was performed well in this prediction, especially in posterior mandible (87.9%). However, its performance in anterior maxillary region was not satisfactory (69.6%). Intergroup comparisons of CBCT and cephalometric results at different regions were significant (p < 0.001).
Our study results show insignificant changes in the length of implants that was exactly planned using CBCT scans. Therefore, accurate prediction of implant lengths can be done using CBCT scans as they have superior and advanced tools that facilitate presurgical decision-making. Lateral cephalometric evaluation has been shown as an imperative radiographic tool for determining implant lengths as it confirmed the significance bone resorption on the selection of implant length at different sites.
The CBCT and lateral cephalogram offer excellent anatomical details that can be judiciously applied for treatment planning and other clinical decision-making, including selection of correct implant length. Our study advocates thorough cephalometric evaluations of mandible wherein implants are to be placed for implant-supported overdentures.
合适长度牙种植体的选择非常主观，很大程度上取决于临床证据和术者的专业知识。本研究旨在评估锥形束计算机断层扫描（CBCT）和头影测量在选择合适种植体长度方面的作用。
该研究纳入了220例获取了影像学和随访记录的患者。年龄在22至58岁之间，其中男性105例，女性115例。共研究了不同无牙区的98个种植位点。在治疗计划阶段预测种植体长度，并与手术阶段最终植入的种植体进行比较。研究还深入探讨了（1）每位患者植入的种植体数量，（2）每个无牙区的种植体，（3）种植体位置，以及（4）种植区域。为预测种植体长度，获取了CBCT结果并与头影测量结果进行比较。还研究了在治疗计划阶段和手术阶段CBCT及头影测量图像所规划的种植体长度的准确性。统计分析与结果：经统计学比较，我们发现治疗计划阶段选择的较大种植体长度在65.5%的患者中未发生变化。此外，较小长度的种植体与较大尺寸的种植体情况大致相同。CBCT结果令人满意（高达98.5%）。头影测量在该预测中表现良好，尤其是在下颌后部（87.9%）。然而，其在上颌前部区域的表现并不令人满意（69.6%）。不同区域CBCT和头影测量结果的组间比较具有显著性（p < 0.001）。
我们的研究结果表明，使用CBCT扫描精确规划的种植体长度变化不显著。因此，使用CBCT扫描可以准确预测种植体长度，因为它们拥有先进的工具，有助于术前决策。头影测量评估已被证明是确定种植体长度必不可少的影像学工具，因为它证实了不同部位骨吸收对种植体长度选择的重要性。
CBCT和侧位头影测量提供了出色的解剖细节，可明智地应用于治疗计划和其他临床决策，包括选择正确的种植体长度。我们的研究提倡对下颌进行全面的头影测量评估，以便为种植体支持的覆盖义齿植入种植体。
