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基于磁共振成像的计算机引导口腔种植手术-临床初步研究。

Magnetic resonance imaging based computer-guided dental implant surgery-A clinical pilot study.

机构信息

Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, Munich, Germany.

Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany.

出版信息

Clin Implant Dent Relat Res. 2020 Oct;22(5):612-621. doi: 10.1111/cid.12939. Epub 2020 Sep 9.

Abstract

BACKGROUND

Computer-guided implant surgery is currently based on radiographic techniques exposing patients to ionizing radiation.

PURPOSE

To assess, whether computer-assisted 3D implant planning with template-guided placement of dental implants based on magnetic resonance imaging (MRI) is feasible.

MATERIALS AND METHODS

3-Tesla MRI was performed in 12 subjects as a basis for prosthetically driven virtual planning and subsequent guided implant surgery. To evaluate the transferability of the virtually planned implant position, deviations between virtually planned and resulting implant position were studied. Matching of occlusal surfaces was assessed by comparing surface scans with MRI-derived images. In addition, the overall image quality and the ability of depicting anatomically important structures were rated.

RESULTS

MRI-based guided implant surgery with subsequent prosthetic treatment was successfully performed in nine patients. Mean deviations between virtually planned and resulting implant position (error at entry point 0.8 ± 0.3 mm, error at apex 1.2 ± 0.6 mm, angular deviation 4.9 ± 3.6°), mean deviation of occlusal surfaces between surface scans and MRI-based tooth reconstructions (mean 0.254 ± 0.026 mm) as well as visualization of important anatomical structures were acceptable for clinical application.

CONCLUSION

Magnetic resonance imaging (MRI) based computer-assisted implant surgery is a feasible and accurate procedure that avoids exposure to ionizing radiation.

摘要

背景

计算机引导的种植手术目前基于放射技术,使患者暴露在电离辐射下。

目的

评估基于磁共振成像(MRI)的计算机辅助 3D 种植规划和模板引导种植体放置是否可行。

材料与方法

对 12 名受试者进行 3T MRI,作为基于修复体驱动的虚拟规划和随后的引导种植手术的基础。为了评估虚拟规划种植体位置的可转移性,研究了虚拟规划和实际种植体位置之间的偏差。通过比较表面扫描和 MRI 衍生图像来评估咬合面的匹配情况。此外,还对整体图像质量和描绘解剖学重要结构的能力进行了评估。

结果

在 9 名患者中成功地进行了基于 MRI 的引导种植手术,随后进行了修复治疗。虚拟规划和实际种植体位置之间的平均偏差(在进入点的偏差为 0.8 ± 0.3mm,在根尖的偏差为 1.2 ± 0.6mm,角度偏差为 4.9 ± 3.6°),表面扫描和基于 MRI 的牙齿重建之间的咬合面平均偏差(平均为 0.254 ± 0.026mm),以及重要解剖结构的可视化,对于临床应用是可接受的。

结论

基于磁共振成像(MRI)的计算机辅助种植手术是一种可行且准确的方法,可以避免电离辐射的暴露。

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