Department of Prosthodontics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Department of Prosthodontics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
J Dent. 2021 Sep;112:103744. doi: 10.1016/j.jdent.2021.103744. Epub 2021 Jul 9.
To investigate the predictability and image quality of low-dose cone-beam computed tomography (LD-CBCT) in computer-guided implantology.
Pig cadaver mandibles were imaged using high-definition CBCT (HD-CBCT) and LD-CBCT (HD-CBCT: 85 kV, 6 mA, 14.2 s, 767 frames, 1184 mGycm, voxel size 80 µm, effective dose 231 µSv; LD-CBCT: 85 kV, 10 mA, 2.1 s, 384 frames, 84 mGycm, voxel size 160 µm, effective dose 16 µSv; Orthophos SL, Dentsply Sirona, Bensheim, Germany). Digital impressions were taken using intraoral scanning (IOS; Omnicam, Dentsply Sirona). Data of CBCT modalities and IOS were aligned. Forty-eight implants were planned virtually (24 implants per modality; Bone Level 4.1 × 10 mm; Straumann AG, Basel, Switzerland). Implants were inserted using templates by initial pilot drilling ("partially-guided implantation"). Implant positions were recorded using IOS. Geometric deviations between planned and definitive positions were assessed regarding implant apex, entry-point and angle. CBCT image quality was evaluated by raters twice on a four point scale. The results were exploratively compared (linear models, Mann-Whitney-U tests).
Regarding implant apex, deviations were greater for LD-CBCT (mean 3.0±1.2 mm), as compared to HD-CBCT (mean 2.3±1.1 mm). For entry-point, no distinct difference was detected with a mean deviation of 1.4±0.9 mm in LD-CBCT, and 1.7±0.6 mm in HD-CBCT. Regarding angle, deviations were greater for LD-CBCT (mean 13.2±6.3°), as compared to HD-CBCT (mean 9.2±5.3°). The image quality of HD-CBCT provided to be better (mean 2.7±0.6) than that of LD-CBCT (mean 2.5±0.6).
Within the partially-guided approach, the results underline the potential of LD-CBCT alternatively to HD-CBCT for computer-guided implantology. Advantages of HD-CBCT need to be balanced against the higher radiation dose.
探讨低剂量锥形束 CT（LD-CBCT）在计算机引导种植中的预测能力和图像质量。
采用高分辨率 CBCT（HD-CBCT）和 LD-CBCT（HD-CBCT：85 kV，6 mA，14.2 s，767 帧，1184 mGycm，体素大小 80 µm，有效剂量 231 µSv；LD-CBCT：85 kV，10 mA，2.1 s，384 帧，84 mGycm，体素大小 160 µm，有效剂量 16 µSv；Orthophos SL，Dentsply Sirona，德国本斯海姆）对猪下颌骨进行成像。使用口腔内扫描（IOS；Dentsply Sirona 的 Omnicam）获取数字印模。对齐 CBCT 模式和 IOS 的数据。虚拟规划 48 个种植体（每种模式 24 个种植体；Bone Level 4.1×10 mm；Straumann AG，瑞士巴塞尔）。使用初始导向钻孔的模板（“部分引导植入”）插入种植体。使用 IOS 记录种植体位置。评估计划和最终位置之间的几何偏差，包括种植体根尖、入口点和角度。由评分者对 CBCT 图像质量进行两次评估（四分制）。结果采用线性模型和曼-惠特尼 U 检验进行探索性比较。
在根尖方面，LD-CBCT 的偏差较大（平均 3.0±1.2mm），而 HD-CBCT 的偏差较小（平均 2.3±1.1mm）。对于入口点，两种方法的偏差没有明显差异，LD-CBCT 的平均偏差为 1.4±0.9mm，HD-CBCT 的平均偏差为 1.7±0.6mm。在角度方面，LD-CBCT 的偏差较大（平均 13.2±6.3°），而 HD-CBCT 的偏差较小（平均 9.2±5.3°）。HD-CBCT 的图像质量（平均 2.7±0.6）优于 LD-CBCT（平均 2.5±0.6）。
在部分引导方法中，结果强调了 LD-CBCT 在计算机引导种植中的潜在替代作用。需要权衡 HD-CBCT 的优势和更高的辐射剂量。
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