Grandoch Andrea, Peterke Nico, Hokamp Nils Grosse, Zöller Joachim E, Lichenstein Thorsten, Neugebauer Jörg
Int J Oral Maxillofac Implants. 2021 Nov-Dec;36(6):1211-1218. doi: 10.11607/jomi.8103.
Cone beam computed tomography (CBCT) is considered both reliable and safe and provides reproducible results in guided dental implant planning procedures. However, it has weaknesses in soft tissue contrast and is associated with radiation exposure. Recent studies showed promising results with magnetic resonance imaging (MRI) as a possible noninvasive, radiation-free, alternative imaging modality for dental indications. The purpose of this study was to evaluate the quality of 1.5 T MRI with a dedicated dental signal-amplification coil in comparison to CBCT for dental implant planning procedures.
Sixteen subjects undergoing preoperative MRI (3D HR T1w TSE and 3D HR T1w FFE) and CBCT were included in this prospective study. All imaging data were used for dental implant planning procedures using commercially available software. Two experts scored the planning as "ideal," "improvable," or "unacceptable." Furthermore, quantitative distances according to EuCC recommendations were collected. Finally, discrepancies between CBCT and 3D HR T1w TSE were analyzed. Statistical analysis was performed using the Mann-Whitney U test and analysis of variance (ANOVA).
The dental implant planning procedure was technically feasibly using all imaging data. CBCT allowed for "ideal" placement in all cases. Ratings for 3D HR T1w TSE and 3D HR T1w FFE were 81.9%, 18.1%, and 0% and 54.2%, 30.0%, and 15.3% for ideal, improvable, and unacceptable, respectively, identifying 3D HR T1w TSE as superior compared with 3D HR T1w FFE. Head-to-head comparison between CBCT and 3D HR T1w TSE revealed no significant differences regarding the apical position of the implant of 1.2 ± 0.7 mm and 1.3 ± 0.5 mm coronally, respectively (P = .287). The deviation of the planed angle was 3.0 ± 1.2 degrees. In these merged data sets, the distance to the mandibular canal was significantly higher with 1.3 ± 0.8 mm, indicating better utilization of the existing bone.
Within the limits of this pilot study, it can be reported that the dental image planning procedure is feasible using 1.5 T MRI with a dedicated dental coil and specific MRI sequences.
锥形束计算机断层扫描（CBCT）被认为既可靠又安全，并且在引导式牙种植体规划程序中能提供可重复的结果。然而，它在软组织对比度方面存在弱点，并且与辐射暴露相关。最近的研究表明，磁共振成像（MRI）作为一种可能的非侵入性、无辐射的替代成像方式用于牙科适应症，显示出了有前景的结果。本研究的目的是评估与CBCT相比，使用专用牙科信号放大线圈的1.5 T MRI在牙种植体规划程序中的图像质量。
本前瞻性研究纳入了16名接受术前MRI（3D HR T1w TSE和3D HR T1w FFE）和CBCT检查的受试者。所有成像数据均使用商用软件用于牙种植体规划程序。两名专家将规划评为“理想”、“可改进”或“不可接受”。此外，根据EuCC建议收集定量距离。最后，分析CBCT与3D HR T1w TSE之间的差异。使用曼-惠特尼U检验和方差分析（ANOVA）进行统计分析。
使用所有成像数据，牙种植体规划程序在技术上是可行的。CBCT在所有病例中都能实现“理想”植入。3D HR T1w TSE和3D HR T1w FFE的“理想”、“可改进”和“不可接受”评级分别为81.9%、18.1%和0%以及54.2%、30.0%和15.3%，表明3D HR T1w TSE优于3D HR T1w FFE。CBCT与3D HR T1w TSE的直接比较显示，种植体根尖位置在冠方分别为1.2±0.7 mm和1.3±0.5 mm，无显著差异（P = 0.287）。规划角度的偏差为3.0±1.2度。在这些合并的数据集中，到下颌管的距离明显更高，为1.3±0.8 mm，表明对现有骨的利用更好。
在本初步研究的范围内，可以报告使用带有专用牙科线圈和特定MRI序列的1.5 T MRI进行牙种植体图像规划程序是可行的。
